Hi Ron The thing is you can make a big difference for this lady and for the staff who work with her. The ACLS screening tool does not go as low as she seems to be and all these questions help to identify her level in order to create an effective plan for staff. One final one is Does she pick up and manipulate objects other than for eating? The reference that I have found most useful in all cases of problematic behaviour is A Cognitive Link: Managing Problematic Bodily Behavior by Delaune Pollard Available from Selectone Rehab www.selectonerehab.com and from S&S. I wrote the foreword for this so I am understandably biased but for practical understandable help I don't think it can be beaten.
Joan Riches B.Sc.O.T., OT(C) Specialist in Cognitive Disability Riches Consulting High River, Alberta, Canada 403 652 7928 -----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: December 13, 2008 5:20 PM To: Joan Riches Subject: Re: [OTlist] Help with Treatment Plan??? Wow Joan, that's a lot of questions. <smile> Truth be known, I only spent about 45 minutes with this patient and she was new at the ALF. There just isn't much information to go on which is a big part of my problem. Maybe I need to go back before I generate a treatment plan??? CGA- Min A is: contact guard assist and minimum assist. Ron -- Ron Carson MHS, OT ----- Original Message ----- From: Joan Riches <jric...@telusplanet.net> Sent: Saturday, December 13, 2008 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] Help with Treatment Plan??? JR> Ron JR> This can be a tough one. JR> What is CGA - Min A? JR> To start with you can assess her gathering all the information you can. JR> What does independent in eating mean - does she use cutlery? What type JR> of diet is she on? Is all her food in bite size pieces that do not need JR> to be cut? Does she eat her food without needing to be cued? JR> Is her speech in Spanish any more complex than her speech in English? JR> Does she grab people and things and 'refuse' to let go? JR> Has she been 'taken down' due to combative behaviour? JR> If not, how is she being managed? JR> Are there any staff members with whom she is not combative? JR> At what points in the day or during what activities is she combative? JR> Are there complaints that she has voided urine in inappropriate JR> containers? JR> Is she being restrained? JR> What are the characteristics of her combative behaviour? Does she punch, JR> kick, bite, spit etc. Is there a consistent pattern? JR> Might the attitude and caution with which she is approached be perceived JR> by her as threatening? JR> Under what circumstances is she settled and content? JR> Is her behaviour both negative and positive being tracked and charted? JR> I suspect she is somewhere in Allen cognitive level 2 with cognitive JR> ability analogous to 9 - 23 months, probably nearer to the top of that JR> range. JR> Joan Riches B.Sc.O.T., OT(C) JR> Specialist in Cognitive Disability JR> Riches Consulting JR> High River, Alberta, Canada JR> 403 652 7928 JR> JR> -----Original Message----- JR> From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JR> Behalf Of Ron Carson JR> Sent: December 12, 2008 6:06 PM JR> To: OTlist@OTnow.com JR> Subject: [OTlist] Help with Treatment Plan??? JR> Evaled a new patient who was just transferred to an Alzheimer's ALF. JR> The patient spoke primarily in Spanish but also in some English. She JR> was very non-cooperative and was physically combative with ALF staff JR> and myself. JR> The staff says she is dependent for all ADL's except eating and that JR> she ambulates with CGA - Min A. JR> What can I do with this patient? JR> Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com No virus found in this incoming message. Checked by AVG - http://www.avg.com Version: 8.0.176 / Virus Database: 270.9.17/1846 - Release Date: 12/12/2008 6:59 PM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
