Ron There are no easy answers here. Try to imagine as a place to start. What would your goals be with a frightened 18 month old child if you were the same size as that child? The difference for this patient is all the possible remaining traces of experiences over a long life and she cannot give you that information.
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 14, 2008 4:52 AM To: Joan Riches Subject: Re: [OTlist] Help with Treatment Plan??? I am hoping to get some help with treatment planning. In other words, what type of goals should/could be formulated with this patient. 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> What kind of help do you want? The answers to those questions are the JR> sort of thing that makes a difference to what may work. I gave you an JR> analogous age 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 13, 2008 6:06 PM JR> To: Joan Riches JR> Subject: Re: [OTlist] Help with Treatment Plan??? JR> Thanks Joan. Interesting reference and something worth considering for JR> my NEXT patient. Unfortunately, I need "help" NOW!! <smile> JR> Ron JR> -- JR> Ron Carson MHS, OT JR> ----- Original Message ----- JR> From: Joan Riches <jric...@telusplanet.net> JR> Sent: Saturday, December 13, 2008 JR> To: OTlist@OTnow.com <OTlist@OTnow.com> JR> Subj: [OTlist] Help with Treatment Plan??? JR>> Hi Ron JR>> The thing is you can make a big difference for this lady and for the JR>> staff who work with her. The ACLS screening tool does not go as low JR> as JR>> she seems to be and all these questions help to identify her level JR> in JR>> order to create an effective plan for staff. One final one is Does JR> she JR>> pick up and manipulate objects other than for eating? JR>> The reference that I have found most useful in all cases of JR> problematic JR>> behaviour is JR>> A Cognitive Link: Managing Problematic Bodily Behavior by Delaune JR>> Pollard JR>> Available from Selectone Rehab www.selectonerehab.com and from S&S. JR> I JR>> wrote the foreword for this so I am understandably biased but for JR>> practical understandable help I don't think it can be beaten. 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 13, 2008 5:20 PM JR>> To: Joan Riches JR>> Subject: Re: [OTlist] Help with Treatment Plan??? JR>> Wow Joan, that's a lot of questions. <smile> Truth be known, I JR> only JR>> spent about 45 minutes with this patient and she was new at the JR> ALF. JR>> There just isn't much information to go on which is a big part of JR> my JR>> problem. Maybe I need to go back before I generate a JR> treatment JR>> plan??? JR>> CGA- Min A is: contact guard assist and minimum assist. JR>> Ron JR>> -- JR>> Ron Carson MHS, OT JR>> ----- Original Message ----- JR>> From: Joan Riches <jric...@telusplanet.net> JR>> Sent: Saturday, December 13, 2008 JR>> To: OTlist@OTnow.com <OTlist@OTnow.com> JR>> 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 JR>> can. JR>>> What does independent in eating mean - does she use cutlery? What JR>> type JR>>> of diet is she on? Is all her food in bite size pieces that do not JR>> 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 JR>> 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 JR>> 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 JR>> punch, JR>>> kick, bite, spit etc. Is there a consistent pattern? JR>>> Might the attitude and caution with which she is approached be JR>> 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 JR>> charted? JR>>> I suspect she is somewhere in Allen cognitive level 2 with JR> cognitive JR>>> ability analogous to 9 - 23 months, probably nearer to the top of JR>> 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 JR>> ALF. JR>>> The patient spoke primarily in Spanish but also in some English. JR>> She JR>>> was very non-cooperative and was physically combative with ALF JR>> staff JR>>> and myself. JR>>> The staff says she is dependent for all ADL's except eating and JR>> that JR>>> she ambulates with CGA - Min A. JR>>> What can I do with this patient? JR>>> Ron JR>> -- JR>> Options? JR>> www.otnow.com/mailman/options/otlist_otnow.com JR>> Archive? 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Checked by AVG - http://www.avg.com Version: 8.0.176 / Virus Database: 270.9.17/1846 - Release Date: 12/13/2008 4:56 PM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
