Barb, I want to offer a suggestion. In my early days as an OT, I worked in adult rehab. It was VERY faced paced and therapists generally had 2 - 3 patient's hour. In the beginning, I was stuck in the peg, cone, etc routine, but one day I read a book that changed my practice.
I changed my practice pattern from UE/ADL to occupation-based treatment. In this approach, a patients occupational needs/desires become the ONLY reason for treatment. In the absence of occupational problems that are improvable, there is no role for OT. This approach 100% clarified my treatment for both myself and patients. I no longer wondered what to do with patients. Suddenly, I began stepping away from typical OT activity and began addressing patient's most important needs. My treatment boundaries greatly expanded and I began feeling much better about my treatments. No longer did I do "contrived" OT treatment, instead I addressed the the ACTUAL needs of the patients. Since you asked for concrete ideas here they are: 1. Identify client's needs/desires 2. Identify why the can't do these things 3. Direct 100% of your treatment to: a. Remediating underlying issues b. Compensating for uncorrectable problems c. Changing environments Forget made up activities, forget games and other silly things. YOU CAN DO THIS! Ron -- Ron Carson MHS, OT www.OTnow.com ----- Original Message ----- From: bbh1...@comcast.net <bbh1...@comcast.net> Sent: Friday, February 13, 2009 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] The Saddest OT Statement I've Ever Heard bcn> Thanks, Sue, for providing some specifics. I understand the need bcn> for functional tx that is specific to the patient! I just need bcn> some more specific, concrete ideas about how others do this in the bcn> clinic environment. With productivity demands it is even difficult bcn> for me to spend time in a patient's room alone with them. I seem bcn> to be the ONLY OT in my department who takes the time to do ADLs with some of my patients. bcn> So I am looking for more concrete ideas and less philosophical bcn> ranting. I do get that part. I know venting is necessary bcn> sometimes, but I joined this list to get more specific ideas to bcn> help with my tx planning and so that is why I asked the question. bcn> Thanks, bcn> Barb Howard COTA bcn> ----- Original Message ----- bcn> From: "Sue Doyle" <sue...@hotmail.com> bcn> To: otlist@otnow.com bcn> Sent: Friday, February 13, 2009 7:46:09 AM GMT -05:00 US/Canada Eastern bcn> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard bcn> I am the lead therapist in an inpatient rehab center. We focus on the bcn> clients goals and predominantly use functional tasks. Even spent the bcn> afternoon knitting and compiling emails with a patient. I have a bcn> carburetor that I have had out several times for some of the men to bcn> work on as their goal has been to go back to working on their car. bcn> Sue D >> From: spark...@rcn.com >> To: OTlist@OTnow.com >> Date: Thu, 12 Feb 2009 19:46:44 -0500 >> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard >> >> I do not have alot of experience yet ...I am still a student, but I have >> been in places that simply sit patients up at tables and gave them something >> to do that may or may not be functional for them specifically. For example, >> a patient may get something out of cognitively out of sorting colored pegs >> on a peg board but is has no meaning to their life. Our challenge as >> professionals is to dig deeper and find something that we can do to reach >> the same goal but make it applicable to the patients life. However, I >> understand this has been all but impossible in many rehabs because of >> productivity demands. I happen to be in a rehab setting that is more >> flexible because the we smaller and it is acute rehab vs. SNF. I cannot >> judge how other places are run, in fact, I do feel I am in a unique facility >> and although I may never be employed there, I will take this experience with >> me wherever I go. ADL's are the first priority and ususaly what the patients >> say are goals for themselves but we can make meals, simulate homemaking >> activites, and the list goes on..the point is that is has some functional >> application to the patient...so it is always different and changing. >> >> -----Original Message----- >> From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on >> Behalf Of bbh1...@comcast.net >> Sent: Thursday, February 12, 2009 19:06 >> To: OTlist@OTnow.com >> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard >> >> >> >> >> How about sharing some specifics - some typical tx sessions. >> >> When you say adult rehab, do you mean outpatient,..home health...? >> >> >> >> This is becoming a mantra - Productivity requirements impose cookie cutter >> approaches. >> >> Therapists are caught in the middle and many give up swimming upstream. I >> haven't given up, but >> >> I know I have to go elsewhere to accomplish this. I'd like to run my own >> department someday, but >> >> I want to learn as much as I can specifically about functional treatment, >> that is, in addition to doing ADLs >> >> with patients. >> >> Any info would be appreciated. >> >> Barb Howard, COTA >> >> >> >> >> ----- Original Message ----- >> From: "Diane Randall" <spark...@rcn.com> >> To: OTlist@OTnow.com >> Sent: Thursday, February 12, 2009 6:31:35 PM GMT -05:00 US/Canada Eastern >> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard >> >> Wow..I am interning in adult rehab right now and UE therex is only used for >> people who really need it. Been there six weeks and everything revolves >> around function. >> >> -----Original Message----- >> From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on >> Behalf Of Ron Carson >> Sent: Wednesday, February 11, 2009 18:40 >> To: OTlist@OTnow.com >> Subject: [OTlist] The Saddest OT Statement I've Ever Heard >> >> >> Today, I met a new PT assistant who was just starting with our home >> health company. He was just finishing with a patient as I was starting >> my evaluation. The PTA came from 20 years of geriatric rehab and rehab >> experiences. >> >> About 1/2 through my eval he said to me, and I quote: "I'm not use to >> OT's working on functional things". He went on to say that at his rehab >> facility, the OT's mainly did UE exercises. >> >> "Living life to the fullest". What a crock! >> >> Ron >> >> -- >> Ron Carson MHS, OT >> www.OTnow.com >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com