I believe the first set of goals (occupational based) are the best way to go. This is how I write my goals, as it does leave room for the therapist to address several areas of impairment/need. It is typically the case that more than one factor is limiting the patient from being independent with their i.e. toileting, dressing, etc.
~ Miranda ~ > To: OTlist@OTnow.com > Date: Mon, 16 Feb 2009 10:28:10 -0500 > From: cmnahrw...@aol.com > Subject: Re: [OTlist] Occupation as THE goal: Does it matter > > Ron, > Great outline.? Can you next explain how the treatment will differ? > > Chris > > > -----Original Message----- > From: Ron Carson <rdcar...@otnow.com> > To: OTlist@OTnow.com > Sent: Mon, 16 Feb 2009 7:52 am > Subject: [OTlist] Occupation as THE goal: Does it matter > > > > Hello All: > > What follows are thoughts and opinion about using occupation as *THE* > goal for OT treatment. > > Here's is the premise for my arguments: > > (1) When occupation is *THE* goal, outcome statements may be written in > concise occupation-based outcomes. For example: > > Patient will safely and independently ambulate to/from toilet > with RW and perform all hygiene without assistive equipment. > > Patient will transfer from w/c to bed using slide board > transfers > > Patient will dress self using adaptive equipment as necessary > > (2) Conversely, when occupation is not *THE* goal, outcomes may be > written so that occupation is a desired outcome but is based on > improving underlying impairment(s). For example: > > Patient will increase UE elbow ROM to 115 degree active flexion > to all for donning/doffing of shirt > > Patient will increase standing endurance/balance to allow them > to safely and independently carry out toileting hygiene. > > -------------------------------------------------------------------- > > Some argue there is little difference in the above approaches. However, > I believe these approaches frame patient problems very differently. This > is important because how we frame a problem drives our treatment. > > The first example clearly identifies that occupation is the goal. There > is no expressed concern for underlying factors impairing occupation. > However, and this if often overlooked, it is IMPLIED that all factors > impairing the goal will be treated within the therapist's abilities. > This is true because occupation includes the following factors: > > Physical, emotional, mental environmental, behavioral, social > > Thus, as OT's and within our scope of practice, occupation-based > outcomes address all factors impairing the desire occupations. > > While the second example does include occupation as an outcome, only > factors addressed in the goals are included for treatment. This severely > limits treatment and > in my opinion indicates that remediation of > underlying impairments is the real goal. The implication is that if > underlying impairments are remediated, occupation will improve. However, > is inconsistent with OT theory because occupation is ALWAYS more than > physical. In my opinion, the second example is much more like a PT > rather than an OT goal! > > In closing, writing occupation-based goals is important for us and for > the patient. These goals allow us to focus on occupation's many elements > and complexity to best enable our patients. > > Thanks, > > 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 _________________________________________________________________ See how Windows Mobile brings your life together—at home, work, or on the go. http://clk.atdmt.com/MRT/go/msnnkwxp1020093182mrt/direct/01/ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
