Ron, Ilene, and Mary Alice and the rest of you I love reading this listserv and enjoy your comments...though somedays reading it makes me want to quit my OT career and join the Circus or start that pumpkin carving business...(maybe not...too seasonal for steady cash flow!;))
<><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><> MARY ALICE: I wanted to respond to you because you have such good comments and DON"T STOP contributing...I agree with you that patients come to rehab and have a lot of preconcieved notions about what efforts/methods will create what results, they think "I just need strengthening" or " I just need to walk".. they don't make the connections about the rehab process that we know so well. So much of the challenge is to educated people on the process of OT, addressing the goals. This requires very good communication skills on the part of the OT. Pt's with chronic illnesses or even subacute health issues are reluctant to attempt the process of adapting to their condition because of denial of the loss function. They really are in phase of wanting to FIX IT NOW back to normal. As we know this is not always possible or realistic. OTs are superior to most other professions at teaching adaptation to "Enable Occupation". In some cases we fix things in an innovative and effective way.The disadvantage is in the OT concepts where ,of course ,we know that occupation is that complex multifactorial phenomena that is the essence of performing daily life and is so much a part of our lives, and so individually subjective. Peeple don't think about it in the same terms we describe it in but they often get the connection when we do our jobs well. It is a tough job but rewarding. <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><>< RON: I related so well to your well written response to Ilene (Message 4,2/21/09), I have a similar history to you and worked in the SNFs in the late 1990's, but woe is me... I still do today. As you stated the business model doesn't foster the best that OT can be as a profession. It is very inflexible and stifles innovation, creativity, and quality in favor of effeciency, profit, and bureaucratic compliance to Medicare rules and regs which set the system up to be as lame as it is. Some how I have found a way continue in this practice setting for almost 15 years and have sought out the most high quality employers and facilities with a bit of luck had good results. But I too am growing VERY WEARY of all the issues you so effectively stated. I even spent one week as a Rehab Manager and quit..it made me physically ill, tried o/p hand therapy for 6months and was quite unsatisfied. I have thought of leaving the SNF setting, but every now and then I get a patient or case or two that goes so well and is so satisfying that it draws me back in...it's like trying to leave the Mafia :), Ron do you think home health is the best OT practice setting? <>><><><><><><>><><><><><><><><><><><><><><><><><><>><><><><><><>< ILENE: I could totally relate to you comments about SNF and goal setting and treatment ideas. Isn't this such a challenging population. SPEAKING OF THEORIES:My theory is that people who know the value of occupation to health status "practice what they preach" in that they engage in meaningful occupations and enjoy a high quality of life and health status, and when they do get sick or have issues they are quick to self -treat with the motivation, and goal-oriented mind set to get back to living and and the flexibility to adapt to their condition. And they use their OT as a resource to achieve goals. I see a few of these kinds of patients in SNFS, BUT, the greater majority of the SNF patient's I see have an ongoing Occupation deficit which correlates with their poor health status and issues and lack of ability to adapt. We are often faced with the toughest cases, with people who's prior level of occupation is so dysfunctional/deficient or co-dependent on a caregiving relationship that they just don't have a OT-like outlook. Many clients "outsource" their occupation by expecting spouses, neighbors, hired caregivers, meals on wheels, etc..to provided ADL.So I think we are often faced with the most challenging and ill fitting clients for OT at the SNF setting, Hello company...it's misery calling. <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><>< So should I begin selling snow cones at the north pole, or take my sock puppet show on a national tour as a new career? What Say you RON? (LOL) Brent -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
