I most certainly address the LE. Usually it is through practice of
occupations, but occasionally I will work on specific leg movements and
standing balance in order to eventually achieve an occupational goal.
I only mentioned flaccid arm, because that is what the prior OTs worked
on with the patient you mentioned.
Chris
-----Original Message-----
From: Ron Carson <rdcar...@otnow.com>
To: cmnahrw...@aol.com <OTlist@OTnow.com>
Sent: Sat, Jul 4, 2009 9:45 pm
Subject: Re: [OTlist] A Vision For Patients?
Thanks Chris. I concept of getting better is difficult to define and
envision. But, I understand what you are saying. And yes, it is possible
he's given up.
Now, this is a "loaded" question. You mention only a flaccid arm is that
because you don't address the LE?
----- Original Message -----
From: cmnahrw...@aol.com <cmnahrw...@aol.com>
Sent: Saturday, July 04, 2009
To: OTlist@OTnow.com <OTlist@OTnow.com>
Subj: [OTlist] A Vision For Patients?
cac> Sounds like the man has given up on life. Perhaps he has no goals
cac> because he has no expectations of getting "better". Perhaps you
can
cac> show him the way on a few self generated goals, and then watch out
the
cac> flood gate of goals may come open. Sad that the prior OTs only
focused
cac> on UE ROM. Sounds like a waste of time. I usually use this
concept to
cac> continue neuromotor training: If a patient has no movement in the
cac> flaccid arm (absolutely no movement) in a reasonable amount of
time,
cac> then I train the patient and family on keeping the arm
comfortable. I
cac> then move on to more reasonable and achievable goals.
cac> Chris Nahrwold MS, OTR
cac> -----Original Message-----
cac> From: Ron Carson <rdcar...@otnow.com>
cac> To: OTlist@OTnow.com
cac> Sent: Sat, Jul 4, 2009 2:16 pm
cac> Subject: [OTlist] A Vision For Patients?
cac> Do you ever sit back and envision a new life for your patients?
Do you
cac> imagine how patients' lives can be after therapy is done? While
fishing
cac> today, a patient I just evaluated crossed my mind and I wondered
how I
cac> could improve the quality of his life. How I could make a life
for this
cac> person. I developed a "vision" of how this many might live his
life.
cac> BUT, this is my vision, not his. In the two meetings I've had
with the
cac> patient, he's not verbalized any goals or passions.
cac> This middle aged man experienced a stroke about 12 years
earlier. It
cac> left him severely impaired. He is essentially dependent
for all
cac> self-care. He is unable to unable to do almost anything for
himself. The
cac> man has received countless hours of therapy since his stroke.
Based on
cac> reports from caregivers, past OT's have focused on ROM for the
patient's
cac> UE.
cac> At my last appointment, I asked the patient "what are your
goals?",
cac> "what do you want to do with your life?" The caregiver, who
has been
cac> with the patient 5x/week for 1 year, stated that no therapist
had ever
cac> asked the patient what HIS goals were. If true, that's a
pretty sad
cac> statement about the OT's who came before me. But that's another
message.
cac> I am seeing this man 5x/week and I want to get inside his brain
and help
cac> him figure out how he wants the rest of his life to play out.
I'm sure
cac> he wishes that this "nightmare" would just end, but the sad
reality is
cac> that he will probably spend the rest of his life in a wheelchair.
I told
cac> him that there was nothing "I" could do to make a
substantial
cac> improvement in his physical condition. I told him that my
job is
cac> teaching people how to take care of themselves and be productive.
At the
cac> moment, self care is out of question, but productivity has
lots of
cac> possibility.
cac> But, I want to get this thing right. I want to ensure that I am
on the
cac> same page as the patient. What if the patient has no goals? What
if he
cac> just doesn't care and has given up? What if he has no vision
for his
cac> life? Can one person give another person a vision? Can I "show"
this man
cac> that his life may never be the way it was, but that it can be
better
cac> than right now? Help me find a vision for this man!!
cac> Thanks,
cac> Ron
cac> ~~~
cac> Ron Carson MHS, OT
cac> www.OTnow.com
cac> --
cac> Options?
cac> www.otnow.com/mailman/options/otlist_otnow.com
cac> Archive?
cac> www.mail-archive.com/otlist@otnow.com
cac> --
cac> Options?
cac> www.otnow.com/mailman/options/otlist_otnow.com
cac> Archive?
cac> 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
