Hi All; We have "Patient Goals" on all our assessment documentation. As an OT and RFT we would still get the most common answer "I want to be able to walk." Instead of ever being discouraged by this response (and especially if ambulation seemed like a distant possibility) I would try to get the functional aspects of why the patient wants to walk. The patient's goal would rapidly become "to be able to walk into the kitchen and make myself a sandwich" or up to "walk into the woods to sit by a stream". Then if ambulation was a long way off I'd see if there were a way to meet the functional need from another level, hence independent at wheelchair level could be more palatable. Again, if ambulation was appropriate and the functional barrier to the goal, it has always seemed to me right up OT's alley.
As I was reading the thread about the patients goals I recalled an old lesson in this that I have incorporated many times since. When the patient cannot come up with any goal, or only states a raw task like walking with no functional reason for it, I've asked the more "bucket list" type question. "What is something you always wanted to do?" It had been put to me in university as "what is something you've always wanted to do before you die?" I haven't always used the weight of that but having it in my mind keeps me focused on what I want them to think about. What a gift if we can get someone out of ruminating on the physical limitations and seeing the possibilities. In particular this has played out in patients with paraplegia/quadriplegia. Where the "I just want you to get me walking again!" can really turn into a new and positive direction if we open up this type of conversation. Also, having it can remind people that they always wanted to play an instrument or write a book. Yours, Ed Kaine, OTR, RFT President of the League of Functional Therapists www.FunctionalTherapist.org <http://www.functionaltherapist.org/> Functional Therapy... the Next Generation of Occupational Therapy! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
