"Is it a roll-in shower, walk-in shower, tub w/ a shower, glass doors, does it have a seat, how big is the shower, does it have grab rails."
Here is another problem. He had been at the SNF forover a month without a shower before he finally transfered in. I aked about his bathing facilites at home and he has a claw foot bathtub that he has not used in over a year because he cannot get into it and it is all around too small. He is renting. He is working with SS to move to another apartment. -----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of Ron Carson Sent: Monday, July 13, 2009 09:25 To: cmnahrw...@aol.com Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE I will take Chris' suggestions a little further. If the patient wants to bathe in the shower, you must 1st know the environment in which this occurs. Is it a roll-in shower, walk-in shower, tub w/ a shower, glass doors, does it have a seat, how big is the shower, does it have grab rails. These environmental issues are VERY important to the goal of showering. Also, you must understand the persons physical, mental, cognitive and social strengths and weakness. IF showering is the goal, a skilled OT looks at all factors involved in the process, identifies which are hindering success and then works on overcoming these factors. Also, if showering is the goal, it is NOT necessary to shower with the patient during every treatment session. What IS important is identifying barriers (and there are more than I listed) and then working on the most significant problem(s). If LE strength is a KNOWN limitation, then make the patient's muscles stronger. Personally, I don't do exercises. I tell patient's that's PT's job. I am not well enough trained to identify and treat SPECIFIC muscle weakness/imbalance. Instead, I ask patients to do challenging physical activity. The list of possible barriers is really endless. Two of the most common barriers patient encounter are fear and lack of competency. In these situations, a skilled OT can progress the patient by engaging them in over-achieving activity. For example, if a patient wants to shower but is afraid to step over a 4" threshold into their shower, set up a clinical situation where the patient has a 5" threshold. Provide various challenges (i.e. walker ~vs~ no walker, rail ~vs~ no rail). Practice, practice, practice is what builds competency and decreases fear. Remember, ALL therapy should require the skills of a therapist. I frequently tell patients, I am not going to do "that" because it does not require my skills. Ask yourself, are you doing something that an aide could be doing? If so, then you are not doing therapy! If you are sitting around bored to death, watching patients do exercise, you are not doing therapy. If you are not challenging your patients beyond their ability, you are not doing therapy. If patients are not progressing to their goals, you are not doing therapy. Therapy is a SKILL. If you are not applying skill, you are not doing therapy! Ron ~~~ Ron Carson MHS, OT www.OTnow.com ----- Original Message ----- From: cmnahrw...@aol.com <cmnahrw...@aol.com> Sent: Sunday, July 12, 2009 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] Why OT's Should NOT Focus on the UE cac> If you want to go by the book, then you have to key into the concept of cac> task specific training. This is usually an easy concept for new cac> clinicians. If you want to get better at walking go ahead and walk, if cac> you want to get better at getting into a shower go ahead an get into a cac> shower, if you want to get better at bathing and dressing go ahead and cac> practice this as well. cac> Hope this helps, cac> Chris -- 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