Re: [OTlist] OT as stand-alone therapy in home health
Sue, I wasn't implying that the PT could or couldn't provide the service. My thought was relative to access. Obviously if the PT was to provide this service in the proferred scenario, the OT would be required to modify intervention so that duplication does not occur. I argue though that PT might address this issue only as part of the base and biomechanical task of walking. OT, at least should be intervening in terms of the big picture - occupation. To clarify though, if one peruses the Medicare regulations which allowed OT to work with low vision patients, they would find that the same regulation states that a PT also can provide like services This is based on reimbursement and not whom would be the better provider. Regarding your scenario of the hand surgery patient: I assume, since you state the PT recently discharged, that the patient is already on caseload. OT can recertify and follow an already opened case without other disciplines involved. If this is a new episode, and acute surgery, why can't nursing provide wound care instruction/services or s/s infection, etc? Jim Sue Hossack [EMAIL PROTECTED] wrote: Thanks for the responses, they have been very helpful. I have been perusing the online manuals on the CMS page for some time but it is difficult to interpret!. I would like to respond to Jim w.r.t. the visual field-cut patient - providing strategies for mobility safety was one of *my* goals - I trained the patient in tracking techniques to overcome the visual-field cut - (he made very good progress) both for functional mobility and for close work such as reading/writing. How could a PT do that as well (without duplication of effort)? In that particular instance the patient had some long-standing knee problems so the PT used that for his skilled visit, but it wasn't really as a result of the minor occipital CVA the pt had had. It seems to be the case that the pt has to have a physical problem that a PT can address before an OT can be utilized. (these patients are usually therapy-only patients). If it is really the correct interpretation I guess the PT can find something for one visit, but it seems strange. I know we are getting a patient next week who has had hand surgery, we have worked with her before and the PT had done all he can with her. I will be working with her hand (looking forward to it) but we are wondering what the PT can document as skilled when he has already documented goals met very recently? I am realising there is more to this that just OT's not being able to start a patient, although we can d/c, recert and resume. Terrianne mentioned that her agency does that to avoid looking like they were using the PT order just to open OT, but surely that is what is happening? A pt can be PT-only, or Speech-only, or nursing-only, but cannot be OT-only unless another discipline is involved initially. And so you have to get a PT (or SLP/RN) to open the patient and do skilled visits before the OT can be stand-alone. Very frustrating! I should point out in all of the cases I have worked with we had both PT and OT orders initially from the referring agency, it was not a case of only PT orders, then the PT did the SOC and ordered OT. (if that is clear!) Sue, They are correct in their interpretation. Check with those PT's and make sure they can't provide some service they may have missed (i.e. the pt. with a visual field cut, providing some strtegies to improve mobility safety.) Check to see if the patient might benefit from education from nursing r/t diagnosis and/or medications. JIm Terrianne Jones wrote: Hi Sue, that is the way my agency does it as well, and I was told that the reason PT needed to go back out at least once was to avoid looking like we were using the PT order just to open OT. Terrianne -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Be a better Globetrotter. Get better travel answers from someone who knows. Yahoo! Answers - Check it out. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] OT as stand-alone therapy in home health
Sue, They are correct in their interpretation. Check with those PT's and make sure they can't provide some service they may have missed (i.e. the pt. with a visual field cut, providing some strtegies to improve mobility safety.) Check to see if the patient might benefit from education from nursing r/t diagnosis and/or medications. JIm Terrianne Jones [EMAIL PROTECTED] wrote: Hi Sue, that is the way my agency does it as well, and I was told that the reason PT needed to go back out at least once was to avoid looking like we were using the PT order just to open OT. Terrianne Sue Hossack wrote: Hi all, I have a question that I am hoping someone on the list can answer. According to AOTA, although OT cannot open a Medicare home-health patient, we can be a stand-alone therapy once the Start-of-care has been performed by the PT/SLP/RN. This makes sense for a patient with OT-only deficits such as visual-field cut, hand or shoulder injury, that has no nursing or PT needs. However, my supervisor has told me that we have to have at least 2 skilled PT or ST visits - one before the OT visit during which the initial assessment also is conducted and one after the initial OT visit. Continuing OT may then be provided as needed and ordered. I.e the PT must provide a skilled visit even though the patient has no PT needs. Does anyone have any experience of this or any documentation that says otherwise? Thanks Sue -- Sue Hossack MOT, OTR/L, ATP Occupational Therapist http://www.ot-care.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Take the Internet to Go: Yahoo!Go puts the Internet in your pocket: mail, news, photos more. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Yahoo! oneSearch: Finally, mobile search that gives answers, not web links. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] reply: duplication of services
Cimberly, Firstly, you can treat them all too. Secondly, is this PT stating he is more qualified to do OT? If so, ask him when the last time he did this is. Then promptly report him to whatever board licenses OT in your state. Jim Arceneaux Cim Viken [EMAIL PROTECTED] wrote: To clarify previous post, examples of Primary Medical diagnosis code are 714.0 rheumatoid arthritis, 438 Late effects of CVA, Examples of treatment (or therapy) diagnosis code are 719.7 Difficulty in walking, 438.81 apraxia, 728.87 muscle weakness. I work in hospital setting where coder enter the diagnoses from our evaluations. The definitions of these are quoted from Rick Gawenda, PT course Outpatient Therapy CPT coding billing and documentation for Rehabilitation Reimbursement. Primary medical diagnosis: this item indicates the medical DX that has related in the therapy disorder and which is most closely related to the current plan of care for therapy. If more than one diagnosis is treated concurrently, the provider enters the diagnosis that represents the most intensive services (over 50 percent of the rehabilitation effort. Treatment diagnosis: This item indicates the DX for which rehabilitative services were furnished. For example, while CVA may be the primary medical DS hemiplegia might be the PT/OT treatment DX. I guess the bottom line is I have a PT claiming OT and PT can't treat some of same diagnoses. Examples are MS, muscle weakness, Lumbar stenosis, My argument is PT and OT have different scope of practices. PT works on exercises and mobility. OT treats occupational performance. Sometimes it's ok for OT and PT to work with the same patient depending of the complexity of diagnosis and overall patient's problem list/goals. (I also am stressing the word sometimes) In other words, this PT claims he can treat them all and he is more qualified. So what are your experiences or opinions? Thank you. Cimberly Viken, OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Pinpoint customers who are looking for what you sell. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Geriatric Men and Lack of Sociialization
Hey Ron, I find that at most ALFs and nursing homes the activities departments are good at offering interesting things for the women to do, but lack in their attraction to men. Face it, Bingo is not a top of the list for most men. I have seen one nursing home that hired a group that brought a large pool that was stocked with fish. The men were all over this. The other thing is that men, in general, socialize as part of engagement in more material matters (i.e. standing over an ice chest of fish and telling fishing jokes.) Women, in general, socialize for the purpose of socialization. They tend to comunicate on a deeper level then what is typically observed of men in a gathering. Just my two cents. Hope its worth at least that. Jim Arceneaux susanne [EMAIL PROTECTED] wrote: Ron Carson wrote: Hello Everyone: I provide OT and an ALF. It's a 33 bed facility that is mostly women but has about 5 or 6 men. Some of the men have been here for years. They are in varying states of physical and mental health, but they are all able to participate in life. BUT, they don't!! The women get together and chat and socialize, but the men stay so isolated from each other. WHY? Maybe their idea of participating in life is to do something outside of the place where they live, sleep, eat - and with someone else? Like, they went out to work all their life - they might still want to spend some of their day somewhere else? I know that I am not an overly social person. I don't hang out with other men just to talk. In fact, I'm uncomfortable in social situations that don't have goals. I'm with you about the goals - and I guess some of us prefer them more visible, or physical... But I also have a picture coming up for me of Turkish cafés filled with retired men, playing backgammon, smoking and drinking tea (or Raki) all day long. And students of both sexes, with books and laptops, spending all day in the cafés that have free refill of coffee. Lots of chatting and socializing going on.. Is the lack of male socialization just part of the male condition? Or has the right opportunity just no presented itself to bring the men together? 5 or 6 is not a lot - might not appear to them that they have much in common. But maybe if they went different places during daytime, they'd have something to discuss at the end of the day - or would like to tell the ladies about their day. Any possibilities in the local area? Or just outside - some hens to look after and a nice bench to hang out? susanne, denmark -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Need a vacation? Get great deals to amazing places on Yahoo! Travel. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] marketing OT to doctors
Hi Karen, You know I had a recent experience that points out the best source of marketing you can possibly describe. A patient that had been discharged from therapy was so happy with her outcome that she literally bragged to her physician about all the things occupational therapy did for her. It seems to have worked as this physician is now a very reliable referral source. The mantra: Keep your patient happy and give them success in things that are meaningful and easy to explain to others. Thats easy enough isn't it (he said in a sarcastic tone.) Jim Arceneaux Tesarek, Karen [EMAIL PROTECTED] wrote: Hi, Ron, Joan, and everyone. I have been reading the otlistserv for about a year and have thoroughly enjoyed it. I recall the conversations about marketing our services. I am in my last semester of graduate school. In one of my classes, we are working on a paper to outline a procedure and make recommendations for marketing OT services to doctors/physicians... We are looking forward to sharing with our classmates. Does anyone want to chime in and re-visit this issue with me? I would welcome any success stories and references. Thanks Karen -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Pinpoint customers who are looking for what you sell. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Sorting Silverware?
Joan your are speaking of using procedural memories. They remember these tasks as part of past occupational involvement and can at times participate at some level. It may not be a true occupation, as it is not in the context of completing some occupational demand, but is a component of an occupation. I do not believe in any way that sorting silverware in the context you mentioned can be compared to sorting pegs or stacking cones. As someone mentioned earlier, at the least the task is a purposeful activity. Jim Joan Riches [EMAIL PROTECTED] wrote: I am talking about advanced dementia Ron. These people are deprived of occupation. Handling and manipulating things they recognise often provides a sense of accomplishment especially when their efforts are recognised and appreciated. Your final statement is quite true when people are able to compare present and past abilities. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Monday, September 10, 2007 5:10 PM To: Joan Riches Subject: Re: [OTlist] Sorting Silverware? Joan, interesting answer, as always. I don't understand the following: JRSorry. [ Enabling ]occupation in this setting is providing support for the satisfaction JR of doing which may be possible only at the level of actions. Also, I'm not sure that I fully accept this statement: JR For many women, cooks, waiters, butlers and footmen the memories and JR sense of accomplishment even in a simulated task will be far greater JR than using cones. Even though a person previously engaged in an occupation, that is no assurance that the person will derive any sense of accomplishment from TRYING the same occupation. In fact, I OFTEN find just the opposite. Many times, people are unwilling to learn a new way of doing what was once a familiar occupation. Interesting topics! Ron - Original Message - From: Joan Riches Sent: Monday, September 10, 2007 To: OTlist@OTnow.com Subj: [OTlist] Sorting Silverware? JR Hi Ron JR One of the Toglia assessments involves sorting cutlery (As a jewellers JR daughter I question whether the utensils in question were actually silver) JR Also one of the renewable activities that we provide for low level dementia JR folk involves sorting plastic cutlery. This activity can be graded up or JR down and is available when needed. I know there is some debate about using JR simulated rather than active productive meaningful tasks. I know that these JR familiar tasks sorting, folding etc. are meaningful for many of our JR residents. The skill involved is in matching the task to the person, JR prescribing both task and supervision and following up to monitor changes in JR cognition. Occupation in this setting is providing support for the JR satisfaction of doing which may be possible only at the level of actions. JR I don't know why the person you saw was sorting cutlery and it may indeed be JR just a step away from using cones. For many women, cooks, waiters, butlers JR and footmen the memories and sense of accomplishment even in a simulated JR task will be far greater than using cones. JR Blessings, Joan JR -Original Message- JR From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf JR Of Ron Carson JR Sent: Monday, September 10, 2007 1:58 PM JR To: OTlist JR Subject: [OTlist] Sorting Silverware? JR Hello Everyone: JR Will someone please tell me why OT would have a SNF (Skilled Nursing JR Facility) standing and sorting silverware? Surely, no patient really has JR a goal of sorting silverware, do they? JR I've never understood this aspect of OT! Why have patients standing to JR do something so that they can do something else? If the patient needs to JR be able to stand and get their clothes, brush their teeth, walk to the JR dining room, go pee, etc, etc, why not use these as the treatment? JR Thanks, JR Ron JR -- JR ... as a profession that offers unique services that are ideally suited JR to meet the health, participation, and quality of life needs of people JR of all ages, occupational therapy is well-positioned to succeed and JR flourish in the 21st century. [Fred Somers, AJOT, April, 2005, p. 127] JR The part of convalescence that I found most profoundly humiliating and JR depressing was [OT]... I was reduced to playing with brightly colored JR plastic letters ... like a three-year-old... [AJOT, April, 2005, p. JR 231] JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com JR JR ** JR Enroll in Boston University's post-professional Master of Science for OTs JR Online. Gain the skills and credentials to propel your career. JR www.otdegree.com/otn JR JR ** JR No virus found in this incoming message. JR Checked by AVG Free Edition. JR
Re: [OTlist] alzheimers disease/cognition
Miriam, I like to use memory books or wallets. You can place information relevant to sources of agitation. Just make sure to keep it simple. I would also recommend the family sign the patient up for the Alzheimer's Association Safe Return Program. Education is a must for what is to come. Communication strategies, environmental modifications and the like can be helpful. Finding things they still can do and providing the opportunity through grading for them to do it will also be beneficial. Jim Joan Riches [EMAIL PROTECTED] wrote: Hi Miriam This is a huge question. It would help to have more information about why you are asking. It really depends on what behaviours the family is seeing. In general, though, being matter of fact and accepting of changes goes a long way. Keeping a running journal with brief notes about behaviours 1) that are new and/or 2) not new but more frequent really helps not to take the behaviour personally and to track gradual changes for reporting to other family and to professionals. One common behaviour is repeated questions or concerns. The concern carries a big emotional impulse that is not relieved by the answer. Simply cheerfully repeat the answer in the same words as the first time without elaborating any further. It satisfies in the moment and relieves the responder of the need to do anything more than the first time. Be aware that most people can pull it together for short periods so changes are most likely to be seen by those who spend most time with the affected person and see them when relaxed or tired. The effort to function at the very top of one's ability is very tiring so someone who has managed 'just fine' in a social situation will need a chance to rest. Unfamiliar situations - people, places, activities, new clothing etc. especially events like weddings, family reunions, special birthdays, trips take a great deal of mental energy and need to be carefully planned by the caregivers to prevent catastrophic reactions as much as possible. There have been many books written on this subject so I'll stop for now. For practical help I find the Allen Cognitive Levels invaluable. Joan Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of miriam Sent: Monday, September 10, 2007 11:43 AM To: OTlist@otnow.com Subject: [OTlist] alzheimers disease/cognition During the early stages of Alzheimers and the patient's cognition begins to decline, what are the first steps that family members can do to be able to cope with this decline in function. Miriam -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.485 / Virus Database: 269.13.13/998 - Release Date: 9/10/2007 8:48 AM No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.485 / Virus Database: 269.13.13/998 - Release Date: 9/10/2007 8:48 AM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Check out the hottest 2008 models today at Yahoo! Autos. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Marketing Results
You know, if the knuckle-heads would just realize there is a difference between productive time and billable time, we would have less problems. All billable time is productive, but there are other productive issues that occupational therapists must pursue to provide optimal care and ensure appropriate reimbursement. Jim Jenny Daup [EMAIL PROTECTED] wrote: I really think this is a manager/facility problem that can be solved by the facility. I think the occupation-based therapy that we need to be delivering takes planning and prep time that isn't available when everyone is asking for 80-90% productivity. If the facility would drop the productivity standard for 3-6 months and allow the therapists to have a planning period of time daily (maybe even set up some team brainstorming time) that is separate from their paperwork time, the therapists would begin to develop a repertoire of great tasks to use when patients had similar challenges and goals. After that time, I really think the therapists would be much faster at pulling activities out of their hats and productivity would rise again. I have always felt that the productivity expectations and large caseloads are a large contributing factor in therapists losing their ability to think out of the box. It seems like everyone is so stressed just to get all of their patients seen and meet all of the paperwork requirements that there isn't any time to plan patient-specific sessions unless they do their planning off the clock. I was always so burned out at the end of the day that I couldn't imagine taking my work issues home (but that is exactly what I ended up doing...planning activities, shopping for supplies, etc. Jenny D. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Carmen Aguirre Sent: Friday, September 07, 2007 8:43 PM To: OTlist Subject: Re: [OTlist] Marketing Results This posting brings me back to the pegs and Putty therapy we deliver and call it OT. Many of colleagues claim that with the ease of portability, these tools are the best they can do therapy with... Where do we put the blame for lack of occupation in our treatments besides the obvious morning ADL session and occasional cooking task if we are lucky? When practitioners claim lack of resources...where do we expect to get them...at the facilities? within our own bag of tricks? from our managesr... Thanks Carmen From: Johnson, Arley Reply-To: OTlist@OTnow.com To: Subject: Re: [OTlist] Marketing Results Date: Fri, 17 Aug 2007 11:21:13 -0400 Thanks Ron and Sue! I have forwarded your comments to my OT staff because I have felt they have fell into that blanket treatment ideology for LE ortho patients. They make me feel as if I don't get it, but I think it's the other way around. I think I have tried everything for them to think outside the box. During their annual reviews, I have discussed this with them and spoke to them that if you identify 5/5 UE strength and no other deficits on the eval, why address UE strength in your treatment??? My staff responses have placed the blame back to limited resources which I don't understand, but I'll find out in our next staff meeting. Here is my last email to them: I'm forwarding you all the comments below. When seeing ortho patients we need to really try to tailor our treatment to what they need, not just place them in our therapy program. It's very easy for ortho patients to make the connection with the PT aspect of the program, but not ours. So we need to make sure we stick close to our OT philosophy and theory to ensure we are making an impact on their lives! Their responses: This email is so sad but true. I think our department is doing a good job in caring for the patients in rehab. We just need to find a new way to package our program and market it both to the patients and the staff of this hospital. More appropriate and diversified activities would be a start. We can only do so much with what we have. Let's come up with some ideas and discuss tem at our next meeting. This is something I've been thinking about for a while, and although I keep patient's individual needs in mind, and try tailoring their sessions, there is only so far I can go given our limited resources. I look forward to this discussion. I totally agree. I think there is only so much we can do to tailor treatment with the limited resources we have. Also, it is not easy to get simple things like shower chairs without a fight. I also think we should all discuss some ideas at the next meeting. Arley Johnson MS, OTR/L The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this
Re: [OTlist] Functional Mobility Training
Could she problem solve with you regarding what would be appropriate items to use as a stabilizer and those that would not? What is her goal? If her goal is to be able to complete mobility aspects of her ADL and IADL with improved confidence, safety and/or independence; you may be able to rationalize with her that she isn't meeting those goals presently with her current practice of grabbing and reaching out for things in her environment. In the end though, if the patient is satisfied with her current practice, you will be hard pressed to change this behavior. Jim Aguirre [EMAIL PROTECTED] wrote: Hi all. Here are my 2 cents... Assuming she can learn new information, teaching her new startegies could work. You have a good opportunity for restoration/adaptation and compensatory approaches... If she can not learn, ( Allen levels 4 ish), adaptation of environment to elimminate hazards, changing the most prevalent tasks she falls during, to be done by/with someone else... signs posted by cupboards that she may want to reach for to remind of doing something safer...rearranging her closets to have things at a safer plane... pictures of her doing something safer to cue to imitate the action Share the rtesults... Carmen From: Christi Vicino Reply-To: OTlist@OTnow.com To: Subject: Re: [OTlist] Functional Mobility Training Date: Tue, 4 Sep 2007 12:09:59 -0700 How to recover from a fall Once on the ground how do you proceed to get up Christi -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Tuesday, September 04, 2007 11:26 AM To: Christi Vicino Subject: Re: [OTlist] Functional Mobility Training What is a fall recovery program?? - Original Message - From: Christi Vicino Sent: Tuesday, September 04, 2007 To: OTlist@OTnow.com Subj: [OTlist] Functional Mobility Training CV Hi Ron... CV I know you have thought of everything...but I love throwing things CV around in hopes something will spark a thought that was not covered CV Since she is pretty with it... Have you considered a fall recovery CV program And slipping in a demonstration of you loosing your CV balance under a variety of circumstances...(including furniture walking) CV Sometimes seeing things in action can click And then have her CV interact and simulate similar circumstances with mats in place??? CV Christi Vicino CV -Original Message- CV From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On CV Behalf Of Ron Carson CV Sent: Tuesday, September 04, 2007 9:49 AM CV To: Christi Vicino CV Subject: Re: [OTlist] Functional Mobility Training CV Hello Christ: CV I have explained these to her. I have pointed out to her when she CV loses balance because she reached for something. I have repeatedly CV shown her how she may misreach for something (visual changes) or the CV item may move or she will have a LOB, but she is adamant about CV holding on to objects when they are in reach. CV This is a tough case! I love it!!! CV - Original Message - CV From: Christi Vicino CV Sent: Tuesday, September 04, 2007 CV To: OTlist@OTnow.com CV Subj: [OTlist] Functional Mobility Training CV The things that she is grabbing hold of may not be stable enough to CV provide assist in sustaining her balance. CV She may not always make appropriate choices of what to grab onto CV especially when a loss of balance occurs. CV Furniture Walking alters her center of gravity when ambulating CV and CV does not encourage the muscles that need to be strengthened by CV walking with the appropriate posture to strengthen and make her a CV safe walker. CV Christi CV -Original Message- CV From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On CV Behalf Of Ron Carson CV Sent: Tuesday, September 04, 2007 8:38 AM CV To: OTlist CV Subject: [OTlist] Functional Mobility Training CV Hello All: CV I've been working with a geriatric friend/patient who is asking CV me a question that I can not convincingly answer. CV This 90 y/o patient is about 6 years s/p CVA with residual CV visual / balance deficits. She has fallen twice this year fracturin CV both hips. CV She previously walked without any AD put had difficulty with CV balance. CV She is very determined to return to functional mobility with a cane. CV She has progressed from a 4-wheel walker (which is unsafe because CV she used it incorrectly (very impulsive)) to a cane. But CV needs additional mobility training. Here's the problem. CV When she walks, she continually grabs doorways, handles, cabinets, CV etc. CV She does NOT need these but feels more stable with them. I have CV stressed that she needs to be consistent with her mobility and CV walk in the same manner. But she asks me why not use them if they CV are there? CV I need help trying to explain to her that it's best if she not CV rely on cabinets, doorways, etc for mobility. But I can't provide a CV
Re: [OTlist] Documentation discussion
Jenny, These PTs may make statements as you noted, but speaking as one that has done quite a bit of documentation review for all rehabilitation desciplines, the PT notes were often some of the worst. Typical for PT notes are a list of exercises and a statement about ambulating a patient so many feet. This as I wrote before is not skilled intervention. The same exercises the PT is doing, can be done by an athletic trainer, whom I might add is not a qualified Medicare contractor per Medicare guidelines. I also add that I ambulate my dog all the time, but I don't charge my insurance for it. For the above to be skilled intervention the PT needs to document why they needed to be there for the patient to be able to do the things listed. examples: The patient's medical situation being unsable required a physical therapist to complete the noted exercises for safety reasons or the specific cueing provided for gait (i.e. step length, reciprocal gait, etc.) Jim Jenny Daup [EMAIL PROTECTED] wrote: Arley, I would love to compare our forms to see if I am missing anything. Interested in swapping? You can e-mail me privately. Jenny Daup [EMAIL PROTECTED] -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Johnson, Arley Sent: Sunday, September 02, 2007 2:52 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Documentation discussion Jen: I refuse to believe that in low vision rehab there is such thing as wordy. Every word is justifying your expert training and intervention. Secondly, With all of the auditing going on in rehab nowadays, the constant theme is the documentation does not explain why therapy needed to be given in an intense setting. I recently reworked our forms after we were audited by our FI and that comment came back about the physician and nursing notes as well. I think many of the national rehab association are on the same page that more, organized documentation is better. Good luck! Arley Johnson, MS, OTR/L Operations Manager Rehabilitation Services Pennsylvania Hospital, the Nation's First Basement, West Wing 800 Spruce Street Philadlephia, PA 19107-6192 215-829-5018 - office 215-422-0174 - pager From: [EMAIL PROTECTED] on behalf of Jenny Daup Sent: Sun 9/2/2007 11:23 AM To: OTlist@OTnow.com Subject: [OTlist] Documentation discussion I am interested in this documentation discussion. When I was designing my new forms I talked to many people within the OT and PT crowd. The overwhelming idea among PTs was that OTs tend to be too wordy. Being wordy equated with an increased chance of a reviewer finding some little section within our ramblings that they could use as a reason to deny a claim. (I used the word ramblings...NOT the PTs.) I see this as a very valid point. On the other hand, our type of therapy is more complex (encompasses many more aspects of a person's life) and by its nature requires more words to describe. We are involved in quality of life and all the nuances that bring that quality to our clients. I can read 2 PT reports on 2 different patients and they will use identical words. Most of the time, the PT performed exactly the same exercise routine. And that is absolutely appropriate for physical therapy. I have rarely written 2 reports that are identical. I admit that I tend to be wordy but I use my notes to guide my next session. When I am in a hurry and quickly write a note with only the required parts of the note, I look back the next week and beat myself up because I don't have enough information to truly get a picture of what was accomplished and where I planned to go next. I work in low vision rehabilitation right now and one of my mentors told me that often the largest change from evaluation to discharge is reflected in the patient's perception of their life with vision loss. We teach clients all of these skills and how to compensate, but at the end, it is their ability to adapt to their current life situation and their satisfaction with their abilities that determine success or failure. I feel the need to be wordy on my documentation...can you tell that in my rambling here? Jenny Daup -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review,
Re: [OTlist] Documentation
I agree with Arley. Denials come more often from the inability to document skilled intervention, than from poor goal writing. I frequently see documentation from therapists such as: Ambulated 75' with min (A) or; completed upper body dressing with mod (A). This is not skilled intervention. An aide can do that. The key is to write what you did that facilitated there ability. An example is utilized reflex inhibiting positioning for tone reduction to allow the patient to don there socks with min (A) for initial application over the toes. Another thing I see often is the documentation of long lists of exercises. Beyond the argument for or against exercise, a list of exercises performed is not skilled. You can go to your local gym and a handy dandy employee of the gym can help you do a long list of exercises. Again, the therapist needs to state what they did that was skilled. an example: Note the exercises you had the patient perform and state what type of cueing was required to limit substitution patterns. Beyond the above, I do not know of a documentation course. It is a good idea to find out what the regulations say in terms of documentation. Transmittal 60, which can be found at the CMS website lists documentation requirements for part B treatments. There is not much available for Part A, however, recently Medicare attempted to make Part B documentation regulations as a rule for Part A. This was later rescinded, but I'm sure it will turn up again sometime. I also agree that being detailed in notes is a good thing. I'm not certain I have ever heard of a Medicare contractor denying a claim as it was too long to read, but if it were denied, I would love to have detailed documentation to help me fight the denial at a hearing. Just make sure you are documenting the salient details only. I've observed many to write a lot without saying much. As for your goal example, I would say that the bit about skilled dressing technique is somewhat confusing. What do you mean by skilled. It may be more appropriate to list specifically what you are training. An example: The patient will display 100% return demonstration of ability to safely transport items of clothing from closet/drawers while using a rolling walker. In the long run, if your supervisor keeps telling you that detailed notes will get you denied, ask him to provide his resource for this information. He will not be able to as there is none. Jim Jet Jen Ramos [EMAIL PROTECTED] wrote: thank you for the feedback...you actually made it to the point. the reason why i am detailed (wordy) was due to the other conditions that needs to be met/addressed - Common example of a Goal for a Pt that may also have Balance impairment in standing (LE weakness could be a G example too): Pt to achieve SBA in UE dressing. In the real world, Pt. may be able to do it min A within X' number of Tx. sessions BUT what needs to be addressed, as well, would be giving skilled instructions on safety techniques, strategies and sequencing in dressing to achieve good carryover since Pt usually do it (prior to ilness/disability) in standing position and skilled dressing techniques need to be carried over while sitted on min A to make more sense. My rant is: I may wrote the goal like this: Pt to achive SBA in UE dressing with G carry over of skilled dressing techniques and strategies in sitted position to increase/compliment safety. Accdg to my PT director and supervisor, it's not necessary, too long and it's not up to the point ... what's more intriguing is, Auditor/Medicare may not read it since it's long and denial of payment is apparent..honestly, I think, more often than not, therapist are used to cookie cutter LTGs and STGs and the real essence of the targeting the problem is not addressed. Safety may show up on progress notes and that skilled instrxns or Pt. education were addressed but the way i worte my goal would account for both - so, even Pt. achieved Min A goal, it's not over yet until carryover of skilled techniques and strategies are met. MY POINT ? - which goal is better now? Come to think of it, one of the reasons why we are training dressing skills might be to sustain task to promote max. independence and put safety in equation because I believe Pt. (an ADULT without cognitive impairment) knows the concept and has the experience on how to do the task per se but because of limitations secondary to trauma, disease or illness, it is compromised. FAVOR, do you (or anyone) know a GOOD training/seminar regarding OT documentations that would improve Medicare reimbursement and avoid denials? I would like to know if there's really something wrong with how I document my Txs. Thanks. Johnson, Arley wrote: The Ramoses: Being detailed is what gets you reimbursed. A course I went to that discussed Medicare Denials PT/OT notes that were status reports ( Min A
Re: [OTlist] Marketing Results
You' re a very smart new OT Linda Jim [EMAIL PROTECTED] wrote: hi, i am a new OT and spent the summer working in a snf. i loved the patients and the staff i worked with were all caring and creative. While I agree that OT is not just upper extremity work I think it's a shame to spend so much time defending or trying to make people understand a philosophy and take that time and put it toward real issues. I always tried to make treatment sessions relevant, and what is important to one patient isn't to another. for example, I would gladly spend time problem solving with a patient on being independent in don/doff shoes and socks if that was important but some people say right now that isn't a priority to me or someone will help me with that when I'm home. but I'd really like to be able to make a cup of tea. all right then, we'll focus on that. OT involves dynamic interaction with the environment, which includes UE and LE. a patient said, well someone will give me a shower, and my sister will cook for me, so I said, well are you going to sit up in bed and get out of the bed. she laughed, but I explained that OT would help her learn and practice these skills so she'd feel comfortable doing these things at home. all this said, I see staff burn out when meeting minutes just keep piling on and on - 600 minutes in a day - 120% productivity - !! - meet that and more is added - working with 4 patients in one session, not in a group session. caseloads are switched to meet more minutes so that it doesn't matter what relationship you've developed over the course of a few weeks, you may come in one day and find that patient off your caseload now. staff and patient morale suffer. the mindset of the dor is getting the money - this makes for terrible OT. I joinged this list hoping to learn from experienced therapists and hear about a wide range of experiences and opportunities. Linda ** Get a sneak peek of the all-new AOL at http://discover.aol.com/memed/aolcom30tour -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Yahoo! oneSearch: Finally, mobile search that gives answers, not web links. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Why are YOU on this list
Hi Joe,
Would you elaborate on what you mean by non-therapeutic approaches.
Jim
Joe Wells [EMAIL PROTECTED] wrote:
Arley Johnson stated WE are the only profession that knows enough about
each area to put it all together in a functional, real world context,
identify the limitations and address that area for remediation. All within
our practice guidelines!
Arley:
I love the way you put it. I agree with you completely. In my opinion, it is
this pan-function, holistic viewpoint that separates us from other
professions. It is this understanding that can help us become the
gatekeepers of rehab services. At the same time, I also believe that while
this ('holistic' view) is our common thread, OTs can practice/ specialize in
different areas- hand, pediatrics, geriatrics, cardiovascular, lymphedema,
pain/ neurological conditions, driver's rehab, low vision, etc. Of course,
functioning within the scope of OT. Example: A cardiologist is still a
physician.
So, if an OT is an UE Therapist, when that is the need for remediation, and
incorporates biomechanical approaches to fulfill the occupational needs of
the clients- I feel that he/ she is justly performing occupational therapy.
However, as in my earlier post, and as faced by Ron's friend, if they just
do UE therapy for no therapeutic reason, they are not only not performing
OT (excuse my two negatives), they are just not doing any kind of therapy.
Let's embrace all our specialization and share the common platform of OT.
And, let's just discard our non-therapeutic approaches. This in turn will
bridge the gap between theory and practice.
Joe
No virus found in this outgoing message.
Checked by AVG Free Edition.
Version: 7.5.476 / Virus Database: 269.11.15/949 - Release Date: 8/12/2007
11:03 AM
--
Options?
www.otnow.com/mailman/options/otlist_otnow.com
Archive?
www.mail-archive.com/otlist@otnow.com
**
Enroll in Boston University's post-professional Master of Science for OTs
Online. Gain the skills and credentials to propel your career.
www.otdegree.com/otn
**
-
Looking for a deal? Find great prices on flights and hotels with Yahoo!
FareChase.
--
Options?
www.otnow.com/mailman/options/otlist_otnow.com
Archive?
www.mail-archive.com/otlist@otnow.com
**
Enroll in Boston University's post-professional Master of Science for OTs
Online. Gain the skills and credentials to propel your career.
www.otdegree.com/otn
**
Re: [OTlist] OTlist Digest, Vol 31, Issue 8
Question: Do we look at how a patient is able to use their foot or leg to complete functional tasks i.e. brushing teeth, combing hair, pulling up pants, etc? OT addresses occupation and the ability to functionally use any extremity (being simplistic again) to complete the same. I agree with LeeAnn that OTs are perceived as the primary providers i.e. splinting and adaptive equipment, but this does not identify us, because other providers can and do provide this service as well. The UE thing is, I believe a corporate thing/description, used to easily explain billing practices. It has easily become a mantra for many a practicing OT. Working with a LE condition does not make one a PT or OT. I'm quoting AOTA, but I believe the practice framework list motor demands and client factors as a constituent of occupation. It does not, by the way, state UE motor demands or client factors limted to the UE. This would leave service lacking if one did not address all deficits associated with an occupational impairment. Jim [EMAIL PROTECTED] wrote: To state that OT focuses on the UE is a simplistic view However, I do believe that OT's do focus on the UE better than PT. Simply because we look at how a patient is able to use their hand or arm to complete functional tasks i.e. brushing teeth, combing hair, pulling up pants, writing,opening jars etc.. We are also the primary providers of joint protection, splinting, and adaptive utensils and all which require hand and UE functions. Physicians have come to rely on OT's to provide this information and if we are not skilled in evaluating UE function in relationship to strength, sensation, ROM, tone and spasticity we are doing a disservice to our clients by not being able to give their physicians the appropriate information. Payors also want this information because they can understand it better. If giving that simplistic definition gets an OT in the door to providing treatment we can then show them how much more we can offer. Don't get defensive about it. Use it to your advantage! LeAnn Lee, OTR/L Albany General Hospital Albany, OR -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of [EMAIL PROTECTED] Sent: Wednesday, August 08, 2007 12:00 PM To: otlist@otnow.com Subject: OTlist Digest, Vol 31, Issue 8 Send OTlist mailing list submissions to otlist@otnow.com To subscribe or unsubscribe via the World Wide Web, visit http://otnow.com/mailman/listinfo/otlist_otnow.com or, via email, send a message with subject or body 'help' to [EMAIL PROTECTED] You can reach the person managing the list at [EMAIL PROTECTED] When replying, please edit your Subject line so it is more specific than Re: Contents of OTlist digest... Today's Topics: 1. OT's and Upper Extremity (Ron Carson) 2. Re: OT's and Upper Extremity (Johnson, Arley) -- Message: 1 Date: Wed, 8 Aug 2007 07:34:41 -0400 From: Ron Carson Subject: [OTlist] OT's and Upper Extremity To: OTlist@OTnow.com Message-ID: [EMAIL PROTECTED] Content-Type: text/plain; charset=us-ascii Why do some therapists think that OT focuses on the upper extremity? I received a brochure from an OT in private practice and it states: [OT] focuses on treatment of upper extremity injuries, disorders and disease Where does this come from? It certainly is not our practice framework? Is it from OT/COTA schools? If so, why? This seems like another example of the dichotomy of our profession. In other words, we say one thing but then do something totally different! Argh.. Ron -- In the United States, occupational therapy is ideally suited to meet the health needs of people of all ages. [Fred Somers, AJOT, April, 2005] The part of convalescence that I found most profoundly humiliating and depressing was [OT]... I was reduced to playing with brightly colored plastic letters ... like a three-year-old... [AJOT, April, 2005, p. 231] -- Message: 2 Date: Wed, 8 Aug 2007 10:49:04 -0400 From: Johnson, Arley Subject: Re: [OTlist] OT's and Upper Extremity To: Message-ID: [EMAIL PROTECTED] Content-Type: text/plain; charset=iso-8859-1 I think I know why. OT things are functionally based. Most of our functional daily activity originates with the use of our hands. Therefore, basic observation of our profession and the medical model's need to simplify everyone's role for the average Joe dictates a simplistic and narrow explanation of our profession. Is it right? Of course not. But it gives our profession relevance to the outsider who may only get a cursory glance of what we do and it may draw them in for the full experience. Let's be honest, OT covers the spectrum of life and it entails a lot of information. Our charge to be the profession that rehabilitates you back into your life roles is not an easy task. Neither is explaining it in a manner that is understood by the
Re: [OTlist] [Retrieved]Re: [Retrieved] neck/back pain
Hey Liz, Thanks for your response. This is an interesting topic. I would disagree though that the spine is more complicated than a hand. I think what you are shooting for is that the opportunity for doing harm with manual therapy to the spine is more so than that same treatment provided to the hand. My thoughts on the subject is that a PT that hasn't had further training has no business doing manual therapy either. But in the end, it seems we agree. OT can work with patient's that have problems with any part of their body as long as they stick to what they know. Jim Liz Klawitter [EMAIL PROTECTED] wrote: Hi Jim That's a good question. I think it's a matter of complexity. The spine and neck are much more complex than the hand, in terms of overall contribution to mobility. If an OT is also a CHT I feel that their level of competency is perhaps one I can trust, as a consumer. However, there is no training for OT's to manually treat the spine and neck, that I'm aware of. If we're just talking about applying modalities, well then that's pain management techniques. Maybe it's semantics, but I don't see that as treating. In response to what you said about OT's not being limited to what types of diagnoses they can treat, yes, I'd say that's true. But HOW we treat should reflect our training as OT's, not as PT's (albeit, yes, I know there's some overlap). I bet some folks won't like that. But there it is. Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Tuesday, March 27, 2007 2:58 PM To: OTlist@OTnow.com Subject: [Retrieved]Re: [OTlist] [Retrieved] neck/back pain Hello Liz, I would agree with your reply in general, but I'm curious how you feel about an OT performing what you termed manually treat a hand. What I'm getting at is OT's are not limited to whom they can provide treatment based on diagnosis. Area of expertise, then again, can be a limiting factor. Jimmie Liz Klawitter wrote: Hi Jim, Yes, I agree, as OT's we have plenty to offer patients with neck and back pain: ADL retraining, body-mechanics training, pacing/energy conservation, pain management techniques, ergonomics. I wanted to understand if the OT's who initiated this discussion are wanting to manually treat the neck and spine, because the wording used was treat neck and spine. I read on another forum where an OT was providing treatment to a patient with severe kyphosis. When the patient got up from the mat she felt like her neck was locked, and she also felt like she couldn't swallow very well after that treatment. My question is, what is an OT doing manually treating the spine? I didn't know if this was a trend out there, or not. Thanks Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Saturday, March 24, 2007 2:55 PM To: OTlist@OTnow.com Subject: [Retrieved][OTlist] neck/back pain Liz, This is in reference to the question you had about what an OT would do with a neck/back pain patient. I am likewise curious why the body part would matter relative to the need for OT services? It should only matter that a deficit in ones ability to complete a desired occupation exists. It would seem plausible that a patient with back pain would have difficulty, if not inability, to complete at least some of their occupations. Therefore, occupational therapy is indicated. Jimmie - Sucker-punch spam with award-winning protection. Try the free Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Bored stiff? Loosen up... Download and play hundreds of games for free on Yahoo! Games. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn
Re: [OTlist] [Retrieved] neck/back pain
Hello Liz, I would agree with your reply in general, but I'm curious how you feel about an OT performing what you termed manually treat a hand. What I'm getting at is OT's are not limited to whom they can provide treatment based on diagnosis. Area of expertise, then again, can be a limiting factor. Jimmie Liz Klawitter [EMAIL PROTECTED] wrote: Hi Jim, Yes, I agree, as OT's we have plenty to offer patients with neck and back pain: ADL retraining, body-mechanics training, pacing/energy conservation, pain management techniques, ergonomics. I wanted to understand if the OT's who initiated this discussion are wanting to manually treat the neck and spine, because the wording used was treat neck and spine. I read on another forum where an OT was providing treatment to a patient with severe kyphosis. When the patient got up from the mat she felt like her neck was locked, and she also felt like she couldn't swallow very well after that treatment. My question is, what is an OT doing manually treating the spine? I didn't know if this was a trend out there, or not. Thanks Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Saturday, March 24, 2007 2:55 PM To: OTlist@OTnow.com Subject: [Retrieved][OTlist] neck/back pain Liz, This is in reference to the question you had about what an OT would do with a neck/back pain patient. I am likewise curious why the body part would matter relative to the need for OT services? It should only matter that a deficit in ones ability to complete a desired occupation exists. It would seem plausible that a patient with back pain would have difficulty, if not inability, to complete at least some of their occupations. Therefore, occupational therapy is indicated. Jimmie - Sucker-punch spam with award-winning protection. Try the free Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Bored stiff? Loosen up... Download and play hundreds of games for free on Yahoo! Games. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Start ups
Hi Meghan, Thanks for your response. Sorry I am so late in writing back. I have looked on Tina Champagne's web site. I tried contacting her by email, but got no response. I would love any information you might be able to share. It would be great to see what you did in your setting. Thanks, Jim Meghan Franklin [EMAIL PROTECTED] wrote: If you go to Tina Champagne's website www.ot-innovations.com she has lists for sensory start-up for different populations. If you want more information, I have just done one for acute adult. Meghan Franklin, MS, OTR/L Butler Hospital 345 Blackstone Blvd Providence, RI 02906 401-455-6412 pg: 401-221-5004 [EMAIL PROTECTED] -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Sunday, February 25, 2007 7:08 PM To: otlist@otnow.com Subject: [OTlist] Start ups Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] SI Info
Heather, If I can swing it, would you be interested in consulting with us on our start up? I would have to discuss it with the administrator, but I don't think that would be a problem. Jim Bleier, Heather N Ctr 65 MDOS/EDIS [EMAIL PROTECTED] wrote: Hello Jim and Terri: Thank you for your interest. Regarding Infinity Walks and use as a as a therapeutic medium/examples: I first heard about this tool at a pediatric vestibular/vision CE by Mary Kawar (http://www.pdppro.com/ws9.shtml). I find it helpful as an adult, age appropriate way to get vestibular input, work on attention, balance/weight-shifting responses, and tracking. Please see the following web site... (be forewarned, it is a little melodramatic and New-age-ish; however, it explains the tool) http://www.infinitywalk.org/index.htm. I work as a traveling OTR. Therefore, my work is typically at SNFs with Medicare A patients. My favorite patients to work with are those with CVA. I also enjoy working with patients for fall prevention and with COPD/respiratory issues. I do work with some LTC patients with dementia and various types of mental illness. Basically, I evaluate the needs of every patient, and if SI strategies are appropriate to improve their function, then I incorporate them into their treatment sessions and patient education. So, if visual tracking is an issue, I may do the infinity walk, then follow this with an activity that involves sciatic eye movement, such as choosing canned food to do simple meal prep task (I will set up cans in therapy room kitchen/cabinet in direction/order I want patient to look). If I have a patient who has COPD and endurance issues, after completing training in energy conservation techniques I may train them in some postural and belly breathing activities through their nose to help with quality of breath, I will especially remind them of their breathing techniques while we do exercise program or ADL tasks (many of these patients use accessory muscles to breath, so, if they attempt to lift their hands above their head, they get short of breath, if they belly breath then this effect is lessoned). I can think of more examples, but this is all I have time for now. =) Best regards, Heather -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - It's here! Your new message! Get new email alerts with the free Yahoo! Toolbar. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Start ups
Thanks Liz, But I checked there already. I don't see anything of the kind listed as a product. i may give Optelec a call. Jim Liz Klawitter [EMAIL PROTECTED] wrote: Jim, You can probably get Mary Warren's kits through www.visabilities.com. Liz -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Orli Weisser-Pike Sent: Wednesday, February 28, 2007 6:02 AM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups I did not get any kits; I think some of the non-optical stuff is not very useful and a waste of money. I don't have everything, but I have a small selection of stand mags (Eschenbach system vario); 5x, 7x, 9x, 11x coil pocket mags; clip-on lenses from Eschenbach; a CCTV donated by a Lions club; a TV screen mag donated by a patient; 2x chest mag; prismatic readers; other high-add readers (Eschenbach Noves); and various and sundry other optical devices. I have a large selection of filters (NoIR)--evaluation kit available for free from NoIR; writing guides; lamps and bulbs; big-eye lamp; reading stands; binocular telescopes, monocular, etc. I have never inventoried my little cubicle but I have enough to go through. I have lots of wide black bookmarks too, and of course, reading workbooks (LUVreading and Pre-reading and writing ex). The principles of using devices are more important than the exact device--I think of it like driving a car--one needs the basic skills of navigation, orientation, alignment, steering, etc Does not matter what make or model the car is. Consider LSS--good merchants. You need to buy directly from Eschenbach--the rep will explain how you can do this. Good luck Orli -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jenny Daup Sent: Tuesday, February 27, 2007 11:15 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups Look for a number on lowvision.com then call for a catalog. They are a sister company to optelec and their new catalog has the Mary Warren kit in it. They also have 90 day trial (you can return and get your money back) on their kits...if you are a new customer. Jenny Daup -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Tuesday, February 27, 2007 9:48 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups Thanks for the post Jessica, I checked Optelec's website and couldn't find the info on Mary Warren's kits. I worked with an optometrist once that had attended several of her conferences, so I guess I could try contacting him. Although, I'm not certain whats become of him lately as we had a recent not planned move to a neighboring state. If you could provide further information on these kits it would be appreciated. The program would be part of a hospital outpatient center. I have seen patient's for low vision services in the past, but only in a SNF and home health background. Never had the need for much equipment, but doing this in outpatient is a different story. Jim Jessica R. Gross wrote: A low vision program could be costly depending on what supplies you have access to. I share a wall with 2 OD's and we share everything!! The clinic has 2 CCTV's, a reader, filters, all sorts of specs and magnifiers, and all the ADL equipment. Mary Warren has 2 kits with devices, which are available from Optelec (not sure the cost). Would your program be connected to a hospital/health care system? Would you see clients in their homes? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Sunday, February 25, 2007 7:08 PM To: otlist@otnow.com Subject: [OTlist] Start ups Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your
Re: [OTlist] Start ups
Thank you Orli! Orli Weisser-Pike [EMAIL PROTECTED] wrote: I did not get any kits; I think some of the non-optical stuff is not very useful and a waste of money. I don't have everything, but I have a small selection of stand mags (Eschenbach system vario); 5x, 7x, 9x, 11x coil pocket mags; clip-on lenses from Eschenbach; a CCTV donated by a Lions club; a TV screen mag donated by a patient; 2x chest mag; prismatic readers; other high-add readers (Eschenbach Noves); and various and sundry other optical devices. I have a large selection of filters (NoIR)--evaluation kit available for free from NoIR; writing guides; lamps and bulbs; big-eye lamp; reading stands; binocular telescopes, monocular, etc. I have never inventoried my little cubicle but I have enough to go through. I have lots of wide black bookmarks too, and of course, reading workbooks (LUVreading and Pre-reading and writing ex). The principles of using devices are more important than the exact device--I think of it like driving a car--one needs the basic skills of navigation, orientation, alignment, steering, etc Does not matter what make or model the car is. Consider LSS--good merchants. You need to buy directly from Eschenbach--the rep will explain how you can do this. Good luck Orli -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jenny Daup Sent: Tuesday, February 27, 2007 11:15 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups Look for a number on lowvision.com then call for a catalog. They are a sister company to optelec and their new catalog has the Mary Warren kit in it. They also have 90 day trial (you can return and get your money back) on their kits...if you are a new customer. Jenny Daup -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Tuesday, February 27, 2007 9:48 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups Thanks for the post Jessica, I checked Optelec's website and couldn't find the info on Mary Warren's kits. I worked with an optometrist once that had attended several of her conferences, so I guess I could try contacting him. Although, I'm not certain whats become of him lately as we had a recent not planned move to a neighboring state. If you could provide further information on these kits it would be appreciated. The program would be part of a hospital outpatient center. I have seen patient's for low vision services in the past, but only in a SNF and home health background. Never had the need for much equipment, but doing this in outpatient is a different story. Jim Jessica R. Gross wrote: A low vision program could be costly depending on what supplies you have access to. I share a wall with 2 OD's and we share everything!! The clinic has 2 CCTV's, a reader, filters, all sorts of specs and magnifiers, and all the ADL equipment. Mary Warren has 2 kits with devices, which are available from Optelec (not sure the cost). Would your program be connected to a hospital/health care system? Would you see clients in their homes? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Sunday, February 25, 2007 7:08 PM To: otlist@otnow.com Subject: [OTlist] Start ups Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - We won't tell. Get more on shows you hate to love (and love to hate): Yahoo! TV's Guilty Pleasures list. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Start ups
I will do that...Thanks Jenny. Jenny Daup [EMAIL PROTECTED] wrote: Look for a number on lowvision.com then call for a catalog. They are a sister company to optelec and their new catalog has the Mary Warren kit in it. They also have 90 day trial (you can return and get your money back) on their kits...if you are a new customer. Jenny Daup -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Tuesday, February 27, 2007 9:48 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Start ups Thanks for the post Jessica, I checked Optelec's website and couldn't find the info on Mary Warren's kits. I worked with an optometrist once that had attended several of her conferences, so I guess I could try contacting him. Although, I'm not certain whats become of him lately as we had a recent not planned move to a neighboring state. If you could provide further information on these kits it would be appreciated. The program would be part of a hospital outpatient center. I have seen patient's for low vision services in the past, but only in a SNF and home health background. Never had the need for much equipment, but doing this in outpatient is a different story. Jim Jessica R. Gross wrote: A low vision program could be costly depending on what supplies you have access to. I share a wall with 2 OD's and we share everything!! The clinic has 2 CCTV's, a reader, filters, all sorts of specs and magnifiers, and all the ADL equipment. Mary Warren has 2 kits with devices, which are available from Optelec (not sure the cost). Would your program be connected to a hospital/health care system? Would you see clients in their homes? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Sunday, February 25, 2007 7:08 PM To: otlist@otnow.com Subject: [OTlist] Start ups Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - We won't tell. Get more on shows you hate to love (and love to hate): Yahoo! TV's Guilty Pleasures list. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - The fish are biting. Get more visitors on your site using Yahoo! Search Marketing. - 8:00? 8:25? 8:40? Find a flick in no time with theYahoo! Search movie showtime shortcut. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Start ups
Thanks for the post Jessica, I checked Optelec's website and couldn't find the info on Mary Warren's kits. I worked with an optometrist once that had attended several of her conferences, so I guess I could try contacting him. Although, I'm not certain whats become of him lately as we had a recent not planned move to a neighboring state. If you could provide further information on these kits it would be appreciated. The program would be part of a hospital outpatient center. I have seen patient's for low vision services in the past, but only in a SNF and home health background. Never had the need for much equipment, but doing this in outpatient is a different story. Jim Jessica R. Gross [EMAIL PROTECTED] wrote: A low vision program could be costly depending on what supplies you have access to. I share a wall with 2 OD's and we share everything!! The clinic has 2 CCTV's, a reader, filters, all sorts of specs and magnifiers, and all the ADL equipment. Mary Warren has 2 kits with devices, which are available from Optelec (not sure the cost). Would your program be connected to a hospital/health care system? Would you see clients in their homes? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Sunday, February 25, 2007 7:08 PM To: otlist@otnow.com Subject: [OTlist] Start ups Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - We won't tell. Get more on shows you hate to love (and love to hate): Yahoo! TV's Guilty Pleasures list. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] Start ups
Hello everyone, Would anyone on the list be willing to share start up supply lists, etc for: 1. Sensory integration with a geriatric pysch. population? I am specifically interested in a sensory room. What would be your choices on training and/or obtaining the expertise needed to pull this off? 2. An outpatient program for low vision rehabilitation. Any information would be greatly appreciated. Jim Arceneaux - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] paperwork and your mother
Hey Jeanne, You are absolutely right about documenting. I worked for quite some time in majority worker's comp practice and as you probably can guess this is heavily litigated. I believe that you should document each note like it will be dragged into court and you will have to prove what you did was ethical, billable, and based on expected practice. Jimmie JM [EMAIL PROTECTED] wrote: Hi Bill I am an OTR who has worked primarily in SNF and hospital based acute care. No, things haven't changed ( as you are really aware of :) ) Another thing that hasn't changed is some professionals consistent poor quality documentation and/or lack of it. One SNF I worked per diem in, I quit because the COTA (who was the Rehab Manager as well) did not write weekly noted, daily notes unless I rode him verbally. My opinion is if it's not documented, it didn't happen and you shouldn't bill for it. I finally quit when I had the strong feeling ( one I couldn't prove though) that he was billing for treatment that didn't happen. He is now gone though and I am back--- Back to the subject matter thoughI too have seen a number of PT/PTA performing activities that traditionally OT/COTA have performed with patients. I get frustrated when they do tasks sitting when I KNOW the patient can stand because I would have had them up in the OT kitchen area ambulating and preparing simple meals. A group of 8 does not speak to me of quality therapy and hopefully this was the only group for these patients in the week. It is frustrating---makes you wonder what progress your mother could of made had she had good treatment. Not saying she didn't but with the lack of documentation regarding her PT in the facility one would never know... sorry for the mini-rant--some things just drive me NUTS and therapists who don't do their paperwork in timely manner irk me ( I guess because I make it a point to get it done no matter how busy I am) jeanne -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Food fight? Enjoy some healthy debate in the Yahoo! Answers Food Drink QA. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] What can we do?
Hey Joan, Isn't it a wonderful thing how different people interpret what they read or hear. It can make it hard to communicate though. But asking for clarification is a great way to make sure one has heard what they thought they did. I don't believe that anyone on the list participates because they are truly evil and wish to denigrate all who dare to post. More likely, they wish to have dialog on a profession that is confusing even to its practitioners at times. Jimmie Joan Riches [EMAIL PROTECTED] wrote: Well Jimmie you asked for a poke on the nose. Your response below made me wonder if you had actually read my post. I was using an example from 20 years ago as up to now I had not made any contribution to the current UE/LE anecdotes. I can read your response as meant to agree that I did the right thing or, that 'You' implies 'we (the enlightened ones)' However on first reading the 'don't worry about the idiots' felt patronising to me. It only lasted for a second because I know you from the list and I really appreciate that you acknowledge other members posts. I wonder if you feel you know me. Your response doesn't give me any sense of that and feels like being addressed as a newbie. How very dangerous this written communication can be! So - civility in posts is important so is monitoring our emotional responses - looking for alternate meanings - asking for clarification. This can generate a defensive response so maybe it is only safe to do with Jimmie who has given permission. Blessings to all - keep the passion alive, Joan Jimmie's response Joan, You just keep doing what your patient needs and don't worry about the kinds of idiots that chastised you. Jimmie Quote from my post Well, hey it was my first client in that placement, my first experience in acute care - anyway I was 50 years old at that point and the person who told me off was 20 years younger and didn't make any sense so I didn't pay much attention. I have never since been in a rehab situation where that would have been said to me. Lucky or what? Joan ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Want to start your own business? Learn how on Yahoo! Small Business. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] OTR who felt derided on the otlist
Hi B, Well, as I wrote before, beach or balloon volleyball cannot be claimed by OT. PTs do claim functional activity as within their realm. Again, let me clarify, I am not deriding the use of balloon volleyball. I'm just saying that playing balloon volleyball is not what differentiates OT from PT. On a different note, as someone previously mentioned, that group was inappropriate. An 8:1 ratio is too high and this is defintely in violation of SNF regulations which, correct me if I'm wrong, is 4:1. It is a shame that there is so much variability in the quality of rehab one can expect to get from one facility or provider to another. This is most probably why the rehab. professions are such a hard sell to payors. Sincerely and forever giving permission to tell me if I offend, Jimmie Charles Sullivan [EMAIL PROTECTED] wrote: Hi All: My Mother went into the ER with a urinary infection and dehydration, she was admitted into the hospital for about a week. This episode really weakened her. The hospital PT felt (and I felt) she needed to go into a SNF for a brief stay for her to get PT and OT daily, as she is in the later stages of Parkinson's. If I had taken her home at that point she would only receive PT 1x a wk/ 6 wks. My goal was to at least getting her back to where she was prior to being in the hospital. She came home yesterday where she was Mod/Max Asst. standing/ambulation with rolling walker 50' -75'. I discussed with the OTR a home UE program in which I will continue and her Medicare/Ins will pay for PT to come to her home 1x a wk/ 6 wks. To get back to why I'm telling you all this is because I walked in on one of her daily therapy sessions on Wed. and there were a group of about eight pt's sitting in their w/c in a circle playing beachball catch (no one standing)...with a PTA. I thought it was OT group session. I mention this only because of the previous OTR who felt derided on the otlist that she uses this therapy with her pt's. I just wanted her to know that PT must be billing for this type therapy too (some how) Also I was surprised at her D/C yesterday when I asked the nurse to look at her PT progress notes and D/C note, (because no one from the PT dept. showed up at her care meeting on Wed. for her DC yesterday. only the OTR and social worker) there was only a copy of her original Eval upon her admit. I wanted to read up on her improvement etc. over her stay. The nurse knew I was a COTA. I asked her her where the DC note or any other daily notes were and she said They don't do that there..I was shocked. So I went downstairs to the Therapy Dept to personally talk to the PT about my Mother. Have things changed?? Everywhere I have ever worked I have had to put my daily and weekly progress notes in the patients medical records that day as required. My pt's original hard copy were always kept in therapy dept. for the billing. Just wanted to share this. Thanks, B Sullivan, COTA/L balloon volleyball has been derided on the list. I always bit my tongue and didn't respond because I am one of those OTs that plays balloon volleyball, and balloon badminton (whether or not we use racquets depends on the size of the group). I never spoke up because I didn't want to come under attack, but I have to say I have found it to be great therapy for my back patients in the chronic pain clinic I work in. I work with a lot of worker's comp patients who have back injuries and can't stand for more than 5-10 minutes. Guess what? I get them involved in a spirited game and before they know it, they have been on their feet for 30-45 minutes without even thinking about their pain! They love it, and it is a wonderful activity for increasing standing tolerance. I have never used Punching balloons. But considering that they don't pop easily and they are large and move slowly, and are good for patients that use canes. I will start use them for appropriate pt's. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Any questions? Get answers on any topic at Yahoo! Answers. Try it now. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn
Re: [OTlist] balloon volleyball
I think I'm going to be apologizing for balloon thing for some time now. Balloon volleyball is not a sin. Neither is doing exercise. Neither is doing NDT. Neither is doing a craft. On the other hand, they are not always an occupation either (before I get the post, notice I wrote not always). The use of balloon vollyeball is fine, but, as an occupational therapist, your interventions hopefully will be a process of addressing occupational performance. In the case of Erika's post, she is improving their affect by using a sensorimotor activity (balloon volleyball). Affect is a part of ones ability to socially participate and thus a component of the ability to complete an occupation. Bravo! Jimmie [EMAIL PROTECTED] wrote: And another thing about balloon volleyball. . . I do it with the acute psych patients where I work in a group I lead called movement and body awareness. Patients with the most flattest of affect, patients with the worst of depression, patients who would otherwise be sedentary, lying in their bed are reaching, bending, moving, increasing reaction time, using eye-hand coordination, smiling, laughing, interacting. Now these things may not carry over too far, but at least somehow and in some way, they were psychologically given a break from all of the negative thoughts, behaviors, etc. Yes, I get annoyed when certain staff members joke around and make some uneducated comment such as, Oh, Erika, are you here to do the balloon games? It is my job to educate and to explain why I do what I do. The thing that matters most, though, is that most patients appreciate what the group had to offer. (which isn't just balloon volleyball, by the way). Their mood has been lifted, they do n't feel as sluggish, they think better. So everyone's who's reading this, don't knock the balloons until you've tried them. I was scared to use them also in the beginning, because I thought patients might feel infantalized (sp?) or that it would not receive a warm reception, but it turns out to be the BEST part of the group. A, now I feel better! Erika - Original Message - From: Jim Arceneaux Date: Saturday, January 20, 2007 1:32 am Subject: Re: [OTlist] balloon volleyball To: OTlist@OTnow.com Hey Pat, Sorry if I made it sound like I was making humor at that interventions expense. I didn't mean it that way. I was just clarifying the fact that balloon volleyball and other contrived activities are no more occupational therapy than exercise. That does not imply that these type of activities do not have place in a occupational therapy plan of care. So does exercise at times, but the purpose of occupational therapy engagement in ballon volleyball, NDT, PNF, e-stim, or whatever non-occupation based intervention is to enhance, allow or improve participation in occupation. Pleae don't be frightened to post. It is healthy to have these types of discussion. I applaud you for standing up for what you believe. Balloon volleyball can be an excellent intervention with the right patients. Jimmie Pat wrote: I can't find the postings now, but I know there have been times that balloon volleyball has been derided on the list. I always bit my tongue and didn't respond because I am one of those OTs that plays balloon volleyball, and balloon badminton (whether or not we use racquets depends on the size of the group). I never spoke up because I didn't want to come under attack, but I have to say I have found it to be great therapy for my back patients in the chronic pain clinic I work in. I work with a lot of worker's comp patients who have back injuries and can't stand for more than 5-10 minutes. Guess what? I get them involved in a spirited game and before they know it, they have been on their feet for 30-45 minutes without even thinking about their pain! They love it, and it is a wonderful activity for increasing standing tolerance. Punching balloons are the best. They don't pop easily and they are large and move slowly, which is good for my patients that use canes. Pat -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com *** *** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn *** *** - Never Miss an Email Stay connected with Yahoo! Mail on your mobile. Get started! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com *** *** Enroll in Boston University's post-professional
[OTlist] NJ State employee benefits blocking OT access
Or How about this:
Court: N.J. wrong to deny therapy for autistic children
Home News Tribune Online 01/21/07By MICHAEL RISPOLI
GANNETT STATE BUREAU TRENTON New Jersey was wrong in denying access to
necessary medical therapy for autistic children whose parents are covered under
the State Health Benefits Program, a state appeals court has ruled.
OAS_AD('Right3');
Occupational, speech and physical therapy, viewed as standard treatment for the
one in 166 children nationwide affected by autism spectrum disorders, did not
fall under the program provided by the State Health Benefits Commission, which
said coverage cannot be extended to promote development beyond any level of
function previously demonstrated. In other words, because the boys could not
previously perform the skills taught in these therapies, the program would not
pay for them. A 1999 state law, however, requires coverage parity in medical
insurance, meaning state medical coverage for those affected by biologically
based mental illnesses must be the same for any other covered sickness. The two
rulings Wednesday struck down previous court decisions in finding the
medical-parity act was intended to cover such therapies. Art Ball, director
of government affairs at the Center for Outreach and Services for the Autism
Community, said his organization has fought for this
cause a long time. The Legislature intended that these kids should get
services, and they didn't intend to create systems by which the state would
deny these services, said Ball. The state's Treasury Department, which
oversees the benefits program, is reviewing the ruling and assessing the impact
it will have on the State Health Benefits Program, said treasury spokesman Mark
Perkiss, who added it is too soon to determine if the department will appeal
the ruling. Prior to denying coverage, Horizon, the benefits administrator
for the state program, actually covered one of the child's therapy for 22
months. According to court documents, the commission's decision to exclude this
type of coverage occurred after a rise in such claims had been recognized by
Horizon's medical director. Insurance needs to be based on what people need
and what they are eligible for, not figuring out what you can run your business
on and deny people and get away with it, said Emmett
Ewyer, director of litigation for New Jersey Protection and Advocacy Inc.
E-mail article Print Subscribe 1){ nletter_link =
gcion_sign_up_form_url;}else{ nletter_link =
/apps/pbcs.dll/section?Category=REGISTER01ForceUserreg=1;} } else {
nletter_link = /apps/pbcs.dll/section?Category=REGISTER01ForceUserreg=1; }
document.write('E-Mail Alerts'); //-- E-Mail Alerts
Post a Comment
-
This article does not have any comments associated with it
.topix-head { font-family: Arial, Helvetica, sans-serif;
font-size: 11px; color: #0; padding-top: 10px} .topix-affil {
font-family: Arial, Helvetica, sans-serif; font-size: 10px; color: #00}
0 ) {document.write('
Related news from the Web
Latest headlines by topic:
');for( i = 0; i ' + topixcats[i].name + '
' );}document.write('
Powered by Topix.net'); } //--
Related news from the Web
Latest headlines by topic:
Family
Kids
Autism
Health
Powered by Topix.net
Advertisement
-
SALES OPTICAL - F/T, P/T
SALES (OPTICAL)- F/T, P/T positions avai...
-
SALES SUPPORT
SALES SUPPORT ; Jamesburg A/V service fi...
-
APPLIANCE REPAIR TECHNICIAN - f/t.5 yrs exp
APPLIANCE REPAIR TECHNICIAN - f/t. 5 yrs...
-
C-ARM TECHExcellent working conditions
C-ARM TECH Excellent working conditions ...
-
MEDICAL ASSISTANT- To assist Dr's in a busy medical ofc
MEDICAL ASSISTANT- To assist Dr's in a ...
-
LEGAL - PARALEGAL busy Mon
LEGAL - PARALEGAL busy Mon. Cnty P. I. f...
-
NANNY- FT Want a great Nannie? Call me
NANNY- FT Want a great Nannie? Call me. ...
-
LPN/MEDICAL ASSISTANT- FT/PT
LPN/MEDICAL ASSISTANT- FT/PT. Busy aller...
-
MAINTENANCE TECH For apt
MAINTENANCE TECH For apt. community in E...
-
GUARDS/FLAGGERS F/T Day work
GUARDS/ FLAGGERS F/T Day work. Howell ar...
-
MEDICALTECHNOLOGIST- F/T
MEDICAL TECHNOLOGIST- F/T. Cert. ASCP or...
-
SPEECH LANGUAGE PATHOLOGISTFT/PT
SPEECH LANGUAGE PATHOLOGIST FT/PT
Re: [OTlist] OTlist Digest, Vol 24, Issue 21
I think it would be great too. How about this one: 01/20/2007 An amazing recovery, thanks to love and care North Bergen woman makes remarkable strides after suffering near-fatal aneurysm, strokeBy Jim Hague That fateful August morning in 2003 was going to be like any other day for Barbara Natali. The North Bergen resident was getting ready to resume her career as a successful real estate agent. Tall, gorgeous and ambitious, Natali had earned the distinction of being the top-selling realtor at one of North Hudson's most prestigious real estate firms, after spending 10 years as a fashion designer. She was like my protégé, said Robert DeRuggiero, the president of DeRuggiero Realtors, Inc. of Union City, where Natali worked for over a decade. We worked very close together. Barbara was enthusiastic, energetic and passionate about her work. She was on the verge of doing some great things, destined for great things. Natali was active, having competed in triathlons and swimming every day. She was frequently seen outside the Parker Imperial complex on Boulevard East, where she resided for the last 18 years, walking her golden retriever to nearby North Hudson Braddock Park. At age 41, Natali was happy and healthy, showing no signs of illness whatsoever. Advertisement var ss_loc_off_root=''; '); } //-- But that all changed in the blink of an eye one morning. I woke up that morning with a terrible headache, Natali recalled. I remember ringing the bell for the doorman, Jason, who was downstairs. I told him that I couldn't breathe and to call an ambulance. That's all I can remember. I thought I was going to die. My life changed forever at that point. A massive stroke As it turned out, Natali was suffering a massive brain aneurysm and stroke. The result was Natali lying in a coma for approximately eight months. Most patients do not recover from the extent of the aneurysm and stroke that Natali suffered. It is believed that if Natali did not call the doorman when she did, she would have died without getting proper treatment. The aneurysm itself causes death in 90 percent of similar cases. When Natali finally came out of the coma, she was lying in a hospital bed at Kessler Rehabilitation Hospital in East Orange. What was her first reaction? I was hungry, Natali laughed. However, the prospects did not look good. Doctors anticipated that Barbara would never recover, that she would more than likely remain in a vegetative state for the rest of her life. I had no idea what was going on, Natali said. It was so frustrating. I couldn't do anything. I couldn't speak. I wanted to scream. I wanted to say, 'Why is this happening to me?' I was hoping it was just a terrible nightmare and I would wake up and be fine. But that wasn't the case. Natali was virtually paralyzed and lying in the fetal position for most of the day. She couldn't communicate and needed care 24 hours a day. Natali's parents, Arnold and Pat, who have been divorced for a period of time, instantly became Barbara's daily caregivers. They arranged to have a live-in caregiver, Elizabeth Cicakova, a native of Czechoslovakia, to remain with Barbara after release from the hospital, albeit with practically no hope of recovery. Insurance had stopped paying for anything related to Barbara's care, because insurance claim adjustors saw no improvement in Barbara's condition. Barbara's angel It was pure circumstance one day two years ago that Arnold Natali ran into Carrie Freed, a fellow resident at Parker Imperial. The two just happened to get in the same elevator together. We just randomly met, said Freed, who is a registered occupational therapist and practitioner, specializing in brain injured victims and neuro-developmental treatment. I didn't know Barbara, even though we live in the same building. Our paths never crossed. I just started up a conversation with her father that day. Once I told him what I do, I then told him that maybe there was something I could do to help his daughter. I gave him my card and told him to call me. That was two years ago. Freed has been a major part of Natali's life ever since. I believe it was fate, Natali said. I believe something brought Carrie to me, because she's been my angel. When Freed first met Barbara, the therapist couldn't believe what she was seeing. Barbara wasn't with it, Freed said. She could open her eyes and smile, but she couldn't do much else. I couldn't believe we lived in the same building and we never met before. She couldn't roll over on her own. She just moved her toes a little. But Freed was determined that something could be done to help Barbara, thanks to a method of healing that she specializes in, called the Feldenkrais method. I realized that Barbara was cognitively impaired, Freed said. I knew she couldn't speak. Her life,
Re: [OTlist] balloon volleyball
Hey Pat, Sorry if I made it sound like I was making humor at that interventions expense. I didn't mean it that way. I was just clarifying the fact that balloon volleyball and other contrived activities are no more occupational therapy than exercise. That does not imply that these type of activities do not have place in a occupational therapy plan of care. So does exercise at times, but the purpose of occupational therapy engagement in ballon volleyball, NDT, PNF, e-stim, or whatever non-occupation based intervention is to enhance, allow or improve participation in occupation. Pleae don't be frightened to post. It is healthy to have these types of discussion. I applaud you for standing up for what you believe. Balloon volleyball can be an excellent intervention with the right patients. Jimmie Pat [EMAIL PROTECTED] wrote: I can't find the postings now, but I know there have been times that balloon volleyball has been derided on the list. I always bit my tongue and didn't respond because I am one of those OTs that plays balloon volleyball, and balloon badminton (whether or not we use racquets depends on the size of the group). I never spoke up because I didn't want to come under attack, but I have to say I have found it to be great therapy for my back patients in the chronic pain clinic I work in. I work with a lot of worker's comp patients who have back injuries and can't stand for more than 5-10 minutes. Guess what? I get them involved in a spirited game and before they know it, they have been on their feet for 30-45 minutes without even thinking about their pain! They love it, and it is a wonderful activity for increasing standing tolerance. Punching balloons are the best. They don't pop easily and they are large and move slowly, which is good for my patients that use canes. Pat -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Never Miss an Email Stay connected with Yahoo! Mail on your mobile. Get started! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Revisiting some old articles for a an updated perspective
Terranne, I believe Ron has attachments turned off. Would you be able to send your work in another format (i.e. cut and paste)? Jimmie Terrianne Jones [EMAIL PROTECTED] wrote: Hello all, In light of the discussions re: UE/LE, exercise, acute care, etc., I'd like to share with you something I wrote for an OT doctoral course recently. It was an argument for the use of an occupation centered approach. The literauture to support that arguement is mostly old, but still highly relevant today, written by some pretty amazing, visionary OT's. Here it is, attached. -Terrianne - Access over 1 million songs - Yahoo! Music Unlimited.-- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Expecting? Get great news right away with email Auto-Check. Try the Yahoo! Mail Beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Acute Care OT?
Terrianne, Home care can be such a rewarding venue to work. It is a wonder that OT doesn't get more respect as part of the home care team. It all stems, at least I think, from the not being a qualifier thing. Jimmie Terrianne Jones [EMAIL PROTECTED] wrote: Jimmie, you make some very good points about the use of exercise in the bigger picture of OT practice. If only most OT's actually practiced as you described, there would be no problem. Unfortunately, in my experience--I currently work in home care and SNF's trans care-rote exercise is the rule rather than the exception. OTR's are routinely observed in my SNF setting to be sitting with clients going through graded exercise programs day after day, for almost all of the clients therapy minutes. In fact, it got so bad last year that the rehab director, a PT (!), had to put up signs in the therapy area reminding the OT's that they must adress functional goals related to self care--apparently an audit of this facility revelaed that OT was using the therapeutic exercise code nearly to the exclusion of the other codes. This company is loaded with new grads who don't know any other way to practice. I theorize that many therapists do not really posess a good understanding of occupation and the theoretical underpinnings of our profession, so out of professional insecurity they grab onto things that look legitimate so they don't have to try to explain something they don't understand. I personally refuse to write goals related to exercises, though it is standard in both of my practice settings that OT writes a goal for upper extremity home exercise programs regardless of the clients situation. I write many home programs which focus on increasing engagement in occupation, and I find that in home care anyway, my clients are pretty motivated to participate, because the programs are created to support the occuaptions they value. Terrianne Jim Arceneaux wrote: One caveat though: Please don't get stuck in the ADL/function thing as well. OTs are too often identified as the ADL guys. This places us, in the eyes of non-rehab. disciplines, as glorified aides. Plus, the PT practice framework, or whatever they call it, states that PT's address ADL and function. OT is more complex than ADL or function. Also, in the rants, as people called them, several individuals mentioned OTs need to stop doing exercise. I argue that exercise is no worse than doing mindless activities like bouncing around a balloon or digging pennies out of therapy putty. Neither is truly OT. But, we must understand that OT practice must utilize occupation as its treatment medium of choice while also employing other learned techniques to facilitate return to the patient's desired occupation. It is not a sin against the OT gods to do an exercise, but it is also not OT if your primary focus is exercise. If you had a patient that couldn't put his sock on because of hip capsular tightness following an ORIF (that had the potential to do this without a sock aid) would you run to the PT to ask them to improve the range for you so you can meet your goal. I hope not! It would be best to find a way through participation in an occupational task to improve this range, but if necessary why can't you provide service to meet an establihed OT goal. AS Chuck stated, there is nothing in my practice act that says I can't and the practice framework from AOTA supports the addressing of client factors (i.e. ROM) in meeting occupational goals. I'm not certain why so often fellow OTs will look at another OT performing an exercise as something akin to a PT, but state another OT is a fine example while watching them play balloon volleyball as I mentioned above. You also don't here OTs often stating that NDT is not OT. Well, really it isn't, but it can be utilized by an OT to facilitate participaton in occupation. The NDT is no different than an exercise. Another rant...Wow! Jimmie Chris Smith wrote: bHalleujah--so many PT wannabees in the field. I have only worked in one LTC facility out of five that addressed Adls in an appropriate manner and by only one of the COTA not the other two. Where I am now the OT who does the majority of the evals and writes an obligatory ADL goal rarely addresses them herself. I do home health for a company owned by the LTC facility and work both in house and in HH. After I complained to the rehab director (a PTA of course) that by pts coming out of the facility couldn't do ADLS she told everyone they had to do one adl run through before DCing--what an attitude. If all we ever bill is 97110 why do they need us? They can just hire PTs. Sorry for the rant. Chris ___ Join Excite! - http://www.excite.com The most personalized portal on the Web! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Acute Care OT?
One caveat though: Please don't get stuck in the ADL/function thing as well. OTs are too often identified as the ADL guys. This places us, in the eyes of non-rehab. disciplines, as glorified aides. Plus, the PT practice framework, or whatever they call it, states that PT's address ADL and function. OT is more complex than ADL or function. Also, in the rants, as people called them, several individuals mentioned OTs need to stop doing exercise. I argue that exercise is no worse than doing mindless activities like bouncing around a balloon or digging pennies out of therapy putty. Neither is truly OT. But, we must understand that OT practice must utilize occupation as its treatment medium of choice while also employing other learned techniques to facilitate return to the patient's desired occupation. It is not a sin against the OT gods to do an exercise, but it is also not OT if your primary focus is exercise. If you had a patient that couldn't put his sock on because of hip capsular tightness following an ORIF (that had the potential to do this without a sock aid) would you run to the PT to ask them to improve the range for you so you can meet your goal. I hope not! It would be best to find a way through participation in an occupational task to improve this range, but if necessary why can't you provide service to meet an establihed OT goal. AS Chuck stated, there is nothing in my practice act that says I can't and the practice framework from AOTA supports the addressing of client factors (i.e. ROM) in meeting occupational goals. I'm not certain why so often fellow OTs will look at another OT performing an exercise as something akin to a PT, but state another OT is a fine example while watching them play balloon volleyball as I mentioned above. You also don't here OTs often stating that NDT is not OT. Well, really it isn't, but it can be utilized by an OT to facilitate participaton in occupation. The NDT is no different than an exercise. Another rant...Wow! Jimmie Chris Smith [EMAIL PROTECTED] wrote: bHalleujah--so many PT wannabees in the field. I have only worked in one LTC facility out of five that addressed Adls in an appropriate manner and by only one of the COTA not the other two. Where I am now the OT who does the majority of the evals and writes an obligatory ADL goal rarely addresses them herself. I do home health for a company owned by the LTC facility and work both in house and in HH. After I complained to the rehab director (a PTA of course) that by pts coming out of the facility couldn't do ADLS she told everyone they had to do one adl run through before DCing--what an attitude. If all we ever bill is 97110 why do they need us? They can just hire PTs. Sorry for the rant. Chris ___ Join Excite! - http://www.excite.com The most personalized portal on the Web! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Everyone is raving about the all-new Yahoo! Mail beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] knot tying
Thanks Veronica, But now I feel kind of dull for tying my shoes the same old way all the time. Jimmie Veronica [EMAIL PROTECTED] wrote: A useful link for learning knots and how to tie shoelaces is: www.fieggen.com/shoelace Regards, Veronica - Original Message From: Jim Arceneaux To: OTlist Sent: Wednesday, 10 January, 2007 2:59:40 AM Subject: [OTlist] knot tying Hello everyone, I just recently finished considerable research on knot tying as part of a treatment plan for a gentleman I am seeing post CVA. He is a rancher and we are beginning to work on return to his prior work duties by doing some light building and tying hitches. The subject seemed very dry at first, but tended to gain a life of its own over time. The complexity of some of these knots is amazing. A true challenge to the fine coordination and perceptually impaired person that I am. Some of the links I found helpful are below if anyone is interested. http://www.tollesburysc.co.uk/Knots/Knots_gallery.htm http://www.iland.net/~jbritton/ I really like this one http://www.realknots.com/knots/index.htm Jimmie __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** Send instant messages to your online friends http://uk.messenger.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] knot tying
Your welcome...I'm glad I don't have to analyze some of those knots...God bless your students. Jimmie Naomi Gil [EMAIL PROTECTED] wrote: Dear Jimmie Thank you for this wonderful idea!!! It's especially good to have a new idea for an activity that can appeal to and challenge both women and men. Also - I teach activity analysis in the OT school in Jerusalem - Israel and think that some of these ties could be an excellant activity to analyze. Thanks again Naomi Gil - Original Message - From: Jim Arceneaux To: OTlist Sent: Wednesday, January 10, 2007 4:59 AM Subject: [OTlist] knot tying Hello everyone, I just recently finished considerable research on knot tying as part of a treatment plan for a gentleman I am seeing post CVA. He is a rancher and we are beginning to work on return to his prior work duties by doing some light building and tying hitches. The subject seemed very dry at first, but tended to gain a life of its own over time. The complexity of some of these knots is amazing. A true challenge to the fine coordination and perceptually impaired person that I am. Some of the links I found helpful are below if anyone is interested. http://www.tollesburysc.co.uk/Knots/Knots_gallery.htm http://www.iland.net/~jbritton/ I really like this one http://www.realknots.com/knots/index.htm Jimmie __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Acute Care OT?
What I have found most upsetting when I have covered prn in acute hospitals is when you talk with the other non-rehab disciplines and they express their idea of what is OT. Generally you here things like, Oh your the OT? Man I'm glad to see you. You can get everybody up and bathed for me (i.e. OT the nursing aide.) O comments like, he is here to do your arm exercises (i.e. OT the PT.) I try to explain to them and then go off and do my own thing. I don't care if the manager sets guidelines like the OT = UE thing. I'll damn well do what I think is best for the patient. Jimmie R. Eren Can [EMAIL PROTECTED] wrote: Ron, I see your reason for frustration- I would think that the person interviewing you somehow has magical powers because how can you work on bathing without getting the person up? I know I know, they will say, in the bed!!! that is insane as when is the last time someone went home from Acute care and decided they will just shower in their beds for the rest of their life (oh and lets add that they are 50) :) I have run into this and usually this is due to (or in part) a strong P.T. manager who insists these things- but this is where we need to stand strong, because these are great complimentary skills but they cannot exist without each other by sheer definition (bathing and getting to the bathroom, or eating and getting and making the ingrediants) So the answer? well since you were interviewing, I say, shake your head yes and then get in there and straighten things out for the OT's who are working during the week and not quite standing as proud as they maybe should! Ryan Can, OTR.L E-bird Therapies Stowe, Vermont From: Ron Carson Reply-To: OTlist@OTnow.com To: OTlist@OTnow.com Subject: [OTlist] Acute Care OT? Date: Wed, 10 Jan 2007 13:11:49 -0500 I went on a PRN OT interview the other day. The position was for acute care weekend coverage. The person interviewing me worked in both outpatient and inpatient care. The OT duties for the acute care setting were explained something like this. We don't get people out of bed or work on mobility issues because this is what PT does. Basically what we do is address self-care issues such as dressing, bathing, etc. The is situation is both frustrating and confusing. Of course, I understand not wanting to duplicate services, but should OT be the profession getting people out of bed?? And, to continue with my rant about OT and UE, the outpatient side of the facility basically did UE rehab. If anyone on this list has acute care OT experience I would love to hear from you. And of course, other's opinion (including spouses :-)) are also welcome!! Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** _ The MSN Entertainment Guide to Golden Globes is here. Get all the scoop. http://tv.msn.com/tv/globes2007/?icid=nctagline2 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] OTs place in the system
Thats a good question Ron. The regs certainly don't truly mention our services. If you look closely the OT regs are identical to the PT regs. Its a shame we have to creatively document to obtain coverage for what they state is a covered service. Basically if you don't document mostly with references to activities; motor/cognitive components and what has been termed client factors you may have difficulty with a focused review. Jimmie Ron Carson [EMAIL PROTECTED] wrote: Hello All: Glad to see some messages!!! The below messages bring up a question that I've always pondered. Does Medicare pay for WHAT we do (i.e CPT codes)or WHY we do them (i.e. goals)? Ron - Original Message - From: Jim Arceneaux Sent: Sunday, January 07, 2007 To: OTlist@OTnow.com Subj: [OTlist] OTs place in the system JA Hi Gina, JA I am familiar with what you are describing in an inpatient JA rehab. setting. I would like to comment on one part of your JA message in particular. We have discussed insurance not paying for JA leisure before. This is true in a sense, but speaking as someone JA that has reviewed Medicare claims for documentation of medical JA necessity, it does not tell the whole story. If an OT writes in JA their note that today the patient was engaged in Bingo, yes the JA claim will be denied (if reviewed). The key is to document what JA you were working on specifically. What performance components (to JA use practice framework terminology) were you addressing. In the JA same scenario above if you stated you provided a therapeutic JA activity with lets say visual cues for scanning strategies in a JA patient with left neglect, magically you would be paid. The truth JA is that the bingo isn't the skilled (or payable) service. Its JA what an OT does to manipulate the activity (grading, etc.) that is JA skilled. It is not JA unethical to document in the manner above as it is truthful JA to what was done. OT does not just play bingo with patients. We JA don't go paly golf or help a patient play golf. We do however JA remediate a patient's ability to engage in activities they enjoy. JA Jimmie JA [EMAIL PROTECTED] wrote: JA Hello All, JA After reading many of the posts on OTs purpose and function. I noticed JA some things were not mentioned. One being that in most Reahb hospitals OT JA is slotted to provide 1.5 hours per day and for many pateints functional JA issues can be addressed more quickly and effieciently and then that leaves JA a lot of itme available that has to be filled in. For example, after a JA couple of OT sessions to address dressing equipment, home management, JA bathing issues, etc, hip knee patients need an OT less than they get in JA Rehab. I think that new students then come away with this idea of OT doing JA exercise because they have to fill in that time. JA Also don't forget insurance payors. You start documenting working on JA leisure skills and they begin to balk. I find that if I really focus on JA functional issues (and yes I do actually work on leisures skills in JA conjuction with my treatment for daily living skills) many times I can be JA out quickly, needing very few treatments or many patients don't want to JA worry about those issues, preferring to have family cook, etc. So I JA believe it is a complex problem. I work in home health and do (in home) JA outpatient OT services and am able to just see patients to address their JA needs and get out without having to make up things to work on as happens JA in Rehab SNF frequently. I have done some PRN work in SNF lately and JA they did not like my style of treatment as many times after a certain JA period and goals were met I would try to decrease minutes for the week JA instead of doing UE exercise to fill in the time. So I do agree that the JA issue often is about money but it is also about OTs retaining a certain JA level of hours (workload) either for payments from insurance or to keep JA their of income at a certain level or lack of patient interest in JA addressing Daily Living Skills. JA Out of my home health caseload, I would estimate that about only 25% of my JA referrals have daily living needs that I can address (or clients want JA addressed). Frequently one to five visits may take care of any area that JA need to be addressed. So my caseload is composed of a few clients who I JA see twice weekly for 9-12 weeks and most who I see one to five visits. JA While PT can go in and do exercises, etc 3X weekly for 4-9 weeksfor most JA of their patients. OT generally doesn't need to see as many patients for JA that length of time. I think sometimes we think quantity more than JA quality. While I do see many patients who need OT not getting it, I also JA see patients getting OT services not needed (by that I mean they aren't JA addressing Daily Living Skills). That means an OTs role may be smaller in JA quantity compared to other disciplines (but no less important) and many JA OTs (or facilities) want more
Re: [OTlist] COPM and Medicare
I believe they leave room for just about anything under the section, Other measurable progress towards identified goals for functioning in the home environment at the conclusion of this therapy episode of care. Jimmie Ron Carson [EMAIL PROTECTED] wrote: Hello All: I posted the following message on AOTA's admin SIS but didn't get any response so I want to try it here: == Medicare recently issued Transmittal 63 regarding the Outpatient Therapy Cap Exceptions Process for Calendar Year (CY) 2007. On page 27, the transmittal addresses documentation requirements for evaluations, re-evaluations and plans of care. In part, the transmittal states: (NOTE: I am piecing together several pieces of the transmittal) Quote The initial evaluation, or the plan of care including an evaluation, should document the necessity for a course of therapy through objective findings and subjective patient self-reporting. Evaluation shall include: º Results of one of the following four measurement instruments are recommended, but not required: National Outcomes Measurement System (NOMS) by the American Speech-Language Hearing Association Patient Inquiry by Focus On Therapeutic Outcomes, Inc. (FOTO) Activity Measure Post Acute Care (AM-PAC) OPTIMAL by Cedaron through the American Physical Therapy Association º If results of one of the four instruments above is not recorded, the record shall contain instead the following information indicated by asterisks... * Documentation required to indicate objective, measurable beneficiary physical function including, e.g., Functional assessment individual item and summary scores (and comparisons to prior assessment scores) from commercially available therapy outcomes instruments other than those listed above; or Functional assessment scores (and comparisons to prior assessment scores) from tests and measurements validated in the professional literature that are appropriate for the condition/function being measured; or Other measurable progress towards identified goals for functioning in the home environment at the conclusion of this therapy episode of care. END QUOTE Now, my question for list members is: In your opinion does the COPM meet the above requirements? I know this is a long confusing e-mail. Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] OTs place in the system
Hi Gina, I am familiar with what you are describing in an inpatient rehab. setting. I would like to comment on one part of your message in particular. We have discussed insurance not paying for leisure before. This is true in a sense, but speaking as someone that has reviewed Medicare claims for documentation of medical necessity, it does not tell the whole story. If an OT writes in their note that today the patient was engaged in Bingo, yes the claim will be denied (if reviewed). The key is to document what you were working on specifically. What performance components (to use practice framework terminology) were you addressing. In the same scenario above if you stated you provided a therapeutic activity with lets say visual cues for scanning strategies in a patient with left neglect, magically you would be paid. The truth is that the bingo isn't the skilled (or payable) service. Its what an OT does to manipulate the activity (grading, etc.) that is skilled. It is not unethical to document in the manner above as it is truthful to what was done. OT does not just play bingo with patients. We don't go paly golf or help a patient play golf. We do however remediate a patient's ability to engage in activities they enjoy. Jimmie [EMAIL PROTECTED] wrote: Hello All, After reading many of the posts on OTs purpose and function. I noticed some things were not mentioned. One being that in most Reahb hospitals OT is slotted to provide 1.5 hours per day and for many pateints functional issues can be addressed more quickly and effieciently and then that leaves a lot of itme available that has to be filled in. For example, after a couple of OT sessions to address dressing equipment, home management, bathing issues, etc, hip knee patients need an OT less than they get in Rehab. I think that new students then come away with this idea of OT doing exercise because they have to fill in that time. Also don't forget insurance payors. You start documenting working on leisure skills and they begin to balk. I find that if I really focus on functional issues (and yes I do actually work on leisures skills in conjuction with my treatment for daily living skills) many times I can be out quickly, needing very few treatments or many patients don't want to worry about those issues, preferring to have family cook, etc. So I believe it is a complex problem. I work in home health and do (in home) outpatient OT services and am able to just see patients to address their needs and get out without having to make up things to work on as happens in Rehab SNF frequently. I have done some PRN work in SNF lately and they did not like my style of treatment as many times after a certain period and goals were met I would try to decrease minutes for the week instead of doing UE exercise to fill in the time. So I do agree that the issue often is about money but it is also about OTs retaining a certain level of hours (workload) either for payments from insurance or to keep their of income at a certain level or lack of patient interest in addressing Daily Living Skills. Out of my home health caseload, I would estimate that about only 25% of my referrals have daily living needs that I can address (or clients want addressed). Frequently one to five visits may take care of any area that need to be addressed. So my caseload is composed of a few clients who I see twice weekly for 9-12 weeks and most who I see one to five visits. While PT can go in and do exercises, etc 3X weekly for 4-9 weeksfor most of their patients. OT generally doesn't need to see as many patients for that length of time. I think sometimes we think quantity more than quality. While I do see many patients who need OT not getting it, I also see patients getting OT services not needed (by that I mean they aren't addressing Daily Living Skills). That means an OTs role may be smaller in quantity compared to other disciplines (but no less important) and many OTs (or facilities) want more time. I realize I am preaching to the choir as most OTs on this lilst understand this or they wouldn't bother to be here. Just my take. Gina Tate -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston
Re: [OTlist] And Yet the Saga Continues
Caryn, You are right - corporate America (at least in America) has defined OT practice and it is not OT. Caryn Carson [EMAIL PROTECTED] wrote: I know... get the names of all the professors at this school and you guys could email them the otnow link (only half joking). I often wonder, not being an OT, only married to one, why is it that this profession is so misunderstood? I would like to tell of an experience with OT of my own. There is a young lady at my church that had an AVM. She is still partially paralyzed in her right side. (Please forgive any medical terminology errors). Anyway, she was doing outpatient rehab, OT and PT. I volunteered to help in rides for her to therapy. I asked her, what exactly is OT doing to help you re-learn how to cook, clean, and take care of you children (she had a 3 month old when this all happened), you know what her reply was? WORKING WITH CONES!! I said, what the heck? Aren't they working with you to help you with your goals of parenting? She said, that is how they are doing it. I asked if it seemed like it was helping and she said she couldn't really answer me. Fast forward 6 + months, she is now doing accupuncture, and outpatient rehab OT/PT. She believes the accupuncture has helped her the most. Anyway, I asked about the current therapy and they are still not working on occupational deficits, only UE exercises. Now realize, she has received therapy from 3 different rehab companies (major therapy corps) and not one of them has worked with her on OT. Of course, Ron has offered his services, but since he doesn't take her insurance, she doesn't have the funds and won't let him do it free. I get so frustrated, I have been so tempted to talk to the OT while I am waiting to pick her up, but I know these cattle companies only want the OT's doing it the way they see as most cost effective. I really feel for you guys and wish there was an easy answer, but with the larger companies running the show, I don't know if it will ever be practiced (as a whole) in the way it was created. Caryn Jim Arceneaux wrote: Sorry for the late response, I have to somewhat disagree that fieldwork sites cause the majority of problems associated with minimalization of OT skills to just UE practice. I know of one OTA school that sends students to my facility with mistaken ideas that batting around a balloon is occupational therapy while condescending the use of an exercise. I beg to differ as neither is truly OT, however the two may be utilized in an occupational therapy plan of care as long as the use of occupation is the focus of treatment. These students also come to our facility with no knowledge of how to perform a LE or trunk goniometrical or muscle testing assessment. This floors me as they are quite versed in testing the UE. Teaching only UE testing sends a message to a young student don't you think. There are more examples and I can think of individual examples from schools from more than one state I have practiced. Jimmie angela jones wrote: Ron, The OT culture of UE domain is far too widespread and we should all be concerned. When the general public primarily describes us as UE therapists there, as you noted, is a large discrepancy between what AOTA presents and what we are seeing and doing as therapists. I wonder how PT's feel about their label as LE therapists. I've never heard them respond when it occurs. On a positive note, I had a great OT moment the other day. A physician came by our gym one morning and asked if the therapists would be available around 8:30 or so. Rresident physicians would be coming in and he would like to bring them to see rehab. To make a long story short (they stayed for 20 to 30 minutes), this physician asked us questions and kept emphasizing what OT does. His explanation centered on purposeful therapeutic activity. He stated that they, as physicians, should consider this and try to remember that their patients are individuals with lives that are very complexyou get the idea. I WAS SO IMPRESSED. My jaw was on the floor and I thanked him for his knowledge and appreciation of OT. Here's the other good note. Students today are being taught OT as it should be and hopefully they (we) will be aware of the difficulty of falling into the old patterns that we see in our profession. The reason I say this about today's students is that the physician I spoke with told me later that his daughter is working on her OT degree. That explains the jaw dropping knowledge he had but it's great to know that his daughter is a an OT advocate and she, along with others will join us in this field and hopefully help move our profession in the right direction. Angie From: Ron Carson Reply-To: OTlist@OTnow.com To: OTlist@OTnow.com Subject: [OTlist] And Yet the Saga Continues Date: Wed, 27 Dec 2006 08:43:32 -0500 Yesterday, while evaluating a new patient in an ALF, I told her that I was an OT
Re: [OTlist] A Funny Thing Happened on Google!
Ron, Thank you for letting us share your article. I have another concern regarding the use of FIMs and other documentation systems that are not occupation based. It is no wonder that we have an identity problem when typical assessments performed by OTs, at least those that I have seen in my 14 years of practice, when these assessments could quite easily be performed by other disciplines as well. Case in point is the FIM. It does not take the skills of an OT to complete the FIM. In fact, a nurse or PT could fill out the FIM quite easily. When I started at the facility I am currently working for, courtesy of hurricane Katrina, the OT outpatient assessment consisted of an identification of problems, associated deficits, a chart of UE only ROM and strength, and goals. The OT psych assessment basically was an interview regarding what the patient considered their strengths, weaknesses, leisure interests, etc. I have successfully introduced the COPM and KELS as standard documentation for the psych department and have developed an OT assessment based on the AOTA practice framework for outpatient. The outpatient assessment has a section in which perfomance and satisfaction ratings can be placed from the COPM. I do not regularly work in inpatient rehab, so thankfully I don't have to often do the FIM. I have made comments, but I don't think this is going to change. Jimmie Ron Carson [EMAIL PROTECTED] wrote: Hello All; Out of shear boredom, I did a Google search for my name. As I was filtering through the pages, I came across a couple hits for messages posted on this forum, which is always exciting. But on about page 5 or 6, I discovered a link for an article that I had written for the Canadian Assoc. of OT's newsletter. It just so happens that the newsletter is named OTnow!, no relation to this e-mail list or website. So, here's the link: http://www.caot.ca/otnow/may99-eng/may99-client.cfm The article is titled: Client-centered Practice in an American Acute Care Rehabilitation Hospital: A Case Study. Reading the article brought back lots of memories. It's hard to believe that I've been an OT for almost 10 years. My, time flys!! Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] And Yet the Saga Continutes
Bravo Orli! Orli Weisser-Pike [EMAIL PROTECTED] wrote: Unfortunately, I have to agree that I see the same thing in our profession. I find myself working with very client-centered occupation-focused OTs--typically the ones who have been working 25 years; alongside newer OTs who are wannabe PTs of the upper extremity. In fact, one colleague in particular stands out. Her patient had a stroke several years ago, and can take care of most of the basics--dressing, toileting, reading, etc. However, every time he has come in in the past several weeks, the OT (my co-worker) comments on how long his nails are; he virtually begs her to cut them; and she proceeds as usual to inform him that she cannot cut his nails--and then stretches his shoulder for the rest of the session. It never ceases to amaze me that nail care has never been addressed in therapy--EVER. Having said that; I also believe in showing the way and leading by example. It irks me to see OTs who spend most of the time with their hemiplegic patients lying on their backs at least 75% of the hour while having their shoulders stretched and ranged. Oh well, bitch bitch bitch, hi--sorry about that. Ron I am joining your collective BITCH about our profession. For the New Year, I will resolve to talk only POSITIVELY about us amazing OT professionals! Happy New Year. From: [EMAIL PROTECTED] on behalf of Ron Carson Sent: Wed 12/27/2006 7:43 AM To: OTlist@OTnow.com Subject: [OTlist] And Yet the Saga Continutes Yesterday, while evaluating a new patient in an ALF, I told her that I was an OT, not a PT. This patient, who was recently d/c from a hospital, says: Oh, I had OT in the hospital. When asked what they did the patient began doing the OT Dance! You know, raising her arms up/down and out to the side (dowel exercises) and moving then in a circular pattern (UE bicycle). I told her that we wouldn't be doing any of that because her arms where not a problem. The patient did say that once a week they baked cookies and that it was fun! As I was leaving the facility, I wanted to clarify with the new director that I was an OT, not PT. You see, I've been providing therapy at this facility for several YEARS. Most orders they receive are for PT. So, I just call the doctor and get it changed to OT or I do a plan of treatment and have the doctor sign it. But, I didn't want the new director thinking I was a PT. As I began explaining to the director, she got a worried look and said Oh. As the conversation progressed, I explained about the whole UE and LE thing and that it's more a matter of convenience and finances than training. She seemed to understand and told me that she thinks of OT as UE and feeding. Finally, in case you ever wonder why I send these messages. It's because there is a cavern of disparity between AOTA official documents about OT and the reality of what is done by practicing OT's. It is my sincere belief that unless this cavern is closed, OT is at risk for failure. Despite our past success as a profession, I don't think such a cavern has existed to the degree that we are seeing today, at least in adult physical dysfunction. So, there you go. And the answer to the question I previously posted is that the director of the rehab hospital said that OT = U and PT = LE. And you know what, they are right! At least as to what is being practiced, not preached!! Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Smart Medicine. Inspired Care. And the awards to prove it. Recognized as a Top 50 Healthcare Network. To learn about other recognition and awards Baptist has earned, visit: http://www.bmhcc.org/aboutus/awards/index.asp This message and any files transmitted with it may contain legally privileged, confidential, or proprietary information. If you are not the intended recipient of this message, you are not permitted to use, copy, or forward it, in whole or in part without the express consent of the sender. Please notify the sender of the error by reply email, disregard the foregoing messages, and delete it immediately. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] And Yet the Saga Continues
Sorry for the late response, I have to somewhat disagree that fieldwork sites cause the majority of problems associated with minimalization of OT skills to just UE practice. I know of one OTA school that sends students to my facility with mistaken ideas that batting around a balloon is occupational therapy while condescending the use of an exercise. I beg to differ as neither is truly OT, however the two may be utilized in an occupational therapy plan of care as long as the use of occupation is the focus of treatment. These students also come to our facility with no knowledge of how to perform a LE or trunk goniometrical or muscle testing assessment. This floors me as they are quite versed in testing the UE. Teaching only UE testing sends a message to a young student don't you think. There are more examples and I can think of individual examples from schools from more than one state I have practiced. Jimmie angela jones [EMAIL PROTECTED] wrote: Ron, The OT culture of UE domain is far too widespread and we should all be concerned. When the general public primarily describes us as UE therapists there, as you noted, is a large discrepancy between what AOTA presents and what we are seeing and doing as therapists. I wonder how PT's feel about their label as LE therapists. I've never heard them respond when it occurs. On a positive note, I had a great OT moment the other day. A physician came by our gym one morning and asked if the therapists would be available around 8:30 or so. Rresident physicians would be coming in and he would like to bring them to see rehab. To make a long story short (they stayed for 20 to 30 minutes), this physician asked us questions and kept emphasizing what OT does. His explanation centered on purposeful therapeutic activity. He stated that they, as physicians, should consider this and try to remember that their patients are individuals with lives that are very complexyou get the idea. I WAS SO IMPRESSED. My jaw was on the floor and I thanked him for his knowledge and appreciation of OT. Here's the other good note. Students today are being taught OT as it should be and hopefully they (we) will be aware of the difficulty of falling into the old patterns that we see in our profession. The reason I say this about today's students is that the physician I spoke with told me later that his daughter is working on her OT degree. That explains the jaw dropping knowledge he had but it's great to know that his daughter is a an OT advocate and she, along with others will join us in this field and hopefully help move our profession in the right direction. Angie From: Ron Carson Reply-To: OTlist@OTnow.com To: OTlist@OTnow.com Subject: [OTlist] And Yet the Saga Continues Date: Wed, 27 Dec 2006 08:43:32 -0500 Yesterday, while evaluating a new patient in an ALF, I told her that I was an OT, not a PT. This patient, who was recently d/c from a hospital, says: Oh, I had OT in the hospital. When asked what they did the patient began doing the OT Dance! You know, raising her arms up/down and out to the side (dowel exercises) and moving then in a circular pattern (UE bicycle). I told her that we wouldn't be doing any of that because her arms where not a problem. The patient did say that once a week they baked cookies and that it was fun! As I was leaving the facility, I wanted to clarify with the new director that I was an OT, not PT. You see, I've been providing therapy at this facility for several YEARS. Most orders they receive are for PT. So, I just call the doctor and get it changed to OT or I do a plan of treatment and have the doctor sign it. But, I didn't want the new director thinking I was a PT. As I began explaining to the director, she got a worried look and said Oh. As the conversation progressed, I explained about the whole UE and LE thing and that it's more a matter of convenience and finances than training. She seemed to understand and told me that she thinks of OT as UE and feeding. Finally, in case you ever wonder why I send these messages. It's because there is a cavern of disparity between AOTA official documents about OT and the reality of what is done by practicing OT's. It is my sincere belief that unless this cavern is closed, OT is at risk for failure. Despite our past success as a profession, I don't think such a cavern has existed to the degree that we are seeing today, at least in adult physical dysfunction. So, there you go. And the answer to the question I previously posted is that the director of the rehab hospital said that OT = U and PT = LE. And you know what, they are right! At least as to what is being practiced, not preached!! Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston
Re: [OTlist] Antedots about OT
Hummm...I'll put a bet on the LE/UE thing. Annoying! Ron Carson [EMAIL PROTECTED] wrote: You guys know that I like sharing my experiences about being an OT. Well, here's another one. I've been working with a patient for 6 weeks because of LE lymphedema. Her husband has been in/out of the hospital for various problems. After his most recent hospitalization, it looks like the husband is going to in-patient rehab. My patient and her family what me to see the husband at home as soon as he's discharged. In preparing for the husband to be transferred to rehab, the family met with the rehab director. They told the director that they wanted me to see the patient at home as soon as he was discharged. As usual, the director balked because I am an OT and two because I don't offer PT. Apparently in the conversation between the director and the family, the topic of PT and OT came up. The director explained to the family the differences between OT and PT. I was going to tell everyone what was said, but maybe it's more fun to hear people guesses. Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Victory on the Cap
No, I sure don't, but isn't it wonerful? Ron Carson [EMAIL PROTECTED] wrote: Jimmie, I thought it was a proposed 5% cut. Either way, I'm thankful. I wonder if there's going to be any increases. Do you know? - Original Message - From: Jim Arceneaux Sent: Monday, December 11, 2006 To: OTlist@OTnow.com Subj: [OTlist] Victory on the Cap JA Unmentioned in the below post is that those of us working in JA sites that bill by cpt codes will now not take a 10% cut. Another JA bit of great news! JA AOTA News Alert wrote: Victory on the Cap JA As one of its final actions before adjourning for the year, JA Congress passed legislation extending the current exceptions JA process on the Medicare outpatient therapy cap. The extension JA lasts until January 1, 2008. JA This victory is the result of a great deal of hard work on JA the part of members and staff of the American Occupational JA Therapy Association (AOTA), and consumers. The cap provision JA was included in H.R. 6111, the Tax Relief and Health Care Act JA of 2006. AOTA staff is currently preparing a full analysis of JA the legislation, which will be available soon. JA Many thanks to all those who worked so hard on this JA important issue. JA AOTA's Federal Affairs Staff JA -- JA Options? JA www.otnow.com/mailman/options/otlist_otnow.com JA Archive? JA www.mail-archive.com/otlist@otnow.com JA ** JA Enroll in Boston University's post-professional Master of JA Science for OTs Online. Gain the skills and credentials to propel JA your career. JA www.otdegree.com/otn JA ** JA - JA Access over 1 million songs - Yahoo! Music Unlimited. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Check out the all-new Yahoo! Mail beta - Fire up a more powerful email and get things done faster. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Victory on the Cap
Unmentioned in the below post is that those of us working in sites that bill by cpt codes will now not take a 10% cut. Another bit of great news! AOTA News Alert [EMAIL PROTECTED] wrote: Victory on the Cap As one of its final actions before adjourning for the year, Congress passed legislation extending the current exceptions process on the Medicare outpatient therapy cap. The extension lasts until January 1, 2008. This victory is the result of a great deal of hard work on the part of members and staff of the American Occupational Therapy Association (AOTA), and consumers. The cap provision was included in H.R. 6111, the Tax Relief and Health Care Act of 2006. AOTA staff is currently preparing a full analysis of the legislation, which will be available soon. Many thanks to all those who worked so hard on this important issue. AOTA's Federal Affairs Staff -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Access over 1 million songs - Yahoo! Music Unlimited. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] Services for clients with visual impairment
OK, picking your brains again: For those out there providing services to visually impaired patients, what would be your list of supplies necessary to provide what you would consider competent OT to this genre of patient in an outpatient setting? The setting in my case would be a rural hospital outpatient department. There are no optometrists specializing in low vision in the area and the nearest Lighthouse for the Blind is about 50 miles away. How would you market? Would you need to go high tech or low tech? I've thought about speaking at the hospital's diabetic education forum. A COTA that works with me is interested in the specialization offered by AOTA. Does anyone know much about that? Jimmie - Access over 1 million songs - Yahoo! Music Unlimited. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] Swallowing
Hello, Is anyone out there working with swallowing patients? It seems to be a dead issue for OT at most sites, but at my work there has been some talk about Vital Stim and the inability for ST to bill for this modality under a Medicare situation. Just curious. Jim - Everyone is raving about the all-new Yahoo! Mail beta. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] OT in the news
Occupational Therapy Helps Those With DementiaBy Ed Edelson HealthDay Reporter THURSDAY, Nov. 16 (HealthDay News) -- Occupational therapy -- training to do simple things around the house -- improved the lives of people with dementia such as Alzheimer's disease, as well as the people who care for them, a Dutch study found. The results of the study, reported in the Nov. 18 British Medical Journal, could help change the attitude of health insurance companies and Medicare about paying for occupational therapy for persons with dementia, one expert said. I like the validation of what I knew instinctively, said Elicia Dunn Cruz, an assistant professor of occupational therapy at the University of Texas Medical Branch, Galveston. Medicare sometimes refuses to pay for such therapy because of a belief that people with dementia don't have a good rehabilitation potential, Cruz said, an attitude also shared by some, but not all, health insurers. I think this article counters that, she said. In the study, researchers at the University Medical Center Nijmegen divided 135 people 65 and older who'd been diagnosed with mild to moderate dementia into two groups. One group received 10 home-based sessions with experienced occupational therapists over five weeks who taught the patients to use various techniques to cope with mental decline. The people looking after them were taught methods of coping as well. Assessments six weeks and three months after the therapy found that 75 percent of the patients who had the training showed an improvement in motor skills, and 82 percent needed less assistance in day-to-day tasks. The same sort of improvement was seen in only 10 percent of those who did not get the training. Nearly half the caretakers who received the training felt more competent to do their duties, compared to a quarter of those who did not. Because outcomes such as improvements in activities of daily living and sense of competence are associated with a decrease in need for assistance, we believe that in the long term, occupational therapy will result in less dependence on social and health-care resources and less need for institutionalization, the researchers wrote. Mary Mittleman, director of the psychosocial research program at New York University's Silberman Aging and Dementia Research Center, said she knew of no previous controlled study on occupational therapy for dementia patients. Mittleman herself just reported a long-term study showing that spouses of Alzheimer's patients are less likely to place their loved ones in a nursing home if the spouses receive enhanced counseling and caregiver support. The study of 406 spouses/caregivers found that those who received sessions of individual and family counseling, access to telephone counseling and participation in a support group delayed placing a loved one in a nursing home by about 18 months, compared to those who did not. As for occupational therapy, Cruz said that training families to use adaptive techniques using familiar objects such as clocks and calendars can help people in the early stages of dementia. It makes Alzheimer's disease less of a death sentence, she said. Families can consult their primary-care physician about a referral to a rehabilitation clinic that provides in-home services, Cruz said: There is a huge home industry, and occupational therapy is very much a part of it. The rub is that if a patient has a diagnosis of dementia that makes it difficult to get coverage. The insurers want to cover only people who are going to get well again. This study may help to change that. SOURCES: Elicia Dunn Cruz, Ph.D., assistant professor of occuptional therapy, University of Texas Medical Branch at Galveston; Mary Mittleman, Ph.D., New York University; Nov. 18, 2006, British Medical Journal Copyright © 2006 ScoutNews LLC. All rights reserved. Occupational Therapy Improves Quality Of Life For Dementia Patients And Their Carers, UK Main Category: Alzheimer's / Dementia News Article Date: 22 Nov 2006 - 10:00am (PST) | email this article | printer friendly | view or write opinions | Article Also Appears In Caregivers / Homecare Useful Article? Digg It Del.icio.us NewsVine Reddit Occupational therapy can help to improve the ability of people with dementia to perform daily activities and can also reduce the pressure on their caregivers, says a BMJ study published today. Dementia can have far reaching effects for patients and their caregivers and is a major driver of costs for both health and social care systems across the developed world. The most significant problems associated with dementia are the losses in independence, initiative and participation in social activities - factors which affect the quality of life for both patients and their caregivers and families. Previous research had
Re: [OTlist] Therapy Cap - Write Your Elected Officals
Thanks for pointing this out. I have already done this several times, but a good reminder is great. Please don't forget the effects generated by the last time the caps were in place without exemption. Jimmie Ron Carson [EMAIL PROTECTED] wrote: Hello All: Please take a few minutes to write your elected officials about extending the therapy cap exception process. Currently, the exception process will expire on December 31, 2006. Unless our officials here from us, they may NOT take action. Time is running out!! AOTA makes this a very easy and quick process. Follow this link: http://capwiz.com/aota/issues/alert/?alertid=8884061type=CO Thanks, Ron -- Ron Carson MHS, OTR/L HOPE Therapy Services www.HopeTherapyServices.com www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Sponsored Link Mortgage rates as low as 4.625% - $150,000 loan for $579 a month. Intro-*Terms -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
Re: [OTlist] Another Question
Beautifully put Joan...Thank you. Ms. Champagne (OT-innovations) is a wealth of knowledge if anyone wishes to sharpen their skills in dementia related behavior managment. Another resource is Dr. Mary Corcoran, OTR/L, PhD at George Washington University. Jimmie Joan Riches [EMAIL PROTECTED] wrote: I think this is the sort of thing Jim is talking about. http://www.changingmindspdx.com/index.htm http://www.ot-innovations.com/ http://www.olinconsulting.com/32.html http://www.allencogadvisor.com/ www.DementiaCareSpecialists.com They all had a passion they could not deny, Ron. What's yours? Joan Riches -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Monday, October 30, 2006 7:50 PM To: OTlist@OTnow.com Subject: Re: [OTlist] Another Question Hey Ron, No problem. Try speaking to the nursing home, not as an OT, but as a consultant regarding for instance behavioral managment strategies for dementia patients. What about laying your cards out on the table. Example: Ask the administator how much therapy utilization he is seeing regarding managment of dementia related behaviors. If the home is typical, he will report very minimal to none. Most nursing home therapies are populated by fresh grads with no idea how to manage dementia patients. Market yourself as a fresh and new way to address the problem. If they have an ironclad contract with the therapy provider, market yourself as utilization review, education, management. This will be harder in part A (homes with skilled nursing units) homes. These homes function under consolidated billing and must be the sole billing agent for all therapy related matters to Medicare. It may be that your area is overpopulated with OT providers willing to contract for OT services. When I was a clinical manager for a home helath agency, we used several providers that billed under company names. Try exploring why you might have a competitive edge over their current OT providers. Home health agencies are all about the bottom line. Research the regs and dazzle them with your understanding of the benefits of high therapy utilization and competent OT services. Ask questions - do they have a problem with overutilization of aide sevices, nursing visits or are their specific case mixes that cause them problems. The trend in home health is to go to a pay for outcomes basis. The majority of the outcomes being considered relate to the OASIS functional questions. These questions are related to basic self care tasks. The other major one will be related to the inpatient admission question. Innovative ideas would be enabling diabetics to self test their glucose levels or teaching a CHF patient how to cook a healthy meal. Let them know you are aware and up to date on this information. If you are not, then research the topic and become an expert. Check with the Florida home health regs. Can an OT supervise a home care aide in Florida? If so, what could you do as a supervisor to reduce overutilization? On another topic, I noticed that someone on the list brought up the topic of vestibular rehab. If you are interested, I could give you the name of a guy that sells equipment for vestibular diagnositic testing. The codes for this type of testing pay really well and are not part of the Stark or Anti Kickback legislation. OTs can be a provider under general supervision (defined as reachable by telephone) of a physician. I had looked into this in reference to opening an IDF and rehab facility at one time. It never went through as the others involved just weren't ready to act on it. Jimmie Ron Carson wrote: Hello Jimmie: Every time I've approached a home health agency, they insist on contracting with me as an individual provider, not my company. In some ways, HH is a competitor so I don't blame them for not wanting to contract with my company. Every nursing home I've approached already has a complement of OT/PT/SLP services. I've yet to find one that is willing to hire an outside OT. I'm not trying to be overly negative about your ideas; I'm just sharing my experience/perceptions. Thanks, Ron - Original Message - From: Jim Arceneaux Sent: Wednesday, October 25, 2006 To: OTlist@OTnow.com Subj: [OTlist] Another Question JA In regards to your question about ways to rejuvinate your JA business: Have you tried contracting with home health agencies to JA provide OT services for them? Key points to discuss witth them: JA Have a thorough knowledge of the payment structure of home care. JA Let them know how aware you are of the benefits a home health JA agency receives from competent OT care. Specifically address how JA OT services can help them to meet the obligations of M0825. This JA is the OASIS question that asks if a patient will meet a high JA therapy utilization or not. It is a major add on to the home care JA agencies bottom
Re: [OTlist] Another Question
Hey Ron, No problem. Try speaking to the nursing home, not as an OT, but as a consultant regarding for instance behavioral managment strategies for dementia patients. What about laying your cards out on the table. Example: Ask the administator how much therapy utilization he is seeing regarding managment of dementia related behaviors. If the home is typical, he will report very minimal to none. Most nursing home therapies are populated by fresh grads with no idea how to manage dementia patients. Market yourself as a fresh and new way to address the problem. If they have an ironclad contract with the therapy provider, market yourself as utilization review, education, management. This will be harder in part A (homes with skilled nursing units) homes. These homes function under consolidated billing and must be the sole billing agent for all therapy related matters to Medicare. It may be that your area is overpopulated with OT providers willing to contract for OT services. When I was a clinical manager for a home helath agency, we used several providers that billed under company names. Try exploring why you might have a competitive edge over their current OT providers. Home health agencies are all about the bottom line. Research the regs and dazzle them with your understanding of the benefits of high therapy utilization and competent OT services. Ask questions - do they have a problem with overutilization of aide sevices, nursing visits or are their specific case mixes that cause them problems. The trend in home health is to go to a pay for outcomes basis. The majority of the outcomes being considered relate to the OASIS functional questions. These questions are related to basic self care tasks. The other major one will be related to the inpatient admission question. Innovative ideas would be enabling diabetics to self test their glucose levels or teaching a CHF patient how to cook a healthy meal. Let them know you are aware and up to date on this information. If you are not, then research the topic and become an expert. Check with the Florida home health regs. Can an OT supervise a home care aide in Florida? If so, what could you do as a supervisor to reduce overutilization? On another topic, I noticed that someone on the list brought up the topic of vestibular rehab. If you are interested, I could give you the name of a guy that sells equipment for vestibular diagnositic testing. The codes for this type of testing pay really well and are not part of the Stark or Anti Kickback legislation. OTs can be a provider under general supervision (defined as reachable by telephone) of a physician. I had looked into this in reference to opening an IDF and rehab facility at one time. It never went through as the others involved just weren't ready to act on it. Jimmie Ron Carson [EMAIL PROTECTED] wrote: Hello Jimmie: Every time I've approached a home health agency, they insist on contracting with me as an individual provider, not my company. In some ways, HH is a competitor so I don't blame them for not wanting to contract with my company. Every nursing home I've approached already has a complement of OT/PT/SLP services. I've yet to find one that is willing to hire an outside OT. I'm not trying to be overly negative about your ideas; I'm just sharing my experience/perceptions. Thanks, Ron - Original Message - From: Jim Arceneaux Sent: Wednesday, October 25, 2006 To: OTlist@OTnow.com Subj: [OTlist] Another Question JA In regards to your question about ways to rejuvinate your JA business: Have you tried contracting with home health agencies to JA provide OT services for them? Key points to discuss witth them: JA Have a thorough knowledge of the payment structure of home care. JA Let them know how aware you are of the benefits a home health JA agency receives from competent OT care. Specifically address how JA OT services can help them to meet the obligations of M0825. This JA is the OASIS question that asks if a patient will meet a high JA therapy utilization or not. It is a major add on to the home care JA agencies bottom line if therapy is indicated at a high utilization JA rate. Let them know how you can help to reduce costs i.e. JA decreasing home care aide visits by making patients more JA independent or by reducing twice a day nursing visits for a JA diabetic that can't self medicate. JA Another idea might be to provide services to nursing homes JA that are having difficulty with behavioral management issues on JA their dementia units. That is an avenue that I am exploring right JA now. It seems that most OTs working in nursing homes are not JA strong at providing interventions for dementia patients. Nursing JA homes, even ones contracted with contracted therapy agencies, in JA my area are requesting training and services to assist them in JA handling behavioral management issues. JA Jimmie JA
Re: [OTlist] Another Question
Ron, You hit the nail on the head. that is exactly why OT is essentially the bottom of the totem pole in the rehab community. Its hard to sell occupation in a world where focus is essentially on somatics. It is far easier to sell OT services to corporate structures which rely on outcome data to show how effective they are (i.e. Inpatient Rehab relies heavilly on OT as it changes key indicators on the FIM and home helath agencies depend on OT to decrease overutilization.) In regards to your question about ways to rejuvinate your business: Have you tried contracting with home health agencies to provide OT services for them? Key points to discuss witth them: Have a thorough knowledge of the payment structure of home care. Let them know how aware you are of the benefits a home health agency receives from competent OT care. Specifically address how OT services can help them to meet the obligations of M0825. This is the OASIS question that asks if a patient will meet a high therapy utilization or not. It is a major add on to the home care agencies bottom line if therapy is indicated at a high utilization rate. Let them know how you can help to reduce costs i.e. decreasing home care aide visits by making patients more independent or by reducing twice a day nursing visits for a diabetic that can't self medicate. Another idea might be to provide services to nursing homes that are having difficulty with behavioral management issues on their dementia units. That is an avenue that I am exploring right now. It seems that most OTs working in nursing homes are not strong at providing interventions for dementia patients. Nursing homes, even ones contracted with contracted therapy agencies, in my area are requesting training and services to assist them in handling behavioral management issues. Jimmie Jimmie earlier posted a question from the website: http://welcome.to/occupationaltherapy.com Here's another interesting question and partial answer from the site: question When a patient is recovering from an injury, what does he question want to do? answer He wants to go back to doing the activities and occupations answer that made his life enjoyable. Is this true? Not in my experience! What I've found is that when a person is is actively recovering from their injury, that's IS what they want to do. They want to recover! In other words, the person wants their pain to decrease, or their body to work better -- that's what they want to get better. In my opinion, a person with an injury is primarily focusing on just that, the injury (or illness). Not that people don't think about getting back to their activities and occupations, but in my experience most people see lost activities and occupations as a by-product of their injury or illness, not as the problem(s) to be addressed. I know that as a profession, we want to believe that people recovering from injury want to get back to doing their activities and occupations but I just don't think that is the way in which our patients generally think. At least not in my experience. If it was the way people think, our profession would be flourishing, both internally and externally. Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ** - Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] OT to broad?
Interesting question: Is the field of OT getting too broad? Why are OTs doing stress reduction seminars, administering psychosocial checklists, leading Baby Me classes, feeding premature ICU neonates, etc? As with all health professions, there is some overlap. For example, nurses, physicians, neurologists, and physician assistants can all take a patient's blood pressure. As OTs with a holistic theory base and clinical background, we are qualified to administer many health care services. Our focus on function and independence provides an additional perspective for assessment and treatment. As OTs, we can also be proud of what I consider two of the profession's most unique and far-reaching contributions: Sensory Integration theory, assessment, and treatment, and Claudia Allen's Cognitive Assessment Levels. from http://welcome.to/occupationaltherapy.com Jim Arceneaux, LOTR - Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. - All-new Yahoo! Mail - Fire up a more powerful email and get things done faster. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **
[OTlist] Exemption extension for therapy caps
Bills are currently in both the House and Senate to extend the exemption process for therapy caps on outpatient therapy. This is important legislation which will undoubtedly affect the job market for occupational therapy services as well as impact the lives and care of our patients. The Senate version was available for printing and I have attached it below. If your Senators are not listed as cosponsors or developers, please write and have them support or cosponsor the bill. Also be sure to write your Representative so that they know your interest in this legislation. Text of Senat version: Securing Effective and Necessary Individual Outpatient Rehabilitation Services (SENIORS) Act of 2006 (Introduced in Senate) S 3912 IS 109th CONGRESS 2d Session S. 3912 To amend title XVIII of the Social Security Act to extend the exceptions process with respect to caps on payments for therapy services under the Medicare program. IN THE SENATE OF THE UNITED STATES September 19, 2006 Mr. ENSIGN (for himself, Mrs. LINCOLN, Ms. COLLINS, Mr. HATCH, and Mr. TALENT) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to extend the exceptions process with respect to caps on payments for therapy services under the Medicare program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the `Securing Effective and Necessary Individual Outpatient Rehabilitation Services (SENIORS) Act of 2006'. SEC. 2. EXTENSION OF EXCEPTIONS PROCESS FOR MEDICARE THERAPY CAPS. Section 1833(g)(5) of the Social Security Act (42 U.S.C. 1395l(g)(5)) is amended by striking `2006' and inserting `the period beginning on January 1, 2006, and ending on December 31, 2007,'. THOMAS Home | Contact | Accessibility | Legal | FirstGov #65529;FPRIVATE TYPE=PICT;ALT= S.3912 Title: A bill to amend title XVIII of the Social Security Act to extend the exceptions process with respect to caps on payments for therapy services under the Medicare program. Sponsor: Sen Ensign, John [NV] (introduced 9/19/2006) Cosponsors (4) Latest Major Action: 9/19/2006 Referred to Senate committee. Status: Read twice and referred to the Committee on Finance. COSPONSORS(4), ALPHABETICAL [followed by Cosponsors withdrawn]: (Sort: by date) Sen Collins, Susan M. [ME] - 9/19/2006 Sen Hatch, Orrin G. [UT] - 9/19/2006 Sen Lincoln, Blanche L. [AR] - 9/19/2006 Sen Talent, Jim [MO] - 9/19/2006 The House version is HR 6132 HR 6132 Jimmie - How low will we go? Check out Yahoo! Messengers low PC-to-Phone call rates. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otnow **
Re: [OTlist] Hello
Hey Ron, Unfortunately this is an outpatient setting, so multidisciplinary means OT, ST and PT. The other problem for this young fellow is poor carryover by his family and caregivers. He also gets a lot of encouragement from peers as they feel his behavior is funny. It does prevent any meaningful level of interaction though. Ron Carson [EMAIL PROTECTED] wrote: Hello Jimmy: I don't have any significant experience with your setting. However, having worked with several patients with similar behavior I think the best approach you can offer is a multi-disciplinary approach to behavior management. Setting up a (+) reinforcement system that is both fair and consistently applied MAY go a long way in helping this man re-establish some self-control. Keep us informed. Ron - Original Message - From: Jim Arceneaux Sent: Sunday, September 10, 2006 To: OTlist@OTnow.com Subj: [OTlist] Hello JA Hey everyone, JA Does anyone have any information to share relative to JA dealing with an individual with occupational performance JA limitations in social participation due to executive function JA dysfunction subsequent to TBI? Basically the young man I'm JA working with has difficulty with social situations due to poor JA impulse control and a tendency to speak his mind (i.e. non JA filtered). JA any help would be great. JA Thanks JA Jim JA Ron Carson wrote: JA Hello Jimmie: JA Welcome back. As you can tell, the list is rather slow. Seems like we JA go for weeks without any discussion and then there's a sudden flurry JA of messages. JA Ron JA - Original Message - JA From: Jim Arceneaux JA Sent: Tuesday, August 08, 2006 JA To: otlist@otnow.com JA Subj: [OTlist] Hello JA Hey Ron, JA Well I'm back. How is the list coming along? I look JA forward to participating in future discussions. JA Jimmie Arceneaux JA - JA Do you Yahoo!? JA Everyone is raving about the all-new Yahoo! Mail Beta. JA -- JA Unsubscribe? JA [EMAIL PROTECTED] JA Change options? JA www.otnow.com/mailman/options/otlist_otnow.com JA Archive? JA www.mail-archive.com/otlist@otnow.com JA Help? JA [EMAIL PROTECTED] JA - JA Do you Yahoo!? JA Everyone is raving about the all-new Yahoo! Mail. Paid Ad-- Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otnow -- Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com - Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otnow **
Re: [OTlist] Hello
Hey everyone, Does anyone have any information to share relative to dealing with an individual with occupational performance limitations in social participation due to executive function dysfunction subsequent to TBI? Basically the young man I'm working with has difficulty with social situations due to poor impulse control and a tendency to speak his mind (i.e. non filtered). any help would be great. Thanks Jim Ron Carson [EMAIL PROTECTED] wrote: Hello Jimmie: Welcome back. As you can tell, the list is rather slow. Seems like we go for weeks without any discussion and then there's a sudden flurry of messages. Ron - Original Message - From: Jim Arceneaux Sent: Tuesday, August 08, 2006 To: otlist@otnow.com Subj: [OTlist] Hello JA Hey Ron, JA Well I'm back. How is the list coming along? I look JA forward to participating in future discussions. JA Jimmie Arceneaux JA - JA Do you Yahoo!? JA Everyone is raving about the all-new Yahoo! Mail Beta. -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED] - Do you Yahoo!? Everyone is raving about the all-new Yahoo! Mail. -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]
[OTlist] Having trouble
Hey Ron, I didn't receive your reply, but I was browsing the OTNow website and saw that you responded. Any idea why I might not be receiving replies? I was wondering if anyone on the list has any information regarding eliciting improved social occupational involvement for an individual with executive function disorder following traumatic brain injury. The unfortuante young man I'm referring to is socially inappropriate quite often i.e. sexual references, cursing, sexual advances. He also has difficulty with concentration relative to communication with associated difficulty benefiting from instruction and cueing for safety. Thanks for any help Jimmie __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]
[OTlist] Hello
Hey Ron, Well I'm back. How is the list coming along? I look forward to participating in future discussions. Jimmie Arceneaux - Do you Yahoo!? Everyone is raving about the all-new Yahoo! Mail Beta. -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]
