Re: [OTlist] Final Goodbye
Thanks David! As the resident PT, you always brought lots of great insight and information!! God Bless, Ron On 10/11/2010 12:43 PM, Lehman, David wrote: Ron! Please send me contact info so we can keep in touch...will miss OTNOW David A. Lehman, PhD, PT Associate Professor Tennessee State University Department of Physical Therapy 3500 John A. Merritt Blvd. Nashville, TN 37209 615-963-5946 office 615-963-5935 fax dleh...@tnstate.edu Visit my website: http://www.tnstate.edu/interior.asp?mid=2410ptid=1 This email and any files transmitted with it may contain confidential information and is intended solely for use by the individual to whom it is addressed. If you receive this correspondence in error, please notify the sender and delete the email from your system. Do not disclose its contents with others. -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: Monday, October 11, 2010 7:02 AM To: OTlist@OTnow.com Subject: [OTlist] Final Goodbye Just a reminder that the OTnow.com website and email list are set to stop functioning on 10/17/2010. Thanks again for everyone that has contributed to this site. There have literally been thousands and thousands of messages posted on the OT list. I've learned a lot and hopefully contributed to others learning as well. So, thanks again! Ron Carson -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Final Goodbye
I appreciate the offer, but I'll just let it die a peaceful death On 10/11/2010 12:42 PM, Physio Bob wrote: Hi Ron Just a side thought. Would you be interested in someone taking it over and continuing it for you in some way I run the largest online Physio one which is a free service with over 20,000 members. We have a small OT section on it but I'd be happy to try and port your website into the format of our on vbulletin and keep it running for the members? regards Richard Bolton Physiobase.com On Mon, Oct 11, 2010 at 1:01 PM, Ron Carsonrdcar...@otnow.com wrote: Just a reminder that the OTnow.com website and email list are set to stop functioning on 10/17/2010. Thanks again for everyone that has contributed to this site. There have literally been thousands and thousands of messages posted on the OT list. I've learned a lot and hopefully contributed to others learning as well. So, thanks again! Ron Carson -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Final Goodbye
Thanks Pat! It is sad to see the sight die. I believe I will truly cry on 10/17. It's been a very long run with much time and effort put forth. There have been so many thoughts and ideas shared, that it's hard to even remember them all. Dang, I get a little teary-eyed just typing this note. None the less, it's time to let this one go. On a different note, it's really strange that there is a sudden influx of new members. We are currently at 417 members, the most in a long time. Thanks again Pat!! Ron On 10/11/2010 03:25 PM, Pat Ellison wrote: Thanks for everything Ron. No one can say you didn't give the site your best, and despite low participation it's kind of sad to see it go. This isn't really goodbye because I know you participate in other groups and that I will see you around. I'll be watching for your posts on other sites! Pat -Original Message- From: Ron Carsonrdcar...@otnow.com Sent: Oct 11, 2010 6:01 AM To: OTlist@OTnow.com Subject: [OTlist] Final Goodbye Just a reminder that the OTnow.com website and email list are set to stop functioning on 10/17/2010. Thanks again for everyone that has contributed to this site. There have literally been thousands and thousands of messages posted on the OT list. I've learned a lot and hopefully contributed to others learning as well. So, thanks again! Ron Carson -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Final Goodbye
Just a reminder that the OTnow.com website and email list are set to stop functioning on 10/17/2010. Thanks again for everyone that has contributed to this site. There have literally been thousands and thousands of messages posted on the OT list. I've learned a lot and hopefully contributed to others learning as well. So, thanks again! Ron Carson -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] The End of an Era
Thank Chuck. I haven't actually considered that. Have you been following the discussions on OT Connections? If so, I'm interested in your opinion. Ron On 09/12/2010 02:49 PM, Chuck Willmarth wrote: Ron, You could start an Otnow group on OT Connections. Of course there is no fee and membership is not required to participate on OT connections in the public forums/groups. Groups can have their own discussion area. Chuck -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: Monday, August 23, 2010 7:04 AM To: OTlist@OTnow.com Subject: [OTlist] The End of an Era I've owned and operated OTnow.com and the OTlist for about 15 years. Until recently, the OTlist was my primary avenue for sharing concepts and ideas relating to occupation-based therapy. About 1 year ago, AOTA instituted an online social site called OT Connections. I find this site to be a wonderful avenue for spreading my thoughts, so I no longer post on the OTlist. For quite some time, the OTlist has essentially been defunct and is no longer an avenue for discussion about occupation and occupation-based practice. I've spent over $1,000 dollars plus COUNTLESS hours paying for hosting and maintenance of this site/list. I did have a couple corporate sponsors along the way to help defray some of this cost, but for the most part it's been a labor of love. However, I've decided to not renew my hosting account which means that in the next couple months, the OTnow.com web site will slide into oblivion. There are close to 400 members from AROUND THE WORLD on this list serve. It has been an honor sharing and learning from the thousands of messages having been generated by list members. It's sad for this to come to an end, but it appears to be the right choice. Thank You, Ron Carson MHS, OT OWNER, OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] The End of an Era
I've owned and operated OTnow.com and the OTlist for about 15 years. Until recently, the OTlist was my primary avenue for sharing concepts and ideas relating to occupation-based therapy. About 1 year ago, AOTA instituted an online social site called OT Connections. I find this site to be a wonderful avenue for spreading my thoughts, so I no longer post on the OTlist. For quite some time, the OTlist has essentially been defunct and is no longer an avenue for discussion about occupation and occupation-based practice. I've spent over $1,000 dollars plus COUNTLESS hours paying for hosting and maintenance of this site/list. I did have a couple corporate sponsors along the way to help defray some of this cost, but for the most part it's been a labor of love. However, I've decided to not renew my hosting account which means that in the next couple months, the OTnow.com web site will slide into oblivion. There are close to 400 members from AROUND THE WORLD on this list serve. It has been an honor sharing and learning from the thousands of messages having been generated by list members. It's sad for this to come to an end, but it appears to be the right choice. Thank You, Ron Carson MHS, OT OWNER, OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Fwd: hygiene issues related to sensory processing- handling with care and dignity
I hate to seem stupid, but exactly how does a bidet work? Obviously, it used to cleanse the anal area, but doesn't the wand become contaminated? Doesn't water spray everywhere and doesn't that imply feces contamination everywhere? What about drying off? Does a person just drip dry? LOL - Original Message - From: Tanya Feddern-Bekcan tfedd...@gmail.com Sent: Saturday, February 13, 2010 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Fwd: hygiene issues related to sensory processing- handling with care and dignity TFB Another option is Mrs. Bidet, sold at Home Depot and/or Lowes for about TFB $35. It can be installed and removed in about 5 minutes. It's handheld, so TFB it gives the user greater control of water flow and water direction. TFB http://www.mrsbidet.com/ TFB Take care, TFB Tanya -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Time management
Michael, he may also find that mindmapping is helpful. I use FreeMind and it can be found here: http://freemind.sourceforge.net/wiki/index.php/Main_Page Ron - Original Message - From: Michael Holmes o...@nvhospital.org Sent: Friday, January 08, 2010 To: otl...@otnow.com. otl...@otnow.com. Subj: [OTlist] Time management MH Good idea. I was trying to guide him along the flow concept by Chicksa MH mahya ( I know I spelled that wrong). I thought he might be able to get into MH a treatment flow first, and then a documentation flow later in the day. MH It seems to transition from treatment to immediately writing a note can take MH extra time to change gears from treatment, ideas, flow action movement, MH to sit down, think a bit, analyze, etc, Then back to another treatment and MH so on. MH MH Thanks for the help. MH MH Michael A. Holmes MSOTR/L MH MH -- MH Options? MH www.otnow.com/mailman/options/otlist_otnow.com MH Archive? MH www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] need your letters
Susan, what do you mean by a second service? Ron - Original Message - From: Susan Orloff sorloff...@aol.com Sent: Tuesday, January 05, 2010 To: OT NOW LIST OTlist@OTnow.com Subj: [OTlist] need your letters SO I am trying to change the policy of OT being a secondary service and I SO would like to hear from you about your frustrations in getting SO services in a timely way to the students that need it the most. I am SO having a meeting in Feb. with the US Dept. of ED and I would like SO letters from all over the country so the more the merrier and I want SO to show that this is not a GA problem but a pervasive on where SO services are so boggled in red tape that the time delay between the SO initiation of the process and the start of therapy is actually SO detrimental to the student's progress and remediation. Thanks SO Susan Orloff, OTR/L SO CEO/Executive Director SO Children's Special Services, LLC SO 7501 Auden Trail SO Atlanta, GA 30350 SO 770-394-9791 SO www.childrens-services.com SO sorloff...@aol.com SO This e-mail and any attachments may contain confidential and SO privileged information. If you are not the intended recipient, please SO notify the sender immediately by return e-mail, delete this e-mail and SO destroy any copies. Any dissemination or use of this information by a SO person other than the intended recipient is unauthorized and may be SO illegal. Unless otherwise stated, opinions expressed in this e-mail SO are those of the author and are not endorsed by the author's employer. SO -- SO Options? SO www.otnow.com/mailman/options/otlist_otnow.com SO Archive? SO www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Bed Mobility
Neal, does the patient have a hospital bed with rails? - Original Message - From: Neal Luther neal.lut...@advhomecare.org Sent: Monday, January 04, 2010 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Bed Mobility NL Hello everyone and Happy New Year! NL Has anyone ever had success in teaching a quadriplegic pt. to be able to NL independently reposition into sidelying in bed? My pt. has great bicep NL and deltoid strength. Little to no triceps. Thanks for any help. NL Neal C. Luther,OTR/L NL Advanced Home Care, Burlington Office NL 1-336-538-1194, xt 6672 NL neal.lut...@advhomecare.org NL Home Care is our Business...Caring is our Specialty NL Neal Luther.vcf NL P Please consider the environment before printing this e-mail NL The information contained in this electronic document from Advanced NL Home Care is privileged and confidential information intended for NL the sole use of otl...@otnow.com. If the reader of this NL communication is not the intended recipient, or the employee or NL agent responsible for delivering it to the intended recipient, you NL are hereby notified that any dissemination, distribution or copying NL of this communication is strictly prohibited. If you have received NL this communication in error, please immediately notify the person NL listed above and discard the original. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Flu shot
I think most of my family has already had the H1N1 flu. As such, we will PROBABLY not get the shot. Ron Pat Ellison wrote: I already got the seasonal flu shot, as did my husband. We both get it every year. As a severe asthmatic, I plan to also get the H1N1 vaccine as soon as it is available. Pat At 09:54 AM 10/25/2009, you wrote: Hello all. I was just wondering what is your thoughts on the flu shots for yourselves and family. Young and old? You guys think it's safe? Sent on the Sprint® Now Network from my BlackBerry® -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Flu shot
What are the risks associated with the H1N1 vaccine? Mary Giarratano wrote: I've had both shots this year. I'm the one in my family most exposed to seasonal flu and plan to have my kids get the H1N1 shot as soon as it's available for their age group (teenagers). Mary - Original Message - From: jcd...@gmail.com To: otlist@otnow.com Sent: Sunday, October 25, 2009 11:54 AM Subject: [OTlist] Flu shot Hello all. I was just wondering what is your thoughts on the flu shots for yourselves and family. Young and old? You guys think it's safe? Sent on the Sprint® Now Network from my BlackBerry® -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Contracting
Juan, while running my private practice, I contacted several home health agency's about contracting with the company. ALL of them indicated they would hire ME as a contractor but not my company. In actuality, it made no difference because I'm the only employee of my company. If they pay the company or pay me, it's one in the same. If I had multiple employees it would be a different situation. Thanks, Ron - Original Message - From: jcd...@gmail.com jcd...@gmail.com Sent: Thursday, October 15, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Contracting jgc Hey Ron, can you elaborate on that. We can work with HC, but what jgc was your experience. And how does it work. We do the work and bill jgc the HC company. They bill the insurance company, and then they pay jgc us? Ron you should write a book or do a class about OT's in PP, jgc medicare, contracting out, billing, ect. I would buy it. You have a jgc lot of knowledge that you share with all of us. Thank you Juan jgc --Original Message-- jgc From: Ron Carson jgc Sender: otlist-boun...@otnow.com jgc To: jcd...@gmail.com jgc ReplyTo: OTlist@OTnow.com jgc Subject: Re: [OTlist] Contracting jgc Sent: Oct 15, 2009 9:38 AM jgc In theory, yes. In my personal experience, no. jgc - Original Message - jgc From: jcd...@gmail.com jcd...@gmail.com jgc Sent: Wednesday, October 14, 2009 jgc To: otlist@otnow.com otlist@otnow.com jgc Subj: [OTlist] Contracting jgc Hello everyone. I have a question for those in private practice. I jgc wanted to know if you have a PP, can your company be contracted by jgc a home care company. So the HC company use your company and your therapist. jgc Sent on the Sprint® Now Network from my BlackBerry® jgc -- jgc Options? jgc www.otnow.com/mailman/options/otlist_otnow.com jgc Archive? jgc www.mail-archive.com/otlist@otnow.com jgc -- jgc Options? jgc www.otnow.com/mailman/options/otlist_otnow.com jgc Archive? jgc www.mail-archive.com/otlist@otnow.com jgc Sent on the Sprint® Now Network from my BlackBerry® jgc -- jgc Options? jgc www.otnow.com/mailman/options/otlist_otnow.com jgc Archive? jgc www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Contracting
In theory, yes. In my personal experience, no. - Original Message - From: jcd...@gmail.com jcd...@gmail.com Sent: Wednesday, October 14, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Contracting jgc Hello everyone. I have a question for those in private practice. I jgc wanted to know if you have a PP, can your company be contracted by jgc a home care company. So the HC company use your company and your therapist. jgc Sent on the Sprint® Now Network from my BlackBerry® jgc -- jgc Options? jgc www.otnow.com/mailman/options/otlist_otnow.com jgc Archive? jgc www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Help please
As long as the survey is related to occupation or the practice of OT, there is no problem posting survey links. Thanks for asking. Ron t - Original Message - From: Neal Luther neal.lut...@advhomecare.org Sent: Tuesday, October 06, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Help please NL Survey Monkey works really well. If Ron allows it it could be very NL helpful. NL P Please consider the environment before printing this e-mail NL The information contained in this electronic document from Advanced NL Home Care is privileged and confidential information intended for the NL sole use of otl...@otnow.com. If the reader of this communication is NL not the intended recipient, or the employee or agent responsible for NL delivering it to the intended recipient, you are hereby notified that NL any dissemination, distribution or copying of this communication is NL strictly prohibited. If you have received this communication in error, NL please immediately notify the person listed above and discard the original.-Original Message- NL From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On NL Behalf Of Sue Doyle NL Sent: Tuesday, October 06, 2009 9:45 AM NL To: otlist@otnow.com NL Subject: Re: [OTlist] Help please NL I have a couple of questions. NL Could I post a link on here for survey monkey for some research for my NL PhD? How many of you would respond? (it is on sensory retraining after NL stroke) NL Has any one had experience with survey monkey and what are you thoughts? NL Thanks NL Sue D From: o...@nvhospital.org To: otl...@otnow.com. Date: Mon, 5 Oct 2009 13:43:20 -0700 Subject: [OTlist] Speaker Just came from the Washington OT conference and our keynote speaker NL was Patch Adams. What a great speaker he was. If anyone ever gets a chance NL to hear him speak it is certainly worth it. Michael A. Holmes MSOTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com NL NL -- NL Options? NL www.otnow.com/mailman/options/otlist_otnow.com NL Archive? NL www.mail-archive.com/otlist@otnow.com NL -- NL Options? NL www.otnow.com/mailman/options/otlist_otnow.com NL Archive? NL www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] hello
It's only as active as the members make it! - Original Message - From: Juan Turcios jcd...@gmail.com Sent: Wednesday, September 23, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] hello JT just wanted to see if this was still active JT -- JT Options? JT www.otnow.com/mailman/options/otlist_otnow.com JT Archive? JT www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Medicaid
Juan, in my state of Florida, Medicare and Medicaid are TOTALLY different. In fact, Florida Medicaid does not even pay for adult therapy (i.e. over 18 years of age) unless the patient is one of the many waivers. I'm a Medicaid provider but almost NEVER bill them. Good luck with the PPOT referrals. I tried for 4 years and had VERY little success. Ron - Original Message - From: jcd...@gmail.com jcd...@gmail.com Sent: Wednesday, September 23, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Medicaid jgc Hello everyone. I have a medicaid question. I'm doing the in-house jgc private practice, and I was wondering if rules are different with jgc medicare and medicaid; from referrals, orders, and reimbursement? Some jgc medicaid clients have contacted me, but I was not sure if I would be jgc reimbursed, as I'm sure medicaid rules are different. By the way the jgc PPOT is very difficult, doctors and clients are skeptical about what we jgc do? - have been trying for a few months and no luck with referrals. So jgc I'm trying to expand to the medicaid thing. Thanks everyone Juan C. jgc Sent on the Sprint® Now Network from my BlackBerry® jgc -- jgc Options? jgc www.otnow.com/mailman/options/otlist_otnow.com jgc Archive? jgc www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Licensure
Thanks Chuck. Do you know if it's the same for OTA? - Original Message - From: Chuck Willmarth cwillma...@aota.org Sent: Friday, September 18, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Licensure CW Ron, CW 48 states, DC and PR licence OTs. CO and HI have state registration laws. CW Chuck CW Sent from my Windows Mobile phone CW -Original Message- CW From: Ron Carson rdcar...@otnow.com CW Sent: Friday, September 18, 2009 6:41 AM CW To: OTlist OTlist@OTnow.com CW Subject: [OTlist] Licensure CW How many states have OT licensure: 48? 49? CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Licensure
How many states have OT licensure: 48? 49? -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Hate the Way OT is Pictured...
The August 31, 2009 edition of Advance for OT Practitioners has an article on OT and home health. I must say, I hate the pictures of the OT in the article. There are 4 pictures of the OT working with a home health patient who has had a CVA; 3 of the 4 pictures show the OT doing upper extremity ROM and/or exercises for this patient. The article states that the OT practitioner transfers the patient to the w/c. The patient's daughter states that before her mom's stroke, the patient was very active; walking to the store, going to the senior center and playing bingo. The article cites a CMS study reporting improvements in home care patients. NONE of these improvement are directly related to UE function. Also, CMS has a study of outcome measures that most home health companies target. The top 10 are: Acute Care Hospitalization Improvement in Management of Oral Medications Any Emergent Care Improvement in Pain Interfering with Activity Improvement in Ambulation/Locomotion Improvement in Dyspnea Improvement in Transferring Improvement in Status of Surgical Wounds Improvement in Urinary Incontinence Improvement in Bathing Again, none of these are directly related to UE function. And VERY few patients are on home health because of only UE dysfunction. That VAST majority of home health patients are home bound and unsafe because of mobility related issues. And yet, the OT in this advance article appears to be focusing her treatment on a w/c bound patient's upper extremity. Is it any wonder that OT is misunderstood? Is it any wonder that no one knows what we do? Does anyone see the elephant in the room? Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Ron! Someone thinks OT is more valuable than PT!
I've always found it interesting that an OT eval pays more than a PT eval. I wish I knew why it's this way. To the best of my knowledge, eval codes are the ONLY discipline specific CPT codes. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: pat pat0...@earthlink.net Sent: Thursday, September 10, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Ron! Someone thinks OT is more valuable than PT! p In setting up the fee schedule for my new private practice, I discovered p that, at least in TX, Medicare thinks OTs are more valuable than PTs. I p was surprised to learn that they allow $70.95 for an OT eval, but only p $67.08 for a PT eval. Why do you suppose there is a difference? None of p the other codes pay differently depending on if the service is performed by an OT or PT. p Pat p -- p Options? p www.otnow.com/mailman/options/otlist_otnow.com p Archive? p www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Unquotable Quote of the Week (9/12/09)
In and OT session, patients with Parkinson's disease can learn to manage te activities of daily living by increasing safety, independence and motor coordination of the upper extremities. (SOURCE: Today in OT. August 31, 2009. pp. 16-17) Why oh why, does this person limit motor coordination to the UE? Why even mention the UE without mentioning the LE? Why can't it just be motor coordination? Please, someone tell me before I go totally crazy joke Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Link for Employment Stats
Does anyone have a link for current OT/OTA employment stats? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Link for Employment Stats
Thanks Chuck: Doesn't AOTA occasionally publish stats on where OT/OTA's are working? I want to know what percentage of therapists report working in home health, SNF, acute care, schools, etc. Ron - Original Message - From: Chuck Willmarth cwillma...@aota.org Sent: Wednesday, September 02, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Link for Employment Stats CW Ron, CW CW The most recent data from BLS is from 2006 CW CW OT CW ftp://ftp.bls.gov/pub/special.requests/ep/ind-occ.matrix/occ_pdf/occ_29-1122.pdf CW CW OTA CW ftp://ftp.bls.gov/pub/special.requests/ep/ind-occ.matrix/occ_pdf/occ_31-2011.pdf CW CW CW Chuck CW CW From: otlist-boun...@otnow.com on behalf of Ron Carson CW Sent: Wed 9/2/2009 8:02 AM CW To: OTlist CW Subject: [OTlist] Link for Employment Stats CW Does anyone have a link for current OT/OTA employment stats? CW Thanks, CW Ron CW ~~~ CW Ron Carson MHS, OT CW www.OTnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Fact Sheet
I can't believe no one responded to the questions. In my opinion, it is exactly this kind of nonsense, published by AOTA, which thwarts the unity of our profession. How many different major focuses can a profession have? Where is occupation in this statement? For me, this is a really sad Fact Sheet published by AOTA. Just one more nail in the coffin. - Original Message - From: Ron Carson rdcar...@otnow.com Sent: Tuesday, September 01, 2009 To: OTlist OTlist@OTnow.com Subj: [OTlist] Fact Sheet RC Does anyone have problems with this statement: RC A major focus of occupational therapy is rehabilitation related to RC impairments of the upper extremity (i.e., shoulder, elbow, forearm, RC wrist, hand). RC Is rehab of the UE really a MAJOR focus? If so, is this consistent with our RC Practice Framework? Why or why not?? RC Thanks, RC Ron RC ~~~ RC Ron Carson MHS, OT RC www.OTnow.com RC -- RC Options? RC www.otnow.com/mailman/options/otlist_otnow.com RC Archive? RC www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Fact Sheet
I understand what you are saying about context. But, I purposely left out the context because it's the statement as it stands which is so worrisome to me. - Original Message - From: Chuck Willmarth cwillma...@aota.org Sent: Wednesday, September 02, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Fact Sheet CW Ron, CW Perhaps post the full text to the fact sheet so listmembers can read in context. CW As I recall a number paragraphs are dedicated to explaining the unique contribution of OT. CW Coffin? Who died? CW Chuck CW Sent from my Windows Mobile phone CW -Original Message- CW From: Ron Carson rdcar...@otnow.com CW Sent: Wednesday, September 02, 2009 8:40 PM CW To: Ron Carson OTlist@OTnow.com CW Subject: Re: [OTlist] Fact Sheet CW I can't believe no one responded to the questions. CW In my opinion, it is exactly this kind of nonsense, published by AOTA, which CW thwarts the unity of our profession. CW How many different major focuses can a profession have? Where is CW occupation in this statement? CW For me, this is a really sad Fact Sheet published by AOTA. Just one more CW nail in the coffin. CW - Original Message - CW From: Ron Carson rdcar...@otnow.com CW Sent: Tuesday, September 01, 2009 CW To: OTlist OTlist@OTnow.com CW Subj: [OTlist] Fact Sheet RC Does anyone have problems with this statement: RC A major focus of occupational therapy is rehabilitation related to RC impairments of the upper extremity (i.e., shoulder, elbow, forearm, RC wrist, hand). RC Is rehab of the UE really a MAJOR focus? If so, is this consistent with our RC Practice Framework? Why or why not?? RC Thanks, RC Ron RC ~~~ RC Ron Carson MHS, OT RC www.OTnow.com RC -- RC Options? RC www.otnow.com/mailman/options/otlist_otnow.com RC Archive? RC www.mail-archive.com/otlist@otnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Standing
I really like the concept of becoming the door!! Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Sunday, August 30, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Standing cac I bet if you get a string of people like Shirley, they would have to cac listen. Really dumb not to. Easy for me to say though. All of my cac bosses and even the higher ups are OTs, so we have a major advantage. cac Perhaps that is another way to get our foot in the door. Become the cac door. cac -Original Message- cac From: Ron Carson rdcar...@otnow.com cac To: cmnahrw...@aol.com OTlist@OTnow.com cac Sent: Sun, Aug 30, 2009 3:18 pm cac Subject: Re: [OTlist] Standing cac As a rule, people are resistant to change. And even worse than cac people, cac institutions are VERY resistant to change. cac Shirley, the mother of a home health patient, wrote an e-mail to the cac CEO of cac my home health company explaining how difficult it was for the cac patient to cac get OT started. Personally, I have heard nothing from my company about cac this cac situation. I wonder why? cac - Original Message - cac From: cmnahrw...@aol.com cmnahrw...@aol.com cac Sent: Sunday, August 30, 2009 cac To: OTlist@OTnow.com OTlist@OTnow.com cac Subj: [OTlist] Standing cac Because some people do not understand what we truly do. The only cac way cac they will see the contribution is through the voice of the patient. cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Fact Sheet
Does anyone have problems with this statement: A major focus of occupational therapy is rehabilitation related to impairments of the upper extremity (i.e., shoulder, elbow, forearm, wrist, hand). Is rehab of the UE really a MAJOR focus? If so, is this consistent with our Practice Framework? Why or why not?? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Standing
Thanks! :-), but a hug won't really help with my problem. What I really need is for OT to: 1. Move to the forefront of healthcare 2. Get its head out of the sand 3. Recognize the reality of our situation within healthcare and do something positive and directional to change 4. Step away from worrying about what other professions think of us and instead do what is right and best for patients and OUR profession 5. Practice in a manner which is consistent with AOTA's Framework 6. Stop giving occupation a bunch of lip service 7. Learn to stand on our own two feet. To defend our practice Hugs won't help with ANY of these :-) Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Joan Riches jric...@telusplanet.net Sent: Saturday, August 29, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Standing JR Shirley JR I think Ron needs a hug. I hope you are close enough. JR Blessings, Joan JR -Original Message- JR From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JR Behalf Of Ron Carson JR Sent: August 29, 2009 2:35 PM JR To: cmnahrw...@aol.com JR Subject: Re: [OTlist] Standing JR Oh Chris, I so value what I do, and I KNOW that other OT's value JR what JR they do. But the PROBLEM, at least in my experience, is that almost no JR one JR else TRULY values our contribution. Why? JR No virus found in this outgoing message. JR Checked by AVG - www.avg.com JR Version: 8.5.409 / Virus Database: 270.13.71/2333 - Release Date: JR 08/29/09 06:39:00 JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Standing
I disagree that our profession as a whole is good about stepping away from worrying about what other professions think of us. Many times on this list, I've read that an OT has good working relationship with PT and they aren't going to jeopardize that. Well, that's all well and fine, but I'm willing to bet that in general, the only reason OT has a good relationship with PT (DON'T think individuals, think as a profession) is because OT is in their place, doing exactly what PT wants. The moment OT begins challenging PT, you watch the claws come out. Not long after I started working in home health, one of the PT's went so far as to look at the OT practice act to see if I was practicing beyond my scope. She even involved clinical directors. When I was called to a meeting, I was armed with my practice act, which is VERY vague about what is and isn't OT. There was nothing they could really do, but I'm confident they would call me out if they could. I am not looking for a fight with other professions, but I am not going to back down from my treatment simply because PT feels threatened. I feel the same way about UE/hand therapy. PT's are supposed to be the musculoskeltal experts, so I defer all such treatment to them. Most of them are not skilled in the UE/hand so they get all freaky about things. They typically refer these patients to another OT who does do hands. While MD's in Canada may recognize OT, such is NOT the case here in USA, at least in adult phys-dys, UNLESS it's for an UE issue. Most MD's working with adults have NO, and I mean NO, idea of occupation or occupational therapy. Like I said, if they do it typically relates to either: 1. UE ortho injury 2. In conjunction with PT for general rehab I'm sure there are OT's who have forged good working relationships with MD, but these are far and few between. OT just does NOT have standing in the world of medicine. Sad and difficult to admit, but it is so true, in my experience. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Joan Riches jric...@telusplanet.net Sent: Sunday, August 30, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Standing JR Maybe trying to focusing more on the good things will - the way this JR list has developed - where are all these new people coming from? I like JR your list below especially number 4. I have seen evidence on the list JR that many of us are doing this. Don't we count as much as the ones who JR aren't? JR In this area we have the respect of the docs. They know and acknowledge JR us. We don't take this for granted. We've worked hard to make it so. JR Joan Riches B.Sc.O.T., OT(C) JR Specialist in Cognitive Disability JR High River, Alberta, Canada JR -Original Message- JR From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JR Behalf Of Ron Carson JR Sent: August 30, 2009 5:57 AM JR To: Joan Riches JR Subject: Re: [OTlist] Standing JR Thanks! :-), but a hug won't really help with my problem. JR What I really need is for OT to: JR 1. Move to the forefront of healthcare JR 2. Get its head out of the sand JR 3. Recognize the reality of our situation within healthcare and do JR something JR positive and directional to change JR 4. Step away from worrying about what other professions think of us JR and JR instead do what is right and best for patients and OUR profession JR 5. Practice in a manner which is consistent with AOTA's Framework JR 6. Stop giving occupation a bunch of lip service JR 7. Learn to stand on our own two feet. To defend our practice JR Hugs won't help with ANY of these :-) JR Ron JR ~~~ JR Ron Carson MHS, OT JR www.OTnow.com JR - Original Message - JR From: Joan Riches jric...@telusplanet.net JR Sent: Saturday, August 29, 2009 JR To: OTlist@OTnow.com OTlist@OTnow.com JR Subj: [OTlist] Standing JR Shirley JR I think Ron needs a hug. I hope you are close enough. JR Blessings, Joan JR -Original Message- JR From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JR Behalf Of Ron Carson JR Sent: August 29, 2009 2:35 PM JR To: cmnahrw...@aol.com JR Subject: Re: [OTlist] Standing JR Oh Chris, I so value what I do, and I KNOW that other OT's JR value JR what JR they do. But the PROBLEM, at least in my experience, is that JR almost no JR one JR else TRULY values our contribution. Why? JR No virus found in this outgoing message. JR Checked by AVG - www.avg.com JR Version: 8.5.409 / Virus Database: 270.13.71/2333 - Release Date: JR 08/29/09 06:39:00 JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com JR No virus found in this incoming message. JR Checked by AVG - www.avg.com JR Version: 8.5.409 / Virus
Re: [OTlist] New subject
It's such a difficult situation. I'm all for taking care of people who are truly unable to take care of themselves. I'm believe that individuals have a moral obligation to take care of themselves AND those around them. If a person is in need and I have the ability to help, then I should. I do NOT believe that healthcare is a RIGHT. And even if it is a right, with every right comes a responsibility. And responsibility is one thing that is sorely lacking in this country. So many people WANT what's theirs but they don't want to take responsibility for what they get. Great topic, I was hoping someone would bring it up. Ron PS, I'm a big fan of Adrian Rogers' teachings. - Original Message - From: Neal Luther neal.lut...@advhomecare.org Sent: Friday, August 28, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] New subject NL Any thoughts on how this should figure into the health care reform NL debate? NL You cannot legislate the poor into prosperity by legislating the wealthy NL out of prosperity. What one person receives without working for, another NL person must work for without receiving. The government cannot give to NL anybody anything that the government does not first take from somebody NL else. When half of the people get the idea that they do not have to work NL because the other half is going to take care of them, and when the other NL half gets the idea that it does no good to work because somebody else is NL going to get what they work for, that my dear friend, is the beginning NL of the end of any nation. You cannot multiply wealth by dividing it. NL - Adrian Rogers, 1931 NL Neal Luther, OTR/L NL Advanced Home Care NL Burlington Office NL 1-336-538-1194, xt. 6672 Office NL 1-336-538-9948 Fax NL P Please consider the environment before printing this e-mail NL The information contained in this electronic document from Advanced NL Home Care is privileged and confidential information intended for the NL sole use of otl...@otnow.com. If the reader of this communication is NL not the intended recipient, or the employee or agent responsible for NL delivering it to the intended recipient, you are hereby notified that NL any dissemination, distribution or copying of this communication is NL strictly prohibited. If you have received this communication in error, NL please immediately notify the person listed above and discard the original. NL -- NL Options? NL www.otnow.com/mailman/options/otlist_otnow.com NL Archive? NL www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Standing
There's a legal term called standing. The legal right to bring a lawsuit. As a general rule, only a person with something at stake has standing to bring a lawsuit. As I understand it, standing means that a person has a legal basis for brining a claim against another entity. I'm sure there's a lot more to the term, but that's my basic understanding. While driving the other day, it dawned on me that in so many settings and with so many people OT has little to no standing. I'm not talking in a legal sense, instead in the sense of what our profession offers. When I think about my home health company, OT is such a non-entity. We have so few OT compared to PT. OT can't open a case. OT very rarely stands alone. OT is rarely called upon as EXPERTS in anything, unless it's fine motor. OT is not recognized by the majority of patients. OT is often not referred to by the MD. For me, the bottom line is that OT hardly even exists as a highly valued profession. In fact, I was thinking yesterday, what happens to the VAST majority of home health patients not getting home health? How is it that I sell my services as invaluable, but most patients don't get the services? The obvious answer is OT services are NOT invaluable and that patients apparently do just fine when receiving PT only. Again, just another missing piece of our confusing puzzle Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Standing
Oh Chris, I so value what I do, and I KNOW that other OT's value what they do. But the PROBLEM, at least in my experience, is that almost no one else TRULY values our contribution. Why? - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Saturday, August 29, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Standing cac The obvious answer is OT services are NOT invaluable and that cac patients cac apparently do just fine when receiving PT only. cac Hmmm.I wonder why there is such a continued prevelance of falls at cac home and readmits into hospitals, because people have not been able to cac take care of themselves and therefore leading to a downward spiral a) cac can't get out of bed or do not have the motivation or a reason to get cac out of bed b) stay in bed for long periods of time c) can't get to cac their medications cac We are much more than a profession of arm movers, but a profession that cac values the patient's well being, and helps by giving people hope that cac they can continue to live a life of purpose and meaning cac We can add so much more than.the popular main stream therapies, if we cac only cared about the lives of our patients. If we only cracked open cac the book, beyond the surface of each patient in which we encounter to cac determine how we could potentially help them in a real way. cac Sorry about all of philosophy, but that comment struck a nerve. cac Chris cac -Original Message- cac From: Ron Carson rdcar...@otnow.com cac To: OTlist OTlist@OTnow.com cac Sent: Sat, Aug 29, 2009 5:09 am cac Subject: [OTlist] Standing cac There's a legal term called standing. cac The legal right to bring a lawsuit. As a general rule, cac only a cac person with something at stake has standing to bring a lawsuit. cac As I understand it, standing means that a person has a legal cac basis for cac brining a claim against another entity. I'm sure there's a lot more cac to the cac term, but that's my basic understanding. cac While driving the other day, it dawned on me that in so many cac settings and cac with so many people OT has little to no standing. I'm not talking in a cac legal cac sense, instead in the sense of what our profession offers. cac When I think about my home health company, OT is such a non-entity. We cac have cac so few OT compared to PT. OT can't open a case. OT very rarely stands cac alone. cac OT is rarely called upon as EXPERTS in anything, unless it's fine cac motor. OT cac is not recognized by the majority of patients. OT is often not cac referred to cac by the MD. cac For me, the bottom line is that OT hardly even exists as a highly cac valued cac profession. In fact, I was thinking yesterday, what happens to the cac VAST cac majority of home health patients not getting home health? How is it cac that I cac sell my services as invaluable, but most patients don't get the cac services? cac The obvious answer is OT services are NOT invaluable and that cac patients cac apparently do just fine when receiving PT only. cac Again, just another missing piece of our confusing puzzle cac Ron cac ~~~ cac Ron Carson MHS, OT cac www.OTnow.com cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
Thanks for the explanation. So, what does PT do in the school systems? - Original Message - From: ocil...@comcast.net ocil...@comcast.net Sent: Monday, August 24, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] A New One ocn Ron, I worked in a public school district for 5 years. There were only ocn 2 kids (out of about 70 on OT caseload) who had diagnoses such as CP ocn that caused them difficulty with transfers or ADL's. The majority of ocn kids I saw had more soft neurological symptoms due to sensory issues, ocn fetal alcohol syndrome, developmental delays, ADD/ADHD, or were ocn somewhere on the autistic spectrum. The kids with the physical problems ocn as well as those with the severe sensory issues were also going for ocn extensive outpatient therapy 2-3 times a week at the same time that ocn they were receiving school-based OT. Most all of these kids could walk, ocn carry their lunch trays, get on and off the swings, but couldn't open ocn and close scissors, use a ruler, or write. So while of course we worked ocn on these things, we also worked on the underlying causes, such as trunk ocn and upper extremity weakness, spatial skills, and yes, fine motor ocn skills. Don't forget we work on the patient's goals, and most of these ocn kids cared very much if they couldn't print their names or cut a ocn straight line. These are all childhood occupations. On most ocn school-based assessments, these very functional skills are classified ocn under fine motor skills so I think when that teacher said fine ocn motor she was thinking in terms of functional things like cutting, ocn writing, etc, where you may be thinking of fine motor as pegs and ocn other exercises that may constitute fine motor in an adult setting. ocn Re: SLP's vs, OT's in SNF, when I see SLP's doing cognitive therapy in ocn a SNF, they are doing tasks such as using flashcards, etc. for the ocn purpose of remediation (which I think is silly when we are talking ocn about dementia; it is not like TBI, in which functional gains could be ocn realistically expected). When I do congitive treatment it is more ocn compensatory to help a resident with orientation or ADL skills. An ocn SLP's goals might consist of things like Resident will recall 3/5 ocn objects presented where mine might be resident will locate her room ocn independently with visual cues (such as a picture placed on her door). ocn I don't think we're necessarily competing with each other or working on the same things. ocn Ilene Rosenthal, OTR/L ocn -- ocn Options? ocn www.otnow.com/mailman/options/otlist_otnow.com ocn Archive? ocn www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
But as a PROFESSION, don't we NEED a common ground? And not just a common ground, but a grounding that is UNIQUE, SEPARATE and DESIRED/NEEDED by other professions and patients? As much as a I preach occupation, I sometimes wonder if it's different enough from PT to be a recognized as a truly unique contribution to healthcare. I find that with very few exceptions, almost 100% of my patients want to increase mobility. Of course, they want to do this so they can go to the toilet, get their clothes, etc. BUT, they also want to be able to walk simply because walking represents independence and normality. I've had many home health patients, in fact most, who I worked on mobility as the PRIMARY treatment. For example, I have 4 patients today and ALL of them have mobility related issues. I am either working on improving ambulation skills or transfer skills. I do this because patients want to be able to walk to the toilet, get their clothes, walk to the dining room, etc. These are their occupational goals and the PRIMARY impedance to these goals is mobility (strength, balance, cognition, environment). I am 100% confident that I'm working on occupation. I say this because the goals are occupational improvement, not mobility goals. But, it APPEARS to patients and other therapists that I am working as a PT. Sometimes, I get so confused and overwhelmed at being an OT and knowing what is and what isn't, that I just want to run and become a car salesman (LOL). Ron - Original Message - From: Michael Holmes o...@nvhospital.org Sent: Monday, August 24, 2009 To: otl...@otnow.com. otl...@otnow.com. Subj: [OTlist] A New One MH Just wanted to say how much I liked the elephant analogy. I think is MH really is clever and indicative of the profession as whole. We do function MH in so many different realms that it is difficult to be united on our MH explanation to lay persons what it really is that we do. Great way to put MH it Mary. MH MH Michael A. Holmes MSOTR/L MH mailto:o...@nvhospital.org o...@nvhospital.org MH MH -- MH Options? MH www.otnow.com/mailman/options/otlist_otnow.com MH Archive? MH www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Ultimate Insult
The other day at a staff meeting, the one where I was the only OT among 9 PT's, one of the PT's commented it was OK, because *I* wanted to be a PT anyway. The comment really insulted me and made me mad. I left the PT a note requesting that she never say that again. But, I'm still left with this bewildering sense of WHY would she say that. Why does and OT addressing UE physical dysfunction seem normal, but an OT addressing mobility-related occupational dysfunction seem like a PT? To me, it's the OT who is FOCUSING treatment on a patient's anatomical body part that is the PT. After all, by definition that is what PT does. Sorry, just one more confusing post from a confused OT... smile Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
Yea, but at least everyone knows what and why a car salesman works on mobility!!! SMILE - Original Message - From: Pat Ellison pat0...@earthlink.net Sent: Wednesday, August 26, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] A New One PE U Ron? As a car salesman, wouldn't you PE *still* be working on mobility?? ;Þ PE Pat PE At 05:48 AM 8/26/2009, you wrote: But as a PROFESSION, don't we NEED a common ground? And not just a common ground, but a grounding that is UNIQUE, SEPARATE and DESIRED/NEEDED by other professions and patients? As much as a I preach occupation, I sometimes wonder if it's different enough from PT to be a recognized as a truly unique contribution to healthcare. I find that with very few exceptions, almost 100% of my patients want to increase mobility. Of course, they want to do this so they can go to the toilet, get their clothes, etc. BUT, they also want to be able to walk simply because walking represents independence and normality. I've had many home health patients, in fact most, who I worked on mobility as the PRIMARY treatment. For example, I have 4 patients today and ALL of them have mobility related issues. I am either working on improving ambulation skills or transfer skills. I do this because patients want to be able to walk to the toilet, get their clothes, walk to the dining room, etc. These are their occupational goals and the PRIMARY impedance to these goals is mobility (strength, balance, cognition, environment). I am 100% confident that I'm working on occupation. I say this because the goals are occupational improvement, not mobility goals. But, it APPEARS to patients and other therapists that I am working as a PT. Sometimes, I get so confused and overwhelmed at being an OT and knowing what is and what isn't, that I just want to run and become a car salesman (LOL). Ron - Original Message - From: Michael Holmes o...@nvhospital.org Sent: Monday, August 24, 2009 To: otl...@otnow.com. otl...@otnow.com. Subj: [OTlist] A New One MH Just wanted to say how much I liked the elephant analogy. I think is MH really is clever and indicative of the profession as whole. We do function MH in so many different realms that it is difficult to be united on our MH explanation to lay persons what it really is that we do. Great way to put MH it Mary. MH MH Michael A. Holmes MSOTR/L MH mailto:o...@nvhospital.org o...@nvhospital.org MH MH -- MH Options? MH www.otnow.com/mailman/options/otlist_otnow.com MH Archive? MH www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com PE -- PE Options? PE www.otnow.com/mailman/options/otlist_otnow.com PE Archive? PE www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
Dude, I am a seasoned OT I really don't like that term! smile - Original Message - From: gr...@backhomesafely.com gr...@backhomesafely.com Sent: Wednesday, August 26, 2009 To: OTlist OTlist@OTnow.com Subj: [OTlist] A New One gbc Ron I understand you are confused. Please stop writing on the internet and gbc have a long conversation in person with a seasoned OT. I do not think you gbc are as confused and insecure as your writing projects and I don't think it gbc helps to have this tone as an example of the profession of OT for people to gbc interpret out of context. Please feel free to call me at (phone number gbc removed by moderator). gbc Have a great day. Sent from my Verizon Wireless gbc BlackBerry gbc -Original Message- gbc From: Pat Ellison pat0...@earthlink.net gbc Date: Wed, 26 Aug 2009 06:35:36 gbc To: OTlist@otnow.com gbc Subject: Re: [OTlist] A New One gbc U Ron? As a car salesman, wouldn't you gbc *still* be working on mobility?? ;Þ gbc Pat gbc At 05:48 AM 8/26/2009, you wrote: But as a PROFESSION, don't we NEED a common ground? And not just a common ground, but a grounding that is UNIQUE, SEPARATE and DESIRED/NEEDED by other professions and patients? As much as a I preach occupation, I sometimes wonder if it's different enough from PT to be a recognized as a truly unique contribution to healthcare. I find that with very few exceptions, almost 100% of my patients want to increase mobility. Of course, they want to do this so they can go to the toilet, get their clothes, etc. BUT, they also want to be able to walk simply because walking represents independence and normality. I've had many home health patients, in fact most, who I worked on mobility as the PRIMARY treatment. For example, I have 4 patients today and ALL of them have mobility related issues. I am either working on improving ambulation skills or transfer skills. I do this because patients want to be able to walk to the toilet, get their clothes, walk to the dining room, etc. These are their occupational goals and the PRIMARY impedance to these goals is mobility (strength, balance, cognition, environment). I am 100% confident that I'm working on occupation. I say this because the goals are occupational improvement, not mobility goals. But, it APPEARS to patients and other therapists that I am working as a PT. Sometimes, I get so confused and overwhelmed at being an OT and knowing what is and what isn't, that I just want to run and become a car salesman (LOL). Ron - Original Message - From: Michael Holmes o...@nvhospital.org Sent: Monday, August 24, 2009 To: otl...@otnow.com. otl...@otnow.com. Subj: [OTlist] A New One MH Just wanted to say how much I liked the elephant analogy. I think is MH really is clever and indicative of the profession as whole. We do function MH in so many different realms that it is difficult to be united on our MH explanation to lay persons what it really is that we do. Great way to put MH it Mary. MH MH Michael A. Holmes MSOTR/L MH mailto:o...@nvhospital.org o...@nvhospital.org MH MH -- MH Options? MH www.otnow.com/mailman/options/otlist_otnow.com MH Archive? MH www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com gbc -- gbc Options? gbc www.otnow.com/mailman/options/otlist_otnow.com gbc Archive? gbc www.mail-archive.com/otlist@otnow.com gbc -- gbc Options? gbc www.otnow.com/mailman/options/otlist_otnow.com gbc Archive? gbc www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Speaking of PT working in our domain
Just received August 09 edition of Advance for Directors in Rehabilitation magazine. Starting on page 10, the article Base of Knowledge: Top 10 lessons of Knee Replacement Surgery gives a brief synopsis of an MD's experience with having knee replacement surgery. Here's a quote, starting on page 3: Postop rehab is essential. Patients should always engage in rehabilitation and physical therapy following knee replacement surgery. ... Goals should be determined in concert with the patient and they should be clear and obtainable. A goal can be as simple as playing with grandchildren or as complex as playing a competitive sport again. The obvious lack of OT is sad, but that PT would write a patient goal similar to playing with children, is glaring OT'ish. One thing of interest is that there is a brief discussion box written by a PT. The therapist never really mentions goals similar to what the article's author suggests. Maybe PT is running into the same thing as OT: Saying one thing but doing something else... Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] I'm Going to do UE Stuff...
I evaluated a patient on Saturday with multiple medical issues including MD. He has difficulty with dressing, bathing, toileting, etc because of bi-lateral shoulder weakness. I would address his shoulder strength but PT is already doing that. So, I will work on adaptive dressing strategies, etc. However, the patient is VERY mechanical but has great difficulty picking up small items because of the MD. He specifically said he has great trouble with his zipper, even after modifying it. During the eval, he told me that he needs something to brace his thumb so that he can use a finger grasp for small items. Immediately, I told him about a thumb spica splint. He was excited about the idea. This is the 1st patient on home health that I've worked with where fine motor control was a primary concern. It's going to be challenging because I haven't made a splint in many years... Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] A New One
You know, I like fillin' everyone in when I come across OT definitions/experiences that are off the scale. Well, this Saturday was a new one. I was evaluating a woman whose daughter is a SLP working in school systems. What do you think the SLP told me was her understanding of the role of OT? 1. ADL's 2. Fine Motor 3. Occupation 4. Upper Extremity The answer is #2. In her experience, OT's worked only on fine motor control. PT does gross/large muscle and SLP does cognition. The SLP was actually surprised that I gave her mom a cognitive screen. It just seems that OT is so pigeon-holed into either FMC or UE. Will we ever break these shackles? Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
Maybe this is the problem with OT. We have several different groups doing their own sort of thing. Yet, we have professional documentation which doesn't support all this fragmentation. We have so many splinter groups and yet no real unified core biding us together. Well, we have a written framework, but no real practice patterns. And certainly, we don't have a consensual by consumers and referrals sources of OT. It's often suggested that OT should change its name. Maybe we should just change what the O stands for. For example: Other Therapy Obscure Therapy Obtuse Therapy LOL Ron - Original Message - From: Mary Giarratano mcg...@charter.net Sent: Sunday, August 23, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] A New One MG In a lot of school systems, most of what OTs do is fine motor and MG handwriting. The OT goals have to be educationally based, not overlap other MG services and the parents want their children to have legible handwriting. MG I'm sure it doesn't fit your definitions but it is the way most school MG systems work when the majority of pts do not have significant motor issues. MG Mary MG - Original Message - MG From: Ron Carson rdcar...@otnow.com MG To: OTlist@OTnow.com MG Sent: Sunday, August 23, 2009 8:39 PM MG Subject: [OTlist] A New One You know, I like fillin' everyone in when I come across OT definitions/experiences that are off the scale. Well, this Saturday was a new one. I was evaluating a woman whose daughter is a SLP working in school systems. What do you think the SLP told me was her understanding of the role of OT? 1. ADL's 2. Fine Motor 3. Occupation 4. Upper Extremity The answer is #2. In her experience, OT's worked only on fine motor control. PT does gross/large muscle and SLP does cognition. The SLP was actually surprised that I gave her mom a cognitive screen. It just seems that OT is so pigeon-holed into either FMC or UE. Will we ever break these shackles? Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com MG -- MG Options? MG www.otnow.com/mailman/options/otlist_otnow.com MG Archive? MG www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A New One
Why does school OT limit itself to the UE? Why don't they address transfers, mobility, toileting, eating, etc? What does PT do in school systems? - Original Message - From: Mary Alice Cafiero m...@mac.com Sent: Sunday, August 23, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] A New One MAC Mary, MAC That has been my experience with school system therapy as well. Goals MAC have to be based on the educational goals for the school year. In MAC fact, in one district near me, the OT no longer makes separate goals. MAC Instead they look at the educational goals for the semester or 6 weeks MAC and sign on to the ones that OT can help with. Sometimes ADLs can be MAC addressed, but it usually has to be a Life Skills type classroom and MAC not a mainstream classroom for these goals. Visual perception, eye/ MAC hand coordination as well as fine motor are often addressed. MAC Since education is the primary focus, therapy (all three) tends to MAC take a backseat role to the academic objectives. MAC It is definitely a different world than medical model. MAC Does anyone remember the old fable of the blind men being asked to MAC feel and then describe the elephant they are feeling? Each man is only MAC given one area of the elephant to feel (i.e. the trunk, ears, tail), MAC so each has a very different idea of what an elephant is. Seems to me MAC that OT is similar. Depending on the piece you have been exposed to, MAC you have a different interpretation of what OT is. None are MAC necessarily wrong, but none actually get the whole picture either. MAC How is that for different? Anyone ever compared our profession to an MAC elephant before? smile MAC Mary Alice MAC Mary Alice Cafiero, MSOT/L, ATP MAC m...@mac.com MAC 972-757-3733 MAC Fax 888-708-8683 MAC This message, including any attachments, may include confidential, MAC privileged and/or inside information. Any distribution or use of this MAC communication by anyone other than the intended recipient(s) is MAC strictly prohibited and may be unlawful. If you are not the recipient MAC of this message, please notify the sender and permanently delete the MAC message from your system. MAC On Aug 23, 2009, at 7:49 PM, Mary Giarratano wrote: In a lot of school systems, most of what OTs do is fine motor and handwriting. The OT goals have to be educationally based, not overlap other services and the parents want their children to have legible handwriting. I'm sure it doesn't fit your definitions but it is the way most school systems work when the majority of pts do not have significant motor issues. Mary - Original Message - From: Ron Carson rdcar...@otnow.com To: OTlist@OTnow.com Sent: Sunday, August 23, 2009 8:39 PM Subject: [OTlist] A New One You know, I like fillin' everyone in when I come across OT definitions/experiences that are off the scale. Well, this Saturday was a new one. I was evaluating a woman whose daughter is a SLP working in school systems. What do you think the SLP told me was her understanding of the role of OT? 1. ADL's 2. Fine Motor 3. Occupation 4. Upper Extremity The answer is #2. In her experience, OT's worked only on fine motor control. PT does gross/large muscle and SLP does cognition. The SLP was actually surprised that I gave her mom a cognitive screen. It just seems that OT is so pigeon-holed into either FMC or UE. Will we ever break these shackles? Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com MAC -- MAC Options? MAC www.otnow.com/mailman/options/otlist_otnow.com MAC Archive? MAC www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Great CEU Article in OT Practice
The July 27, 2009 issue of OT Practice has a very informative CEU article on Medicare Coverage of Occupational Therapy Provided in the Home and Community. It briefly discusses many of the issues facing an OT in Private Practice. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Welcome To Our Newest Members...
Welcome to our newest members!! == Gabriel gsnaka...@gmail.com kit_o...@yahoo.com katie katiemyers...@hotmail.com AspiringOT moggi...@hotmail.com Deepa deepa_bhara...@rediffmail.com Betsy chase.be...@gmail.com donna donnascriv...@hotmail.com Kim kim-b...@live.com Gregg Frank gr...@backhomesafely.com Noreen Loth saree...@aol.com = Ron Deepa deepa_bhara...@rediffmail.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Inconsistency?
Took the following from AOTA's Legislative Action page. It's from the AOTA president: “As a part of the Centennial Vision, we are pushing forward to strengthen occupational therapy’s role in enhancing the well-being and functional status of older adults so they are more likely to remain safely in their homes This is a great concept and goal. BUT, how is OT going to meet this goal when it seems that the majority of home health therapists work above the waist? Aren't we once again SAYING one thing but doing something different? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Difference?
I would like the MD to have stated something like what YOU said. In other words, that OT was using basketball to improve the patient's ability to take care of themselves. Instead, the MD said: The OT used this task for counting, visual perceptual training and attention. Personally, I don't see counting, visual perception or attention to be very specific to OT. And that's my concern. I so wish, OT would be known as the profession that teaches people to take care of themselves, be productive and have fun. Unfortunately, it seems just about impossible for this to happen. - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Tuesday, August 18, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Difference? cac PT's walking and stair climbing goals. I'm sure working on a game like cac that in OT would help with their ADL goals and the actual leisure goal cac of playing BB -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Renew AOTA or NOT??????
It's not only (+) commentary that grows a profession. In fact, our profession is sorely lacking in (-) commentary. - Original Message - From: Carmen Aguirre caguirr...@msn.com Sent: Wednesday, August 19, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Renew AOTA or NOT?? CA Again, I said it long time ago in this listserve: What are you CA complainers doing to make the difference AOTA is not doing in your CA opinion? Where is the useful commentary that helps outr profession grow CA and serve the community even better? -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Renew AOTA or NOT??????
I am 100% confident that AOTA already promotes OT as more than arm pumpers (great saying by the way). My concern is that AOTA is dormant on ensuring that OT's are actually DOING more than arm pumping. It's all great that AOTA promulgates wonderful documents like the Framework, but why are they not investigating, publicizing and trying to change the fact that the vast majority of phys-dys OT's ARE arm pumpers? Ron - Original Message - From: Michael Holmes o...@nvhospital.org Sent: Thursday, August 20, 2009 To: otl...@otnow.com. otl...@otnow.com. Subj: [OTlist] Renew AOTA or NOT?? MH The AOTA is for the advancement of this profession, and MH perhaps Ron, if you wanted to change OT's perception from UE therapist, you MH might find them an ally. I am sure the AOTA would welcome the opportunity to MH promote OT as more than an arm pumper -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Renew AOTA or NOT??????
Chuck, you know that I highly value your membership and input on this list, so please don't take offense to this. In all honesty, it does NOT take a national organization to lobby Medicare contractors for change. I have PERSONALLY done the same thing, by simply send the right person at FCSO an e-mail. I don't want to take away from AOTA's success but that doesn't really seem like a significant accomplish. Now, if AOTA can get OT as a qualifying home health service, that will be something. Although, it won't make much difference in my HH company because like I previously said, there are 4x more PT's than OT's. Go figure. Also, the new branding campaign is just about enough to send me over the edge. I was VERY active on AOTA's OT Connection forums about how the brand misses the mark. It kept being reiterated that AOTA had done research on the brand, but no research was made available on the forum. So, I don't know. It just seems like AOTA is out of step with what I perceive as the greatest needs of the OT community. And, I really feel like I have NO voice. I remember that all the negative comments about the brand, drew some negative comments from the President. I understand that when you volunteer for a position, you certainly don't want to read a bunch of complaining from a member. But, what I want to say is negative. So, I don't really know what to do Ron - Original Message - From: Chuck Willmarth cwillma...@aota.org Sent: Thursday, August 20, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Renew AOTA or NOT?? CW Ron, CW I do hope that you choose to renew your AOTA membership. Your dues CW help provide the resources we need to advocate on behalf of the CW profession. I know that you don't agree with everything the CW Association has done. I think it is important that leadership hears CW from members from different perspectives; your voice does count. CW I believe that the the national Association does make a difference. CW Actually just the other day we lobbied the Medicare Contractors in CW Florida (First Coast) to cover the assistive technology code (97755) and CW they agreed. See: CW http://occupational-therapy.advanceweb.com/Article/FL-Contractor-Restore CW s-Code.aspx. CW I hope you renew and that we see each other in Orlando. CW Chuck Willmarth CW Director, State Affairs and Reimbursement and Regulatory Policy CW AOTA CW -Original Message- CW From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On CW Behalf Of Ron Carson CW Sent: Tuesday, August 18, 2009 8:23 PM CW To: OTlist CW Subject: [OTlist] Renew AOTA or NOT?? CW That is the question. I've supported AOTA for most of the years CW since graduating. But, I am really struggling to justify sending them CW $225.00 this year. I'm mean what do I personally get out of that CW money? I haven't supported much of what they've done. I don't think CW they are leading our profession down the correct path. I think they CW are hung up on doing what THEY want rather than what's best for the CW profession. CW About the only good thing I guess is that I can go to the 2010 CW Orlando, FL national conference for a reduced rate. LOL. CW I'm looking for what others say about paying dues to AOTA. CW Thanks, CW Ron CW ~~~ CW Ron Carson MHS, OT CW www.OTnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com CW -- CW Options? CW www.otnow.com/mailman/options/otlist_otnow.com CW Archive? CW www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Backpack Unawareness
Diane, I'm not sure of what money is being spent. I do know that a while back, AOTA entered into a marketing campaign with LL Bean to place an AOTA endorsed logo on some catalog backpack items. I bet this cost money, but who knows how much. As a marketing campaign for OT, I think that the backpack awareness has very limited usefullness. Other professions also market backpack awareness and I just don't see OT being a leader in this arena. I think OT MUST establish itself in areas that others haven't already established. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Tuesday, August 18, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Backpack Unawareness DR I am not familiar with what the controversy is surrounding this issue. What DR research about this is lacking? What kind of money is being spent on the DR issue and why is it not relevant to OT? Diane COTA/L Peds -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Difference?
If a patient does not respond to a specific treatment intervention, team members discuss what is working for them and incorporate that into the PT sessions. For example, we had a patient who enjoyed playing basketball but wasn't interested in much else due to his agitated state from his brain injury. The OT used this task for counting, visual perceptual training and attention. The PT used this task by having the patient stand and shoot baskets from varying distances to address balance and coordination. When treating persons with acquired brain injury, it is essential to identify what will motivate them to participate in therapy while providing interventions that will address their impairments and functional limitations SOURCE: (Rehab Management. Vol. 22, No.7, Page 15.) The above quote is taken from a brief physician written article on an interdisciplinary approach to stroke rehab. I should mention that the magazines article has a picture of an OT doing UE range of motion, what else right??? None the less, look at the quote. Notice that the MD refers to incorporating intervention into PT sessions? Oversight on his part, or just a fact that PT IS the team? Also, please tell me what the heck is the difference between what the PT and the OT are doing? The whole concept of separating basketball into specific treatment spectrums is just plain silly. If a person is playing basketball isn't he working on ALL the processes needed to through the ball into a hoop? Why would OT segment out their treatment into cognitive stuff while the PT addresses the physical stuff? In my opinion OT should be the ONLY discipline using basketball for rehab. PT should be in the gym working on ROM, strength, pain, etc. For 10 YEARS, I've been preaching that occupation is our bread and butter. But, phys-dys OT's are so stupidly stuck on limiting themselves to UE rehab that OTHER disciplines are grabbing onto the VERY TERRITORY that we should be staking claim to. I predict, that one day in the future, OT's will look back and say, why did we let PT take over using daily occupation as a treatment modality. We are literally shooting ourselves in the foot just so we can lay claim to the stupid arm! Tragic really!!! Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Backpack Unawareness
Does anyone else think that AOTA's dribble on Backpack Awareness is a total waste of time and money? Well, maybe not for school/ped therapists, but certainly for the rest of the OT world. Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Renew AOTA or NOT??????
That is the question. I've supported AOTA for most of the years since graduating. But, I am really struggling to justify sending them $225.00 this year. I'm mean what do I personally get out of that money? I haven't supported much of what they've done. I don't think they are leading our profession down the correct path. I think they are hung up on doing what THEY want rather than what's best for the profession. About the only good thing I guess is that I can go to the 2010 Orlando, FL national conference for a reduced rate. LOL. I'm looking for what others say about paying dues to AOTA. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Backpack Unawareness
Do tell! - Original Message - From: Pat Ellison pat0...@earthlink.net Sent: Tuesday, August 18, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Backpack Unawareness PE I just took the plunge and quit my job and opened my own clinic! PE Pat -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Interestingly, I just noticed that the EBRSR article actually sites the Cochrane article... - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Ron, SD While that is the current Cochrane one it is over 3 years old. SD The one from EBRSR is this last year. As a Cochrane author I SD prefer the Cochrane methodology to some of the others and think it SD produces a more accurate and thorough outcome but in this case I SD think the EBSR is a little more current. SD Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com SD -- SD Options? SD www.otnow.com/mailman/options/otlist_otnow.com SD Archive? SD www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] OTlist Digest, Vol 74, Issue 1
Hello Angela and All: I strongly agree with much of what you said. It seems that you take an inclusive rather than exclusive approach to neglect. And that's EXACTLY how I see OT's role. In other words, people experiencing neglect should be treated by verbal/tactile cuing and environmental mods to promote increased attention during daily activity. This is what I call inclusive because the neglect treatment is included in the treatment. I do this sort of treatment ALL the time. In fact, I did it today with a patient who has right disregard/neglect. I am constantly giving verbal and tactile cues during his therapy. Whether is working on sit to stands, transfers, toileting/hygiene, etc. I am constantly cueing him to include his right side. It seems that either I expressed myself poorly or my words were misconstrued about OT's treating neglect. Thanks for writing... Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Angela King (ADHB) ang...@adhb.govt.nz Sent: Thursday, August 13, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] OTlist Digest, Vol 74, Issue 1 AKA On this whole issue of the neglect thing I have a couple more things to AKA add, because like Ron I have an opinion on just about everything (except AKA the whole UE thing!!). AKA Ron I understand where you are coming from in that neglect can be AKA difficult to improve but in most clients some degree of improvement does AKA occur. Yes a lot of that is down to spontaneous recovery but most of AKA what improves post stroke is down to spontaneous recovery and it is our AKA job as therapists to provide the correct stimulation to the brain during AKA this time when it is trying to fix itself. If we neglect the neglect AKA when the brain is geared up to heal then we are not maximising the AKA improvements that can be made. Well that's what I tell myself anyway! AKA Things like arranging the room so that a person must attend to that side AKA is quick and easy and if it gives them 2% improvement that is a start. AKA The significant other side of this is the education and compensation AKA side of things. I have had clients with very bad neglect who through AKA intensive training have learned to compensate for their neglect. I AKA personally think that education is one of the best things we can do for AKA our clients. I try and train my stroke clients to know what I know so AKA that when they leave me they can be their own therapist. My clients AKA probably know more about neuroplasticity and grading activities than AKA many OT's! That way they can continue to improve if they are motivated AKA to. I have an ex-client with a shocking neglect who uses a power AKA wheelchair for mobility. She does crash into doorways occasionally when AKA distracted but for the most part she is ok and has the freedom to get AKA herself around (inside anyway)- all down to compensation. AKA So even if someone months post stroke has an awful neglect and are not AKA making spontaneous recovery I'd be teaching them how to compensate for AKA it in daily life, because that is what we as OT's do! We don't give up AKA on people with paraplegia because they don't walk again. AKA Haha my opinion yet again. AKA Angela King NZROT, Assessor AKA Outpatients, Directions Appraisal Team - REHAB PLUS AKA 54 Carrington Road AKA Pt Chevalier, Auckland AKA Auckland District Health Board AKA # AKA Scanned by MailMarshal - Marshal8e6's comprehensive email content security solution. AKA Download a free evaluation of MailMarshal at www.marshal.com AKA # AKA -- AKA Options? AKA www.otnow.com/mailman/options/otlist_otnow.com AKA Archive? AKA www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] One Example of How Other Dispciplines Address Function...
Joan: I like your statement of expertise. I fits well with something that I occasionally use. Sometimes, I describe OT as being a bridge builder between what patients want to do and what they are currently able to do. I sort of use this idea when deciding if a treatment is OT or something else. For example, when I provide lymphedema tx. I am NOT providing OT. Instead, I am doing something to the patient to help control symptoms of a disease. Conversely, when I provide OT, I am doing something FOR the patient to help them better do what they want. For me, it's all about goals. Goals define the direction, progress and final outcome of treatment. If the goal is improving a stated occupation, then in my mind it's OT. If the goal is anything else, then it's OT doing something - lymphedema in my case. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Joan Riches jric...@telusplanet.net Sent: Tuesday, August 11, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] One Example of How Other Dispciplines Address Function... JR Hi Ron JR Some time ago there was a discussion about the expertise of OT with very JR good input. At that time I offered the following definition. There was JR no reaction to it. I challenge everyone to find an OT practice of which JR they approve that does not fit this statement about our expertise. JR My formulation of the expertise of the profession of Occupational JR Therapy (not necessarily the expertise of individual therapists) is; JR 1. to become CONSCIOUSLY aware of mismatches between client abilities JR and task demands (cognitive, psychological, social and physical), which JR interfere with the performance of needed, wanted, expected or potential JR occupations; JR 2. to analyze the mismatches; and JR 3. to design and offer interventions to mediate the mismatches. JR In various contexts and circumstances there is much more to say, of JR course, but what does not fit? JR I acknowledge the thinking from this list, the Canadian practice JR document (Enabling Occupation II)especially the Taxonomic Code of JR Occupational Performance (TCOP), and the work I have been doing with JR Sarah Austin to articulate the theory of the cognitive disabilities JR model developed by Claudia Kay Allen in seeing that our expertise is a JR particular application of the concept of occupation. JR Blessings, Joan JR 403 652 7928 JR -Original Message- JR From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JR Behalf Of Ron Carson JR Sent: August 11, 2009 7:20 AM JR To: OTlist JR Subject: [OTlist] One Example of How Other Dispciplines Address JR Function... JR This is a partial quote from a PT on a different listserve: One thing to note is that this guy is an avid marathoner. He runs several a year, including Boston. His surgeon actually said he was more worried about his scapula than his lungs regarding returning to running. JR I have previously argued that all healthcare disciplines address JR function. And this is just one example. Often OT claims to be JR experts in function, but that is just not the case. Anymore, every JR discipline is an expert in function. Everyone from surgeons to OT's JR claim to restore people back to daily living. JR So, what is OT's expertise that separates us from everyone else JR Thanks, JR Ron JR ~~~ JR Ron Carson MHS, OT JR www.OTnow.com JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com JR No virus found in this incoming message. JR Checked by AVG - www.avg.com JR Version: 8.5.392 / Virus Database: 270.13.49/2294 - Release Date: JR 08/11/09 06:10:00 JR No virus found in this outgoing message. JR Checked by AVG - www.avg.com JR Version: 8.5.392 / Virus Database: 270.13.49/2294 - Release Date: JR 08/11/09 06:10:00 JR -- JR Options? JR www.otnow.com/mailman/options/otlist_otnow.com JR Archive? JR www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] OTlist Digest, Vol 74, Issue 1
Angela, your below quoted statement sort of grabbed my attention. I understand what you are saying if looking at the individual body components such as arm, leg, sensory, etc. But I don't agree that spontaneous recovery occurs at the whole person level. What do you think? Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Angela King (ADHB) ang...@adhb.govt.nz Sent: Thursday, August 13, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] OTlist Digest, Vol 74, Issue 1 AKA Yes a lot of that is down to spontaneous recovery but most of what AKA improves post stroke is down to spontaneous recovery and it is our job AKA as therapists to provide the correct stimulation to the brain during AKA this time when it is trying to fix itself. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Sitting Down
Definitely agree that many occupations occur while sitting. However, I always maintain that occupational therapy should include how the patient is going to get to the place to engage in occupation. Occasionally, I hear OT's say: PT teaches you how to get 'there' and OT teaches you how do 'it' when you are 'there'. I really hate that saying because it removes OT from the continuity of occupational preparation. If OT can teach people how to transfer, then they can teach people how to get to the transfer place. Transferring is nothing more than putting weight on your feet and moving them. Mobility training is a natural extension of transfer training. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: roxannedi...@aol.com roxannedi...@aol.com Sent: Thursday, August 13, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Sitting Down Rac With that said, I think Rac it would be foolish to say that there aren't numerous activities that call Rac for us to be sitting on a surface. For example, we eat, read (at times), type, Rac dress ourselves (some, not all), play games, drive, ride a bike etc... Rac Roxanne Disla, OTR/L -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Bully
Several people, some long-time members, have recently left the list. They commented that I am coming off as a bully and this list should not be about me. If you feel bullied by my comments, then I am sorry. It is not my desire nor intention to bully anyone. However, I do have strong opinions and convictions about OT-related topics and I'm not hesitant to post them. But, do NOT let that stop you from posting as well. In my opinion, one thing sorely lacking in the OT profession is CONVICTION. We have too few people with too little conviction about their theory, beliefs and practices. Conversely, we have way too many sheep just going with the flow of traditional practice patterns, even when these patterns are inconsistent with theory. Finally, don't take things personally. This is NOT about YOU or ME, it's about the practice of OT. I have NO negative feelings towards anyone, past or present, on this list. I will gladly shake the hand of any OTnow.com list member or ex-member. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Even PT's Think OT's Do Too Much ThereEx... LOL
Once again, this is taken from another listserve and is written by a PT: In the IRF setting, what percentage of your patients' OT services are ADL training each day? What are typical staffing schedules for your OTs? What do you see happening regularly as functional training tasks other than basic dressing/bathing tasks? I have a couple of staff that seem to be in a rut. I see my OTs doing what I percieve to be too much basic ther ex and too few ADL tasks. I am looking for data/statistics from other IRF settings to give them an idea of what is typical and expected from an ADL perspective. How much of your OTs' time is spent in patient rooms with ADLs vs. in the gym with ther ex? Now we have a PT questioning that OT is spending too much time doing EXERCISES. too funny!!! Not funny at all. Just plain sad! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] OTlist Digest, Vol 74, Issue 1
It's so weird that you mention empathy. I was just discussing with the OTA program director that I believe that having students do disability/impairment simulation tends to minimize patients' actual experiences. I say this because the biggest problem facing patients is the LONG term impact of impairment/disability. And, this can NOT be simulated in the classroom. Anyway, it's just funny you mentioned it because I was just talking about. And on a final note, the OTA program director disagreed with my assertion. LOL Ron - Original Message - From: Diane Randall spark...@rcn.com Sent: Thursday, August 13, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] OTlist Digest, Vol 74, Issue 1 DR My clients DR probably know more about neuroplasticity and grading activities than DR many OT's! DR That brings to mind Ron's thread about teaching COTA's. A very powerful DR teaching approach is to help students empathize with the plight of those DR with disease and disability. I heard there are glasses that can be worn that DR mimic neglect? Is that true? I remember the Vaseline on the glasses to mimic DR cataracts and clothes pins on fingers to mimic the pain of arthritis. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Sitting Down
I'm starting work on the COTA course. While scanning the text book, I noticed that about 95% of the pictures show patients who are sitting down. In fact, the 1st chapter of the book has 11 pictures and ALL the patients are sitting. Just strikes me as odd that we are a profession of participation but based on these pics, I could be surmised that participation ONLY occurs in a seated position. I wonder why that is? Ron Ron Carson, MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] One Example of How Other Dispciplines Address Function...
This is a partial quote from a PT on a different listserve: One thing to note is that this guy is an avid marathoner. He runs several a year, including Boston. His surgeon actually said he was more worried about his scapula than his lungs regarding returning to running. I have previously argued that all healthcare disciplines address function. And this is just one example. Often OT claims to be experts in function, but that is just not the case. Anymore, every discipline is an expert in function. Everyone from surgeons to OT's claim to restore people back to daily living. So, what is OT's expertise that separates us from everyone else Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Good observation and very good point. This topic has been a good learning experience for me. My experience with neglect is still the same, but based on some of the research, others have more success. Thanks for all the comments. Ron - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Ron, SD While that is the current Cochrane one it is over 3 years old. SD The one from EBRSR is this last year. As a Cochrane author I SD prefer the Cochrane methodology to some of the others and think it SD produces a more accurate and thorough outcome but in this case I SD think the EBSR is a little more current. SD Sue D Date: Thu, 6 Aug 2009 17:27:58 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: Re: [OTlist] Massive new CVA patient From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com SD -- SD Options? SD www.otnow.com/mailman/options/otlist_otnow.com SD Archive? SD www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Great patient to work with. At this point, there is nothing YOU can do to SIGNIFICANTLY increase his awareness. I would educate him, if appropriate, and family, if available, about visual and verbal cueing, but I would NOT waste a lot of time doing this. Over time, the neglect may subside but I believe this is one of those areas that takes a great deal of time and sort of spontaneous recovery. Are you a COTA or OT (this is why I ask people to include their credentials in messages). If you are the OT, I would change the goal to: Patient will perform basic ADL's Don't limit the patient and your treatment to the neglect. Surely there are other things inhibiting the patient's independence. Make a list of the patient's problems: physical, mental, emotional, environmental. Prioritize which of these problems are most significant AND that you have the ability to significantly improve. There is no use working on something that will not likely show significant change. My suspicion, is that you should be working on sitting balance. If the patient can sit, then work on standing balance, if the patient can stand, work on mobility. And no matter what, you must address the patient's emotional needs to be in control and have self-worth and dignity. In my opinion, this is best done through an honest therapeutic relationship. I believe that in complicated situations, the therapist MUST organize available information in a manner that allows them to address the most salient issues. We only have limited time with patients, so we MUST make best use of that time by addressing those issues which most impair patient's occupations. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient DR Hello, I have been given (along with 11 other patients I have) a new CVA DR patient. I have never worked with someone tis impaired and i don't know DR where to start. I am in a SNF and pt had been in an acute rehab for about a DR month prior for therapy. He is Dependent for all ADL's and DR transfers...sometimes hard to get his attention at all. Total left neglect. DR Trouble following simple commands. 1 finger sublux. Just not sure where to DR even begin. Goals are to increase attention to the left to perform ADL's DR but is this relistic at this point and what activites can I do with him that DR will encourge attention to left or attention to anything at all. Thanks DR Diane DR -- DR Options? DR www.otnow.com/mailman/options/otlist_otnow.com DR Archive? DR www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would you?
Hello All: No, this is not a hypothetical situation. I did in fact decline seeing this therapist's patients. To me, it only makes sense that a therapist who believes that OT should NOT focus on the UE would not treat patients where the focus is on the UE. Remember, that a while back, I sent my clinical supervisor and regional manager a message declining to work with UE-focused patients. I was called into their offices to explain my message. So, to now see patients with an UE focus is just wrong. Regarding the statement, goals should be related to function, EVERY therapists goals are related to function. Almost every PT goal is read is about function. So, what is it that makes OT different? I remain convinced that the insistent focus on treating UE is nothing but 'crappy PT', to quote another OT listserver. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Amber nollen nollen...@msn.com Sent: Wednesday, August 05, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Would you? An H, I have to say... I hope these are hypothetical ethics An questions. I guess I really am not seeing why you would refuse to An cover the patient, because of the treatment the other therapist is An providing. Wouldn't this be your time to shine, a time to An prove what OT really is. The therapists goals should be related An to function in some way, right. And even if not, we are OT's for An Gods sake, we are all about adapting, grading, and analyzing An activities. In summary... yes, I would cover for the therapist. An I would look at the goals, and bring function into the mix if it had not been addressed. An Amber An From: re_...@hotmail.com To: otlist@otnow.com Date: Thu, 6 Aug 2009 01:04:52 + Subject: Re: [OTlist] Would you? haaa sometimes you ask things that are thought provoking and I get that- and sometimes I wonder if you are insane! haaa agree with last comment- I AINT YOU pal Date: Wed, 5 Aug 2009 15:28:19 -0700 From: audra...@yahoo.com To: OTlist@OTnow.com Subject: Re: [OTlist] Would you? No, I would not refuse to see another OT's patients, because I don't mind treating patients with UE problems, But I am not you. --- On Tue, 8/4/09, Ron Carson rdcar...@otnow.com wrote: From: Ron Carson rdcar...@otnow.com Subject: [OTlist] Would you? To: OTlist OTlist@OTnow.com Date: Tuesday, August 4, 2009, 5:53 PM Would you refuse to treat another OT's patient because the other OT sees patients primarily for UE rehab? We have an OT on vacation and I was asked to cover. When I learned who the OT was and knowing her practice patterns, I suggested the agency find another OT. Would you do this, why or why not? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com _ Get free photo software from Windows Live http://www.windowslive.com/online/photos?ocid=PID23393::T:WLMTAGL:ON:WL:en-US:SI_PH_software:082009 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com An _ An Get your vacation photos on your phone! An http://windowsliveformobile.com/en-us/photos/default.aspx?OCID=0809TL-HM An -- An Options? An www.otnow.com/mailman/options/otlist_otnow.com An Archive? An www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
From Cochrane.org: http://www.cochrane.org/reviews/en/ab003586.html The benefit of cognitive rehabilitation for unilateral spatial neglect, a condition that can affect stroke survivors, is unclear. Unilateral spatial neglect is a condition which reduces a person's ability to look, listen or make movements in one half of their environment. This can affect their ability to carry out many everyday tasks such as eating, reading and getting dressed, and restricts a person's independence. Our review of 12 studies involving306participants found that rehabilitation specifically targeted at neglect appeared to improve a person's ability to complete tests such as finding visual targets and marking the mid-point of a line. However, its effect on their ability to carry out a meaningful everyday task or to live independently was not clear. Patients with neglect should continue to receive general stroke rehabilitation services but better quality research is needed to identify optimal treatments. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Linda Stovall lstov...@mhg.com Sent: Thursday, August 06, 2009 To: otlist@OTnow.com otlist@OTnow.com Subj: [OTlist] Massive new CVA patient LS In contrast to Ron, I think there are some things to be done to address LS the neglect...and it is important to work on this, so that function can LS become a reality. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] OTlist Digest, Vol 73, Issue 2
In my experience, some people do recover from neglect and some don't. It is my experience and belief that therapy has very little, but some, contribution in this recovery. It is my belief that significant spontaneous recover will or wont' occur regardless of therapeutic intervention. This is not to say that OT has NO role. I do believe we can facilitate this recovery but only in a limited fashion. The question of how best to do this is a whole different topic. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Angela King (ADHB) ang...@adhb.govt.nz Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] OTlist Digest, Vol 73, Issue 2 AKA I disagree with Ron in AKA that I've seen people make huge recovery in terms of left neglect, AKA partly through brain fixing itself and partly through compensation. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Massive new CVA patient
Interesting website. Thanks for the link... Ron - Original Message - From: Sue Doyle sue...@hotmail.com Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Massive new CVA patient SD Diane, SD I am going to comment here rather than Lurking. SD There are some great resources to help you with evidence-based interventions SD Treatment of Neglect etc. SD Go to www.ebrsr.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] World According to Ron - not
If you don't like my views, then simply delete without reading. Someone ask a question and I provided and answer and I also provided information from Cochrane.org substantiating my experience and opinion. Is that the evidence you speak of? Others have posted information that seems to counter Cochrane.org. That's good, and the topic has given me some additional food for thought about neglect. And don't forget, evidence also exists outside of published journals. And, I never said that OT could not affect neglect. I stated that we will have only minimal impact. Also, not everyone knows my views about OT. People join the list who have never been exposed to some of the concepts discussed here. It should be no secret that I started this list to share my opinion on occupation and OT. But, the topics have NEVER been restricted to supporting my views. ANY topic relating to OT is welcome. This message board exists for ALL of us to express our opinion. It's a free board in more ways than one. Anyone differing with my (or others) opinion can do one of three things: 1. Reply 2. Ignore 3. Unsubscribe I see you've chosen 1 and 2. Good, I'm glad you haven't chosen 3. There is ONLY one reason why I have more messages and express my views more frequently. EVERYONE on here can do the same. I have no magic want that I wave to make messages magically appear or disappear. Messages only appear when someone has enough concern or passion to write. Obviously, I have a lot of passion about occupation. I'm sure I will one day grow weary of all this typing, but until then you should expect more of the same from me. smile Thanks for sharing your opinion. Hopefully it made your day a little better honestly! Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Mary Alice Cafiero m...@mac.com Sent: Thursday, August 06, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] OTlist Digest, Vol 73, Issue 2 MAC Ron, MAC I must say that as our entire profession moves toward a practice model MAC that is more evidence based, you seem intent to do what you do and MAC believe what you believe because that is what you do. We are all very MAC aware of your feelings on occupation and not being an upper extremity MAC therapist. I think that is quite different, however, than saying that MAC OT does not/cannot influence neglect syndromes as a result of CVA when MAC there is documented research that shows differently. MAC We all have beliefs based on our long or short term experience in the MAC field and with patients. However, we must also be willing to modify MAC our beliefs based on current trends and advances in medicine, science, MAC therapy, and research. When there is evidence that OT makes a MAC difference, OT should try to make a difference. MAC I am typically very patient and tolerant. I am growing weary, however, MAC of this appearing to be a message board based on the World According MAC to Ron. I don't think that is how you mean it. You have strong views MAC and no reluctance to share them. However, it gets tiresome (to me at MAC least). MAC Maybe if more people continue to express their views and speak up on MAC here, it will continue to grow in diversity and freedom of expression. MAC I think some people, especially new to the list, are intimidated about MAC speaking up when one view is expressed most often and most loudly. MAC Sorry this doesn't sound respectful. I don't mean to sound harsh. It MAC has been a very long day. MAC Mary Alice MAC Mary Alice Cafiero, MSOT/L, ATP MAC m...@mac.com MAC 972-757-3733 MAC Fax 888-708-8683 MAC This message, including any attachments, may include confidential, MAC privileged and/or inside information. Any distribution or use of this MAC communication by anyone other than the intended recipient(s) is MAC strictly prohibited and may be unlawful. If you are not the recipient MAC of this message, please notify the sender and permanently delete the MAC message from your system. MAC On Aug 6, 2009, at 5:06 PM, Ron Carson wrote: In my experience, some people do recover from neglect and some don't. It is my experience and belief that therapy has very little, but some, contribution in this recovery. It is my belief that significant spontaneous recover will or wont' occur regardless of therapeutic intervention. This is not to say that OT has NO role. I do believe we can facilitate this recovery but only in a limited fashion. The question of how best to do this is a whole different topic. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Angela King (ADHB) ang...@adhb.govt.nz Sent: Thursday, August 06, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] OTlist Digest, Vol 73, Issue 2 AKA I disagree with Ron in AKA that I've seen people make huge recovery in terms of left neglect, AKA partly
[OTlist] Patient Requests Different Therapist....
Yesterday, a patient requested that I not be his therapist. He told an appt scheduler that our personality's clashed. I have previously seen this patient and agree with his assessment about personality clash. I KNOW these things happen, at least to me. I am very interested in learning what it is about my personality that clashes. Is it my words, actions, attitude, etc that the patient doesn't like. The ONLY reason I want to know is really just for 'learning'. I want to know if there is something that I'm doing wrong. But, how can I find this out. Most people are not willing or maybe able to talk about such things. Would YOU pursue trying to find this out? If so, how? Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Would you?
Would you refuse to treat another OT's patient because the other OT sees patients primarily for UE rehab? We have an OT on vacation and I was asked to cover. When I learned who the OT was and knowing her practice patterns, I suggested the agency find another OT. Would you do this, why or why not? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Patient Requests Different Therapist....
I don't think anything about him clashed with me. However, I do believe that the patient was wanting a therapist to do something TO him. Instead, what he got with me was a therapist asking a lot of nosy questions, prying into the why and how comes of his situation. In retrospect, I do NOT believe the patient: 1. Valued 2. Understood my approach. But, I don't know, which is why I asked our secretary to inquire with the patient. I haven't hear anything yet, and I doubt I ever will. Which I don't understand. How can we improve ourselves if we are not told how we've possibly erred? Thanks to everyone who responded... Ron . - Original Message - From: Jane Wilson jane.wil...@bopdhb.govt.nz Sent: Tuesday, August 04, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Patient Requests Different Therapist JW Hi Ron, JW I wonder if you had thought about reversing the question- what about his JW personality clashed for you? JW Reflective practice helps us see things from a different view, and helps JW us consider what we may do differently next time. JW Think about the clash which was obviously there for both of you, and JW maybe 'try his shoes'. JW Cheers, JW Jane JW -Original Message- JW From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On JW Behalf Of cmnahrw...@aol.com JW Sent: Wednesday, 5 August 2009 09:14 AM JW To: OTlist@OTnow.com JW Subject: Re: [OTlist] Patient Requests Different Therapist JW Ron, JW Usually the answer to those types of questions come from within. Why do JW you think that your personalities clashed? JW Chris JW -Original Message- JW From: Ron Carson rdcar...@otnow.com JW To: OTlist@OTnow.com JW Sent: Tue, Aug 4, 2009 5:58 am JW Subject: [OTlist] Patient Requests Different Therapist JW Yesterday, a patient requested that I not be his therapist. He told an JW appt scheduler that our personality's clashed. I have previously seen JW this patient and agree with his assessment about personality clash. JW I KNOW these things happen, at least to me. I am very interested in JW learning what it is about my personality that clashes. Is it my words, JW actions, attitude, etc that the patient doesn't like. The ONLY reason I JW want to know is really just for 'learning'. I want to know if there is JW something that I'm doing wrong. But, how can I find this out. Most JW people are not willing or maybe able to talk about such things. JW Would YOU pursue trying to find this out? If so, how? JW Thanks, JW Ron JW -- JW Options? JW www.otnow.com/mailman/options/otlist_otnow.com JW Archive? JW www.mail-archive.com/otlist@otnow.com JW -- JW Options? JW www.otnow.com/mailman/options/otlist_otnow.com JW Archive? JW www.mail-archive.com/otlist@otnow.com JW Notice of Legal Status and Confidential Information: This electronic mail JW message and any accompanying attachments may contain information that is JW privileged and CONFIDENTIAL. If you are not the intended recipient you are JW advised that any use, review, dissemination, distribution or reproduction of JW the information is strictly prohibited and may be unlawful. If you have JW received this document in error, please notify the sender immediately and JW destroy the message. JW __ JW This email has been scrubbed for your protection by SMX. JW For more information visit http://smx.co.nz JW __ JW -- JW Options? JW www.otnow.com/mailman/options/otlist_otnow.com JW Archive? JW www.mail-archive.com/otlist@otnow.com JW No virus found in this incoming message JW Checked by PC Tools AntiVirus (6.0.0.19 - 10.004.060). JW http://www.pctools.com/free-antivirus/ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Just About To Give UP............
Personally, yes I do not provide OT to severally cognitively challenged individuals. I am not gifted nor comfortable working in the realm of cog rehab. And, what I have seen and done has NEVER yielded significant results that I could be clearly associated with the therapy. If you are asking whether providing treatment to someone unable to identify OT-related goals is OT, well that's a bit more difficult to answer. I think sometimes it's OT and sometimes it's not. Let me start with the not. In my experience, OT's working with acutely and severely brain injured often do a couple of things with the ASSUMPTION that they are either facilitating or preserving loss of occupation. I put occupation in parenthesis because they really aren't addressing occupation, but it's the preferred lingo today. In these cases, OT is probably doing something more closely related to PT; things such as ROM, stretching, coma stim, etc. To me, these are really PT'ish type of things. On the other end of the spectrum, just because someone can not verbally communicate or is cognitively impaired , that should not imply that they are devoid of occupational pursuits. In fact, I have a patient in this situation. I have done the best that I can to understand the person before he was sick, to ascertain his wife's needs and goals for the patient and try to communicate these to the patient. I feel that I am addressing the patient's occupational desires, but at this point it's really a best guess scenario. These situations are never perfect. Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: ehthiers ehthi...@earthlink.net Sent: Monday, August 03, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Just About To Give UP e So, you are limiting your self to people who are only cognitively able to e express those ideas? What about mental health patients? People with e learning disabilities? Low cognintion? Do you help set safe levels of e supervision and set up with a OT style cognitive behavioral assessment? e Elizabeth Thiers, OTR/L e FECTS e ehthiersfe...@earthlink.net e -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: Wednesday, July 01, 2009 9:32 AM To: Diane Randall Subject: Re: [OTlist] Just About To Give UP Hello Diane and other: Diane, I strongly believe that when a patient has no identifiable occupational goals, then they should not be seen by OT. After all, if the goal of OT is enabling people to engage in occupation and yet there are no occupational goals, then what is OT doing? More likely than not, they are doing exercises, which is wrong on two levels: 1. Does not REQUIRE the skills of a therapist 2. Is not OT Here's two patients I have today: 1. Patient is unable to care for himself because of weakness and fear of falling. We will work on standing, transfers and mobility. 2. Patient is unable to care for herself and carry out daily occupations related to her role as a wife. We will work on standing, transfers, mobility, etc. None of my interventions include focused treatment on UE, LE, strength, etc. Instead the focus is on restoring lost occupation. This is done by addressing SPECIFIC and IDENTIFIABLE problems which are preventing SPECIFIC and IDENTIFIED occupational goals. It really is a practical approach that I liken to learning to ride a bike. If a person wants to ride a bike the best way is to practice, practice, practice. Like wise, if a person wants to dress, toilet, bathe, shower, cook, clean, laundry, etc, the best approach is practice, practice, practice. I want to address some other things, but I'm off to work. Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Tuesday, June 30, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Just About To Give UP DR Hello, As a new OTA/L a week into my first job in a SNF, I have DR become well acquainted with the UE focus of OT. But, I think the DR most frustrating part of the process is not some much the DR interventions but the fact that so many of my patients have really DR no occupation to look forward to when discharged from rehab. It is DR no wonder we may be tempted to stick with just UE exercises. ( DR besides ADL's we do in rooms) DR Question...tell me about a typical day you spend at home? DR Replies (paraphrased) DR Patient A- I just watch Soaps..my daughter does everything DR (cooking, cleaning) DR Patient B- I have not worked since I gained weight...have not left DR the house except to come here for 2 weeks...thank god for disability. DR Patient C- I don't want therapy and you can't make me go. DR patient D- The nurses do
Re: [OTlist] Intro To OT: Assignments?
Thanks Beth: What are some the assignments that you found challenging? - Original Message - From: Beth Woodcock cota2...@newwavecomm.net Sent: Monday, July 27, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Intro To OT: Assignments? BW Ron, BW As a relatively new grad I have to say the most important thing my BW instructors did was to cultivate my resourcefulness! They repeatedly BW challenged us to assignments that made us research and find alternative BW methods for treatment. When you go to work you quickly realize that there is BW no way your instructor can prepare you for everything you will see, but by BW being challenged in that way I felt more able to handle things as they came BW up. BW Does that help at all? I hope so! BW Sincerely, BW Beth (COTA/L in IL) BW - Original Message - BW From: Ron Carson rdcar...@otnow.com BW To: OTlist@OTnow.com BW Sent: Sunday, July 26, 2009 4:35 PM BW Subject: [OTlist] Intro To OT: Assignments? Hello All: I'm teaching an Intro to OT course at a local OTA program. I would like to develop some really good practical experiences for the students. What suggestions do you have? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com BW -- BW Options? BW www.otnow.com/mailman/options/otlist_otnow.com BW Archive? BW www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Intro To OT: Assignments?
Hello All: I'm teaching an Intro to OT course at a local OTA program. I would like to develop some really good practical experiences for the students. What suggestions do you have? Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Vision vs Reality
Great post and I REALLY like the saying at the end... - Original Message - From: Brent Cheyne brentche...@yahoo.com Sent: Friday, July 24, 2009 To: Ron Carson otlist@otnow.com Subj: [OTlist] Vision vs Reality BC Everyone is making great points in this dialogue, BC BC My practice patterns would fall closely in line with how a lot of BC you are describing- Ron, Chris, Diane, Joan too. It's nice to hear BC other people have the same challenges and frustraions. BC BC Here are 2 that bug me alot! BC BC 1) Don't get me wrong, I love working with COTA's and with PRN OT BC Staff- we usually need the extra help at our busy SNF but...I find BC people don't read the evals and goals that I so pain-stakingly design and select with patients. BC Frequently, I can look across the treatment area as see a BC colleague of mine having the pt I evaluated doing pegs or bicep BC curls or some other task with a Total Knee patient whose goal are BC lower body dressing and shower transfers and meal prep etc..I BC had absolutely NO goal for UE ROM for strength or hand dexterity BC etcc.., I always try to teach and instill in new staff or students BC to read the eval, PLOF, goals and design treatment based on those, I BC am frequently frustrated by people just making up any old activity BC or exercise willy-nilly to put in time. BC If you are taking on a patient that you didn't eval, be sure the BC treatment matches the planned goals and treatment set out in the BC eval, also see if the eval matches what the patient is presenting BC with and talking about...talk to the patient. BC BC 2) Despite high productivity and stressful schedules, therapists BC not taking time to know the patient, or engage and educate their BC family members and communicate to assess their needs and goals and BC incorporated them into the eval goals and planbasically making the interventions skilled. BC BC There's an old adage that hopefully is appropriate here BC --Management is all about doing things right-( productivity, BC filling out forms, schedules, compliance) BC --Leadership is about doing the right things, (client centered occupations and interventions) BC BC We clinicians may not be managers but we still can and should be Leaders.. BC Keep up the good work people! BC BC -- BC Options? BC www.otnow.com/mailman/options/otlist_otnow.com BC Archive? BC www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Vision ~vs~ Reality
Shirley, what if I did OT the way past OT's had done? If I focused treatment on the upper extremity would you still say we are beginning to see how well OT works for our loved ones? Just to remind everyone, Shirley is the mother of a patient that I'm seeing. She has been exposed to a LOT a therapy. - Original Message - From: shirley roberson lrih...@yahoo.com Sent: Wednesday, July 22, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Vision ~vs~ Reality sr Ron, sr sr Maybe somehow you could inform the public..? I sure have learned sr about OT this past year. I know this week when I told my sr son-in-law to contact the agency and ask for you, he was given first sr a CNA and then a PT, but I had to have him call again to get you, sr the OT. It seems that as patients and family we are beginning to sr see how well OT works for our loved ones, but for whatever reason, sr the agencies want to send out personnel as ie: 1,2,3 and the OT seems to be 3. sr Shirley -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Vision ~vs~ Reality
Folding towels is not an occupation, it's an activity. IF a patient TRULY, and I mean truly, had a goal of doing laundry and for some reason they could not fold towels and by folding towels, the OT was addressing the underlying medical, social, environmental barriers, then folding towels would be a fine activity. In fact, Susan transferred laundry from the washer to the dryer. Why? Because laundry was one of her occupations and is something she will need/want to do as she get's better. Plus, it worked on the numerous underlying issues which impairs many of Susan's other occupations. When I first started working on occupation after I read Enabling Occupation: An Occupational Therapy Perspective. This book outlines my treatment philosophy an goes hand and hand with the COPM. So, I started administering the COPM. This assessment helped me identify patient's most needed goals. It was my job to identify the problems impeding their goals. Once I had painted the portrait, I started addressing the problems. The 1st thing I found is that patients are mostly interested in mobility issues. The primary goals were almost always mobility related. Patients want to be able to walk to the kitchen and cook, they want to walk to the toilet and poop. They want to stand at the sink. They want to stand up and walk to do their occupations in as normal a fashion as possible. So, I got busy helping people be more mobile. If they couldn't sit, I worked on sitting. If they couldn't stand, I worked on standing. If they couldn't walk, I worked on mobility. I almost never did pure exercises. Instead, I engaged patients to their maximum potential and beyond in the necessary components of the desired occupation which was missing in the patient. I also found out about their homes. I had people bring in measurements. I found out if they had steps. I learned about the bathroom and the layout of the shower. I simulated these home environments in the rehab gym. If someone had 3 steps into theirs house, we went to the stairs of the hospital. If someone had a 6 inch threshold to get into their shower, we practiced stepping over bolsters of the same height. If they had a tub, I explained tub transfer benches and we practiced. And these are just the things I did in the gym. I did car transfers in the parking lot, I had patient get their own trays and go through the food line in the hospital. If patient's needed and wanted to cook at home (very few), we did cooking. I had patients engaging all sorts of daily occupation. BUT ONLY BECAUSE it was THEIR goal. I hate the idea of OT having patient's washing windows because there's some magical therapeutic power in the fact that it meaningful. Hooey!, that's what I say! The list was endless. I was never at a loss of what to do. Sometimes, I didn't know HOW to do something but I always knew what to do. And that was very different. Before the COPM, I had no REAL idea what patient's wanted. I don't know, does that help? - Original Message - From: Miranda Hayek mltaylo...@hotmail.com Sent: Thursday, July 23, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Vision ~vs~ Reality MH Ron can you provide some examples of how you made it work in the MH in-patient rehab setting. You mentioned that you would see 2-3 MH people at a time, how did you work with each of them on their own occupations? MH MH Also, why is a cooking group, folding towels, not good occupations to work on? MH Thanks, MH ~ Miranda ~ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Vision ~vs~ Reality
In all honesty, the problem of OT is not directly related to the work setting. I've worked or have direct experience in acute care rehab, academia, very briefly in-patient hospital, outpatient, private practice, SNF and home health. ALL of these settings have a majority of OT's focusing treatment on the UE. As far as being in the trenches, that's a choice. I said no to inpatient, got fired from a SNF, quite rehab to work and academia. There are plenty of jobs. But, the problem is not the location. The problem is the therapist. If an OT focuses on occupation, they WILL NOT BE UE THERAPISTS. You can't be both! Many people claim to do it, but I think that's a line of junk. I fully understand that being in a SNF is VERY tough. The primary problem in that setting is not UE ~vs~ occupation, its fraud ~vs~ medically necessary treatment. I got fired because I REFUSED to treat patient's like cattle. Neither the 'system' nor I were willing to change, so they let me go during my probationary period. No harm and no foul, but there was no way I was going to cheat Medicare and rob patients in that system. I first started practicing occupation-based treatment while working at an in-patient rehab hospital. It was routine to see 2 patients at a time and 3 at a time wasn't unheard of. I couldn't spend an hour with each patient but the time I had WAS spent on improving their desired occupation(s). I wasn't perfect, but in my opinion, it was a heck of a lot more therapeutic than having patients fold laundry, do dowel exercises in a large group, wash windows, cook group, sanding a table top, playing childish games, etc. At times, I despise my profession because of the way so many adult phys-dys OT practice. Our professional identity STINKS. In fact, I don't even think we have an identity. And if we do, it's pretty dang crappy. Today, I made up a flyer to distribute to my home health company's nurses. Here it is: = Occupational Therapy: What Is It? 1) Education: a) OT’s have either a bachelor, masters or doctoral degree b) OT assistants have an associate degree 2) Definitions of occupation: a) Any activity that occupies a person's attention b) Activity that a person does to take care of themselves and be productive 3) History of OT: a) Founded in 1914 b) Originally performed by nurses c) Use of crafts to restore meaning and value to injured and impaired soldiers returning from war d) Later, moved to the medical model of care 4) Current Practice: a) Very diverse profession b) Work across the life span because all people have occupational needs/issues i) OT works with neo-nates to terminally ill c) Some OT’s focus on treating the upper extremity, i.e. hand therapists d) Some OT’s focus on treating occupation 5) Common Misconceptions about OT: a) OT is above the waist and PT is below the waist b) OT is small muscles and PT is large muscles c) OT is about helping people find jobs 6) When to Refer to OT: a) Patient has difficulty taking care of themselves or being productive in their home: i) Can’t safely dress, bathe or toilet ii) Can’t safely access bathroom, shower or other areas of the home iii) Can’t safely transferring to/from bed, chair, wheelchair, etc iv) Can’t safely cook, clean, care for animals, laundry, etc 7) Bottom Line: a) When a patient has difficulty or is unable to take care of themselves and be productive in their homes, regardless of the cause(s), an OT evaluation is indicated. = Why in world is it necessary to distribute a flyer to a HOME HEALTH company explaining OT? How can we be so far off the radar map that a HOME HEALTH company is unsure when to refer to OT? IT'S A SAD STATE OF AFFAIRS, THAT'S HOW!!! Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: Diane Randall spark...@rcn.com Sent: Thursday, July 23, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Vision ~vs~ Reality DR I am with you about the UE problem in rehab but I really need to DR know how we can fix this...I have 14 patients to see within 6 hours, DR some are ADL's but I cannot have one on one treatments most of the DR time. I cannot do a shower transfer and have 6 patients waiting in DR the gym. I am kind of at a loss and wondering what a typical gym SNF DR would look like in ideal circumstances. I think a lot of blame is DR one therapists when we are the ones
[OTlist] Vision ~vs~ Reality
Part of AOTA's vision statement is that our profession will be widely recognized. When is our centennial: 2014? Why is is that TODAY, I am writing up a flyer to distribute to my home health office explaining OT and yet in 5 years, OT is going to be widely recognized? Why is it that after almost 100 years, OT is not known? Why is that my home health agency has 3 times as many PT's as OT's? What is going to happen in the next 5 years to make a significant difference in OT's presence? I am one frustrated OT.. Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Really Should be Studying But....
Carmen, that's so funny you asked. I talked with her today and just sent her one of my typical rants. The call went very well. She was open to everything I had to say. I had decided to not say anything, but she actually brought it up. I am very happy with the call! - Original Message - From: Carmen Aguirre caguirr...@msn.com Sent: Monday, July 20, 2009 To: otlist@otnow.com otlist@otnow.com Subj: [OTlist] Really Should be Studying But CA Did you talk to the COTA? CA Carmen -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Welcome to Our Newest Member(s)
Welcome to our newest member(s): # Stephanie rockydo...@gmail.com amber nollen...@msn.com Tova tovago...@gmail.com sophia sophia_had...@hotmail.com Elisa eli...@live.co.uk Shirley R lrih...@yahoo.com Andy mcm_o...@yahoo.com beckymurp...@hotmail.com Michael Holmes o...@nvhospital.org # I like to offer a personal welcome to the above members. Also, I encourage EVERYONE to post messages and replies to the list. The discussions that we have are limited only by the topics that are posted. = REMINDERS = 1. We currently have 354 members on the list 2. ALL messages are archived and are publicly viewable. So, even though this is a members only list, the messages are easily read by anyone. Don't post information that you do not want others to read. 3. Please include your full name and credentials with your message 4. Remove extraneous and unrelated informations from replies. 5. If you are replying to a digest message, PLEASE change the subject title so it is appropriate to the topic. 6. Attachments and HTML messages are not allowed. You can post in HTML, but it is automatically removed. So, bold, italics, underlines, etc do not show in posted messages. Instead, use something like *THIS* to emphasis important text == Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Really Should be Studying But....
I just can't pass up posting about today's OT experience. First thing at the office, I hear a nurse say to a new-hire nurse: You how what OT is, right? I just want you to be clear on the difference between OT and PT. The new nurse replies, and I quote: Yea, OT is above the waist and PT is below the waist, right? The other nurse agreed and I was standing in the corner like a beat dog with my head low... After this lowly start, I'm off to my 1st therapy appt. A very nice elderly lady sitting in her chair wearing only slippers, diaper, and a shirt. I tell her I'm the OT and ask her if she knows what that is. She say's Yea, you help get back to living their lives. I smile BRIGHTLY and say: That's right, but how do you know that. She says: I have Parkinson's and the support group talks about all sorts of therapies and stuff. But, I've never actually had OT. That's OK because at least she know why I'm there!!! So, off to the next patient. This patient has been treated by a COTA under my treatment plan. The man is recovering from lung cancer and is frail, fatigues easily and is a fall risk. The goals I wrote were basic self-care and transfer goals. So, what has the COTA been doing?? Upper extremity exercises and thera-putty. The man does have some neuropathy, but it does not significanatly contribute to his problems. But, because of the whole UE thing the COTA primarily focues on this part of his body.. Oh well, 1 out of 3 is what I consider a good day!! Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Why OT's Should NOT Focus on the UE
Hello Diane: Here would be my approach: 1. Identify the patient's occupational goal(s) a. What does he want/need to do in order to live as safely and independently as reasonably possible 2. Identify underlying barriers: a. Physical b. Cognitive c. Mental d. Social e. Environmental 3. Prioritize the goals/barriers 4. Address those barriers that are within your scope of practice and expertise. Forget about the UE, LE stuff. Focus on the occupational needs/desires of the patient. If it's endurance, then work on endurance. If it's fear, then work on fear. If it's motivation, then work on motivation. The BIGGEST challenge is knowing the occupations and barriers to address On a final note. It may be time to d/c the patient if: 1. There are no occupational goals 2. The goals have been met 3. You are unable to address the causes leading to the occupational dysfunction. 4. The patient does not desire to address his occupational need. In my opinion, you must not let yourself be pigeon-holed into the UE therex mentality. Expand your horizons. Meet the patient where THEY are. Figure out who and what they are about. Develop rapport with him so that you can be of greatest therapeutic benefit. Remember, the goal is to improve occupational performance. Stay in touch, keep us informed and keep asking questions. You are 100% on the right track to becomming a non-UE therex occupational therapist. Gotta love it! Ron - Original Message - From: Diane Randall spark...@rcn.com Sent: Monday, July 13, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Why OT's Should NOT Focus on the UE DR Being that I am new to this and my employment forces me to live in UE DR therex landperhaps you could give me an indication as to what I can do DR with this person. Others more experienced than me in the dept go with the DR flow. He is 500 pounds...can now walk about 50ft with someone following him DR in a W/C and he is able to stand aboout 2-3 min in a RW. DR I have done all ADL's..and although he is able to life weights in all planes DR he does not have the arm length to bipass his midsection to do LE dresssing. DR He has serious LE PN issues so he cannot use a sock aid. he has refused both DR a dressing stick and reacher. DR I have done transfers with him from W/C to bed, W/C to toilet, W/C to shower DR I have done standing tolerance...he likes to draw so I have him stand in DR front of a white boards and he draws murals for the department. DR He does W/C pushups. DR He lives alone, rarely ever left his home due to his weight, microwaves all DR his meals, and lives on disbaility. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Why OT's Should NOT Focus on the UE
In my opinion, if a therapist is consistently PERFORMING 'therapy' that an aide an do, then it's not therapy. By definition, therapy REQUIRES the skills of a therapist. Again it's my opinion, that routine, repetitive exercises that do not target SPECIFIC muscle(s) is not-therapy. Now, if someone has an injury and there are concerns about certain movements, weight restrictions, etc, then a therapist is necessary. But, my experience is that VERY few patient's meet this criteria. Ron - Original Message - From: Diane Randall spark...@rcn.com Sent: Monday, July 13, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Why OT's Should NOT Focus on the UE RC Ask yourself, are you doing something that an aide could be doing? RC If so, then you are not doing therapy! DR Please explain... you are correct in that aides may not know the clinical DR reasoning behind a therapy but the actual physical part of engaging in DR theraputic activity with a patient can sometimes be done by an aide although DR unethical...just saying it is physically possible. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Why OT's Should NOT Focus on the UE
I would NOT recommend them unless you are there to supervise their use. On the other hand, you may make patients aware of the device while at the same time giving them precautions such as: 1. Proper placement is critical 2. Not designed to bear weight 3. Check before using etc. Also, there are different quality suction devices. I always recommend the most expensive devices. I like empowering patients to make informed decisions about devices. Be it a walker or reacher, I try leaving the final decision up to the patient/caregiver, if possible. Ron - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Monday, July 13, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Why OT's Should NOT Focus on the UE cac That reminds me of a question that I had this morning. Has anyone had cac any luck with suction cup grab bars. I work in acute rehab and cac patients often want to order them for home, but I do not get to follow cac up with them after their DC to determine if they actually work. I cac think this may be a good question for the home heatlh OTs. I read in cac consumer reports that the person should not put significant weight cac through them, and to only use them for balance. I am wondering if I cac should recommend them at all -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Why OT's Should NOT Focus on the UE
I will take Chris' suggestions a little further. If the patient wants to bathe in the shower, you must 1st know the environment in which this occurs. Is it a roll-in shower, walk-in shower, tub w/ a shower, glass doors, does it have a seat, how big is the shower, does it have grab rails. These environmental issues are VERY important to the goal of showering. Also, you must understand the persons physical, mental, cognitive and social strengths and weakness. IF showering is the goal, a skilled OT looks at all factors involved in the process, identifies which are hindering success and then works on overcoming these factors. Also, if showering is the goal, it is NOT necessary to shower with the patient during every treatment session. What IS important is identifying barriers (and there are more than I listed) and then working on the most significant problem(s). If LE strength is a KNOWN limitation, then make the patient's muscles stronger. Personally, I don't do exercises. I tell patient's that's PT's job. I am not well enough trained to identify and treat SPECIFIC muscle weakness/imbalance. Instead, I ask patients to do challenging physical activity. The list of possible barriers is really endless. Two of the most common barriers patient encounter are fear and lack of competency. In these situations, a skilled OT can progress the patient by engaging them in over-achieving activity. For example, if a patient wants to shower but is afraid to step over a 4 threshold into their shower, set up a clinical situation where the patient has a 5 threshold. Provide various challenges (i.e. walker ~vs~ no walker, rail ~vs~ no rail). Practice, practice, practice is what builds competency and decreases fear. Remember, ALL therapy should require the skills of a therapist. I frequently tell patients, I am not going to do that because it does not require my skills. Ask yourself, are you doing something that an aide could be doing? If so, then you are not doing therapy! If you are sitting around bored to death, watching patients do exercise, you are not doing therapy. If you are not challenging your patients beyond their ability, you are not doing therapy. If patients are not progressing to their goals, you are not doing therapy. Therapy is a SKILL. If you are not applying skill, you are not doing therapy! Ron ~~~ Ron Carson MHS, OT www.OTnow.com - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Sunday, July 12, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Why OT's Should NOT Focus on the UE cac If you want to go by the book, then you have to key into the concept of cac task specific training. This is usually an easy concept for new cac clinicians. If you want to get better at walking go ahead and walk, if cac you want to get better at getting into a shower go ahead an get into a cac shower, if you want to get better at bathing and dressing go ahead and cac practice this as well. cac Hope this helps, cac Chris -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Function is NOT Occupation
I want to try and make this painfully clear. Occupation and function are NOT the same thing. There are both major and subtle differences between the words, and these are NOT just semantics. OT must embrace occupation. We must live, breathe and practice occupation. We must sell it to ourselves, each other, other professions, and to patients. When we say we are occupation therapists, it must be expected that we are going to work on improving patient's occupations. It makes no difference the manner in which we work. Be it weights, ambulation, games, dressing, or cooking. The means is NOT ultimately important, but the outcome is fundamentally what separates us from other professions. We hold the keys to our success! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Yes, PT's skill set is much superior to OT's in the domain and manner in which they are applied. While on one hand, OT is often seen as UE experts, I am constantly amazed at the number of OT's who ask how to treat a rotator cuff injury (not that I know how). And beyond the actual skill set, PT has earned, developed and marketed itself as EXPERTS in physical function. Also, there is general consistency from one phy-dys PT to another phy-dys PT. And, not only is what they similar, it's what doctors expect and it's what patients expect. Basically, PT provides well know solutions to perceived problems. They are like car mechanics. When the car breaks and you can't fix it yourself, you take it to a mechanic, right. Same thing with the human body; you take it to a PT. Now, it's not PT's NAME that has brought them recognition and fame. It the entire package of being a profession that they have successfully grown over the years. There name helps, but it's only a small part of why others see them superior to OT. Now, I personally don't think PT is superior to OT. I think we each have our domains. However, when an OT operates outside the domain of occupation, then I generally think they are less effective than PT. The same is true for PT. When they start operating in the domain of occupation, they are generally less effective than PT. Ron - Original Message - From: Ed Kaine aloft@gmail.com Sent: Friday, July 10, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Over Utilization of PT in Home Health EK If not in a name... then what? Is PTs service and skill set that EK much superior to OTs that it warrants about a 3 to 5 fold bias from EK OT to PT in nearly every setting? Your facility is probably fairly EK average in the 3 to 15 ratio... and that is home care. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Why OT's Should NOT Focus on the UE
My concern in this is that you ONLY mention and UE program. If general conditioning prevented the patient from performing occupation, why limit it only to the UE? For me, general phy-dys practitioner's focus on the UE while disregarding the rest of the body severely hampers our professional autonomy. We MUST break free from the mold of being UE therapists! Ron - Original Message - From: Diane Randall spark...@rcn.com Sent: Sunday, July 12, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Why OT's Should NOT Focus on the UE DR I see your point...I was mistaken if I implied in my very first post that I DR told the patient that he needed UE program in order to transfer. It was DR justified to increase his overall conditioning. My inital reason for the DR post was to point out that sometimes our patients assume the things we do in DR the gym are therapy and the functional ADL's are just extras we do...which DR of course is the very opposite. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] The History of the word Occupation
Like many words, occupation has different meanings. Here's the one that I use. 1 a : an activity in which one engages pursuing pleasure has been his major occupation Source: http://www.merriam-webster.com/dictionary/occupation A while back, I wrote an e-mail to the editors of Merriam_Webster's dictionary. Here's my message and the reply: -Original Message- Date: Tue, 28 Oct 2003 23:57:31 -0800 (PST) From: Ron Carson rdcar...@otnow.com Subject: History of the word occupation To: l...@merriam-webster.com Hello: I am an occupational therapist. My profession has existed since about 1914 but is very unknown. One reason may be related to the use of the word 'occupation'. While the word occupation has several meanings, I am interested in knowing the history of it as it applies to the meaning of occupation as it relates to occupational therapy. Thanks, Ron Carson Occupation is related to the word occupy, and both words ultimately come from the same Latin root word meaning to seize, to possess or take up. An occupation is a taking up of something: occupation of another country is the taking up or seizing of land; an occupation in the sense of an activity is something that takes up one's time; occupation meaning a vocation, profession, employment is the taking up of one's time, energies, and life. This word is very old, and has been in use for centuries. Occupation in the sense of employment, business, and/or an activity has been around since the 1300s at least and was used by authors like Chaucer. However, occupational is more recent. The _Oxford English Dictionary_ gives a citation for it from 1850, and I am unaware of any earlier appearances of this word. As for the naming of occupational therapy...I should begin by saying that I don't know much about occupational therapy, but from reading several Web pages about the history of occupational therapy and related disciplines put up by college students studying occupational therapy (like http://www.ceap.wcu.edu/hhp/students/JeffMansfield/archive/rthistory.htm l http://www.angelfire.com/ut/otpsych/history.html http://tiger.towson.edu/users/ptappe1/historyOT.htm ) I drew these conclusions: 1) Occupational therapy is rooted in efforts in the 1700s and 1800s to improve the well-being of mentally ill and infirm people. 2) These forerunners of modern-day occupational therapists tried to make the lives of the mentally ill and infirm more fulfilling by finding them activities to *occupy* their time and teaching them skills that would be useful in an *occupation*. 3) Nowadays, occupational therapy is concerned with rehabilitating sufferers of physical illness: injuries (often obtained at work--one's *occupation*), disabilities, and infirmity. (Perhaps the field of occupational therapy expanded in the US after soldiers returned from the first World War?) 4) Someone claimed on the Internet that George Edward Barton was the originator of the term occupational therapy (http://groups.google.com/groups?hl=enlr=ie=UTF-8oe=UTF-8th=61e953aa a46c2c35rnum=1). I can't prove or disprove his assertion at the moment, but you may find the writing I linked to to be interesting reading. In any case, it seems to me that occupational therapy is called just that because of its focus on activity, compared to, say, physical therapy. A physical therapist would help a victim of a car accident regain muscle tone in his or her legs and the ability to walk, but an occupational therapist would teach the person how to climb a ladder, how to go up and down stairs, etc. I think one reason why occupational therapy remains unknown is that it is often confused with physical therapy. But as the population (especially the baby boomer segment) ages, knowledge of occupational therapy will probably spread, since more people will find themselves needing the services of occupational therapists. I hope I have been helpful. Thank you for writing to Merriam-Webster. Sincerely, Judy Yeh Assistant Editor Merriam-Webster, Inc. 47 Federal Street, P.O. Box 281 Springfield, MA 01102 Phone: 413-734-3134, ext. 133 j...@merriam-webster.com http://www.Merriam-Webster.com http://www.WordCentral.com http://www.merriam-websterunabridged.com http://www.merriam-webstercollegiate.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Why OT's Should NOT Focus on the UE
Today, I evaled a man on home health who had a recent cardiac bypass surgery. He was just home after 10 days in a rehab hospital getting OT and PT. During my eval, I explained what OT was all about. Thinking my words were falling on deaf ears, one of my worst nightmares came true. The patient had previously received OT. They explained that they already had hand exercisers and a reachers and that they didn't need any more OT. Now, this is a sad picture. The patient did need OT and I offered it but they declined. Here are two reasons why: 1. Previous OT's demonstrated that OT was about strengthening hands and arms. 2. Home health PT had already evaled the patient and THEY were providing what the patient needed. Now, why would OT work on giving this man hand exercisers? That makes NO sense to me and for the patient, OT has no apparent value for making this man safe and independent in his home. They felt that PT could do this better than OT. AND THAT IS AN ALL TO OFTEN STATEMENT ABOUT OT! AND THAT IS THE PROBLEM WITH OUR PROFESSION. IT'S NOT OUR NAME, IT'S THE THERAPISTS THAT ARE THE PROBLEM. Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Hey Ed and others: There is no doubt in my mind that in the world of adult phy-dys, OT is GREATLY under utilized. For me, the question is not if, but why! Unfortunately, I don't think it's related to our name. Ron - Original Message - From: Ed Kaine aloft@gmail.com Sent: Thursday, July 09, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Over Utilization of PT in Home Health EK Hi Ron; EK I think the better question is Does anyone think OT is under utilized in EK most health care settings? I think there would be so much that PT could EK learn from OT about functioning in a home environment. There are probably EK many PTs who do a great job in the field. EK As you may imagine... I think they have their very understandable name going EK for them. EK Recently I made the argument that it is OT who should be consulted in the EK case of a fall at home. Why not PT? Was it not the functional environment EK that they fell in? Ot was likely due to something they were doing (like EK getting into the tub) rather than any type of gait abnormality. This falls EK more into the problem solving mindset of an OT. Most of the mobility issues EK we come across in a hospital are :Functional Mobility issues rather than EK significant need for gait training. EK Though I have a few more consults coming in for OT now I have the problem of EK very minimal staffing that will lead to a difficulty in meeting the demand. EK I have the problem of staffing OTs because administration does not EK understand what we can do. EK Yours in Occupational Therapy and Functional Therapy, EK Ed Kaine, OTR, RFT EK President of the League of Functional Therapists EK On Thu, Jul 9, 2009 at 8:38 PM, Ron Carson rdcar...@otnow.com wrote: Does anyone else think that PT is WAY, WAY over utilized in home health? I do! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com EK -- EK Options? EK www.otnow.com/mailman/options/otlist_otnow.com EK Archive? EK www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] OT Consumer Lurking In Our Midst
Last week, I invited the mother of a patient to visit the OTnow.com website and possibly join the list. Today, she told me that she was enjoying reading the messages on the list. She hasn't joined as of yet, but I'm encouraging her to come aboard and share her experiences about OT and therapy in general. Just wanted to let everyone know!! If S. does join, I think it will be a first! Take care, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A Vision For Patients?
Good deal! Thanks Chris!! If you don't mind, here's another loaded question. smile And not just for you but for ALL OTlist readers You mention standing balance, do you also work on mobility/ambulation? For example, would you work on mobility/ambulation for a patient currently using a wheelchair, stands and transfers with mod A but is unable to ambulate? Would you trial them with different mobility aids? - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Saturday, July 04, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] A Vision For Patients? cac I most certainly address the LE. Usually it is through practice of cac occupations, but occasionally I will work on specific leg movements and cac standing balance in order to eventually achieve an occupational goal. cac I only mentioned flaccid arm, because that is what the prior OTs worked cac on with the patient you mentioned. cac Chris -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] OT's as Teachers: Adult Phy Dys
Do you think of yourself as a teacher? I do! I say that my job is teaching people how to take care of themselves and be productive. FYI, this is an adaptation of the Canadian Model of Occupational Performance's definition of occupation. So, think about it, aren't we really teachers? Patients want to LEARN how to do things. They want to learn to dress themselves, walk to the bathroom, clean themselves, get in/out of the car, cook, clean, etc. If patient's want to learn, then isn't our job to teach? At the heart of it, OT's are teachers. Just some random thoughts before church Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] A Vision For Patients?
Very Cool! Sounds like you and I have similar practice pattens and ideals. I hope others reply - Original Message - From: cmnahrw...@aol.com cmnahrw...@aol.com Sent: Sunday, July 05, 2009 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] A Vision For Patients? cac Ron and the gang, cac Yes, I would work on mobility and functional ambulation. I choose to cac complete them in a functional dynamic, in which the patient clearly cac knows why we are working on walking (example walking from the family cac room recliner to the kitchen so the patient can cook, etc etc). Yes, I cac would trail them with different mobility aids if the mobility aids in cac which they currently have are not helping to advance the patient in cac their personal goals of occupaton. I work with a physical therapist in cac a rehab hospital, so I always communicate with her what I am doing, so cac carry over can be best assured. She also talks to me when she thinks a cac certain mobility aide will work best for walking. We usuaally are on cac the same page, since we have worked with each other for a while now. cac -Original Message- cac From: Ron Carson rdcar...@otnow.com cac To: cmnahrw...@aol.com OTlist@OTnow.com cac Sent: Sun, Jul 5, 2009 6:12 am cac Subject: Re: [OTlist] A Vision For Patients? cac Good deal! Thanks Chris!! cac If you don't mind, here's another loaded question. smile And not just cac for you but for ALL OTlist readers cac You mention standing balance, do you also work on mobility/ambulation? cac For example, would you work on mobility/ambulation for a patient cac currently using a wheelchair, stands and transfers with mod A but is cac unable to ambulate? Would you trial them with different mobility aids? cac - Original Message - cac From: cmnahrw...@aol.com cmnahrw...@aol.com cac Sent: Saturday, July 04, 2009 cac To: OTlist@OTnow.com OTlist@OTnow.com cac Subj: [OTlist] A Vision For Patients? cac I most certainly address the LE. Usually it is through practice cac of cac occupations, but occasionally I will work on specific leg cac movements and cac standing balance in order to eventually achieve an occupational cac goal. cac I only mentioned flaccid arm, because that is what the prior OTs cac worked cac on with the patient you mentioned. cac Chris cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
