Re: [OTlist] NEED HELP WITH PATIENT
How about checking with Department of Aging for services and programs? Maybe a relief worker who can spend time with the woman a few hours a week could give the husband a break or time to do something else. Would he husband be open to support groups for spouses with dementia in their area? I do know older couples may have a lot of pride and may not be open to outside help. Caregivers do take on a lot and forget about taking care of themselves, too. I would tell my clients- if you are hurt/sick, who will take care of their loved one and try to get a dialogue going to figure out ways to plan for the present and for the future... Just a thought... From: Barbara H. Hale bhh...@musfiber.com To: OTlist@OTnow.com Sent: Tuesday, April 14, 2009 12:28:48 PM Subject: Re: [OTlist] NEED HELP WITH PATIENT It is difficult conceptualize what a day in the life of a dementia patient would be like. She probably will not initiate tasks. She is in need of someone to work with her on anything she does. Maybe she could help with clean up rather than cooking. Could she read the recipe to her husband while he is cooking? It is hard to believe she is an avid reader, it may be a bluff to allow her to feel better about herself. If husband is falling he may benefit from helping her with some exercise. He could start walking with her daily while it is getting nice outside and both would gain from the movements, fresh air, stimulation. You could look at their daily routines to assist in community resources for maintaining their health and safety. -- 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] NEED HELP WITH PATIENT
Hi Ron, The only thing I can think of is really what your wife suggested. Maybe see her do a couple of kitchen tasks and see whether she might need prompt cards or instructions set out for her otherwise there is not alot else I can think of... but if she has no goals that she wants to achieve then really there isn't much that you can provide. Is she keen on doing things in the kitchen? Becky :-) Date: Mon, 13 Apr 2009 18:08:18 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: [OTlist] NEED HELP WITH PATIENT I evaluated a home health patient and I need help determining if OT is indicated. The patient's primary diagnosis is Alz. dementia. She also was recently d/c'd from the hospital secondary to a non-healing brown recluse spider bite, s/p 5 years ago. Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe dementia. She lives with her husband, who is healthy but has had two recent falls in their modular home. The husband does all the housework, cooking and driving. The patient performs her own basic selfcare with supervison. She req. occasional asst. with sequencing for dressing. The patient reports she is an active reader. She attends church services every Sunday. The patient has no stated goals. She reports being happy and content with her life. She says that everyone else is worried about her memory but she knows that it will get better. The husband states it would be nice if his wife were able to help out in the kitchen. I told the husband that I needed to ponder the situation. I wasn't sure if I could help his wife or not. So, I'm turning to you guys. My wife suggested that I work with both the husband and the patient to teach him how to better integrate his wife into the daily routines. I presented this idea to him tonight on the phone and he said: hum, I need to think about that. So, what do you guys say. Can OT help this lady? If so, how 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 _ View your Twitter and Flickr updates from one place – Learn more! http://clk.atdmt.com/UKM/go/137984870/direct/01/ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] NEED HELP WITH PATIENT
Ron, How does she currently perform in the kitchen (min/mod/ max assist/or verbal cues?). If the patient had completed the cooking prior to the dementia it is possible that this will be an automatic task for her like bathing and dressing is still generrally easy for her. I would then find something in the kitchen for her to be able to complete so the patient's husband goal of able to help out in the kitchen would be clearly addressed. There has to be something she can do to help in the kitchen that is safe and relatively simple. Are there any key dementia problems in which you could address or educate the clients on? 1) wondering 2) agitation 3) reluctance to shower or dress 4) reluctance to take her meds 5) other neurobehavioral issues. Chris Nahrwold -Original Message- From: Ron Carson rdcar...@otnow.com To: OTlist@OTnow.com Sent: Mon, 13 Apr 2009 5:08 pm Subject: [OTlist] NEED HELP WITH PATIENT I evaluated a home health patient and I need help determining if OT is indicated. The patient's primary diagnosis is Alz. dementia. She also was recently d/c'd from the hospital secondary to a non-healing brown recluse spider bite, s/p 5 years ago. Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe dementia. She lives with her husband, who is healthy but has had two recent falls in their modular home. The husband does all the housework, cooking and driving. The patient performs her own basic selfcare with supervison. She req. occasional asst. with sequencing for dressing. The patient reports she is an active reader. She attends church services every Sunday. The patient has no stated goals. She reports being happy and content with her life. She says that everyone else is worried about her memory but she knows that it will get better. The husband states it would be nice if his wife were able to help out in the kitchen. I told the husband that I needed to ponder the situation. I wasn't sure if I could help his wife or not. So, I'm turning to you guys. My wife suggested that I work with both the husband and the patient to teach him how to better integrate his wife into the daily routines. I presented this idea to him tonight on the phone and he said: hum, I need to think about that. So, what do you guys say. Can OT help this lady? If so, how 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
[OTlist] NEED HELP WITH PATIENT
I evaluated a home health patient and I need help determining if OT is indicated. The patient's primary diagnosis is Alz. dementia. She also was recently d/c'd from the hospital secondary to a non-healing brown recluse spider bite, s/p 5 years ago. Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe dementia. She lives with her husband, who is healthy but has had two recent falls in their modular home. The husband does all the housework, cooking and driving. The patient performs her own basic selfcare with supervison. She req. occasional asst. with sequencing for dressing. The patient reports she is an active reader. She attends church services every Sunday. The patient has no stated goals. She reports being happy and content with her life. She says that everyone else is worried about her memory but she knows that it will get better. The husband states it would be nice if his wife were able to help out in the kitchen. I told the husband that I needed to ponder the situation. I wasn't sure if I could help his wife or not. So, I'm turning to you guys. My wife suggested that I work with both the husband and the patient to teach him how to better integrate his wife into the daily routines. I presented this idea to him tonight on the phone and he said: hum, I need to think about that. So, what do you guys say. Can OT help this lady? If so, how 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] NEED HELP WITH PATIENT
It seems that set up of certain tasks in the kitchen could be a successful outcome provided the husband accepts the notion that independent performance is out of the question. Setup/superv of the most safe routines can be adapted for her provided she was interested on those in the past and expresses desire to help the husband with those chores. Perhaps recommend to him a respite -type of programing and the use of supportive services available in the community to enhance his role as caregiver. Any fall prevention adaptations needed for the home? any visual compensatory strategies to decrease fall risk on her due to decreased environm. awareness? Any health management needs to maximize her current state of health? Just thoughts of what could be impacted with your expertise. Carmen Date: Mon, 13 Apr 2009 18:08:18 -0400 From: rdcar...@otnow.com To: OTlist@OTnow.com Subject: [OTlist] NEED HELP WITH PATIENT I evaluated a home health patient and I need help determining if OT is indicated. The patient's primary diagnosis is Alz. dementia. She also was recently d/c'd from the hospital secondary to a non-healing brown recluse spider bite, s/p 5 years ago. Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe dementia. She lives with her husband, who is healthy but has had two recent falls in their modular home. The husband does all the housework, cooking and driving. The patient performs her own basic selfcare with supervison. She req. occasional asst. with sequencing for dressing. The patient reports she is an active reader. She attends church services every Sunday. The patient has no stated goals. She reports being happy and content with her life. She says that everyone else is worried about her memory but she knows that it will get better. The husband states it would be nice if his wife were able to help out in the kitchen. I told the husband that I needed to ponder the situation. I wasn't sure if I could help his wife or not. So, I'm turning to you guys. My wife suggested that I work with both the husband and the patient to teach him how to better integrate his wife into the daily routines. I presented this idea to him tonight on the phone and he said: hum, I need to think about that. So, what do you guys say. Can OT help this lady? If so, how 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 _ Rediscover Hotmail®: Get quick friend updates right in your inbox. http://windowslive.com/RediscoverHotmail?ocid=TXT_TAGLM_WL_HM_Rediscover_Updates1_042009 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] NEED HELP WITH PATIENT
You're wife's correct. Work with both people. My mother-in-law has mild/moderate dementia and her goal setting sucks. She doesn't understand what her needs are and is a happy lass with short term memory problems. This lady needs to help her husband that sounds like what he wants, observe the interaction in the kitchen safety strategies, wound care strategies, etc. Why is husband falling and does this need to be another referral? Beth Thiers, OTR/L East Central District FECTS ehthiersfe...@earthlink.net -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: Monday, April 13, 2009 6:08 PM To: OTlist@OTnow.com Subject: [OTlist] NEED HELP WITH PATIENT I evaluated a home health patient and I need help determining if OT is indicated. The patient's primary diagnosis is Alz. dementia. She also was recently d/c'd from the hospital secondary to a non-healing brown recluse spider bite, s/p 5 years ago. Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe dementia. She lives with her husband, who is healthy but has had two recent falls in their modular home. The husband does all the housework, cooking and driving. The patient performs her own basic selfcare with supervison. She req. occasional asst. with sequencing for dressing. The patient reports she is an active reader. She attends church services every Sunday. The patient has no stated goals. She reports being happy and content with her life. She says that everyone else is worried about her memory but she knows that it will get better. The husband states it would be nice if his wife were able to help out in the kitchen. I told the husband that I needed to ponder the situation. I wasn't sure if I could help his wife or not. So, I'm turning to you guys. My wife suggested that I work with both the husband and the patient to teach him how to better integrate his wife into the daily routines. I presented this idea to him tonight on the phone and he said: hum, I need to think about that. So, what do you guys say. Can OT help this lady? If so, how 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
