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] 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] OTlist Digest, Vol 74, Issue 1
On this whole issue of the neglect thing I have a couple more things to add, because like Ron I have an opinion on just about everything (except the whole UE thing!!). Ron I understand where you are coming from in that neglect can be difficult to improve but in most clients some degree of improvement does occur. Yes a lot of that is down to spontaneous recovery but most of what improves post stroke is down to spontaneous recovery and it is our job as therapists to provide the correct stimulation to the brain during this time when it is trying to fix itself. If we neglect the neglect when the brain is geared up to heal then we are not maximising the improvements that can be made. Well that's what I tell myself anyway! Things like arranging the room so that a person must attend to that side is quick and easy and if it gives them 2% improvement that is a start. The significant other side of this is the education and compensation side of things. I have had clients with very bad neglect who through intensive training have learned to compensate for their neglect. I personally think that education is one of the best things we can do for our clients. I try and train my stroke clients to know what I know so that when they leave me they can be their own therapist. My clients probably know more about neuroplasticity and grading activities than many OT's! That way they can continue to improve if they are motivated to. I have an ex-client with a shocking neglect who uses a power wheelchair for mobility. She does crash into doorways occasionally when distracted but for the most part she is ok and has the freedom to get herself around (inside anyway)- all down to compensation. So even if someone months post stroke has an awful neglect and are not making spontaneous recovery I'd be teaching them how to compensate for it in daily life, because that is what we as OT's do! We don't give up on people with paraplegia because they don't walk again. Haha my opinion yet again. Angela King NZROT, Assessor Outpatients, Directions Appraisal Team - REHAB PLUS 54 Carrington Road Pt Chevalier, Auckland Auckland District Health Board # Scanned by MailMarshal - Marshal8e6's comprehensive email content security solution. Download a free evaluation of MailMarshal at www.marshal.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
My clients probably know more about neuroplasticity and grading activities than many OT's! That brings to mind Ron's thread about teaching COTA's. A very powerful teaching approach is to help students empathize with the plight of those with disease and disability. I heard there are glasses that can be worn that mimic neglect? Is that true? I remember the Vaseline on the glasses to mimic cataracts and clothes pins on fingers to mimic the pain of arthritis. -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of Angela King (ADHB) Sent: Thursday, August 13, 2009 16:56 To: otlist@otnow.com Subject: Re: [OTlist] OTlist Digest, Vol 74, Issue 1 On this whole issue of the neglect thing I have a couple more things to add, because like Ron I have an opinion on just about everything (except the whole UE thing!!). Ron I understand where you are coming from in that neglect can be difficult to improve but in most clients some degree of improvement does occur. Yes a lot of that is down to spontaneous recovery but most of what improves post stroke is down to spontaneous recovery and it is our job as therapists to provide the correct stimulation to the brain during this time when it is trying to fix itself. If we neglect the neglect when the brain is geared up to heal then we are not maximising the improvements that can be made. Well that's what I tell myself anyway! Things like arranging the room so that a person must attend to that side is quick and easy and if it gives them 2% improvement that is a start. The significant other side of this is the education and compensation side of things. I have had clients with very bad neglect who through intensive training have learned to compensate for their neglect. I personally think that education is one of the best things we can do for our clients. I try and train my stroke clients to know what I know so that when they leave me they can be their own therapist. My clients probably know more about neuroplasticity and grading activities than many OT's! That way they can continue to improve if they are motivated to. I have an ex-client with a shocking neglect who uses a power wheelchair for mobility. She does crash into doorways occasionally when distracted but for the most part she is ok and has the freedom to get herself around (inside anyway)- all down to compensation. So even if someone months post stroke has an awful neglect and are not making spontaneous recovery I'd be teaching them how to compensate for it in daily life, because that is what we as OT's do! We don't give up on people with paraplegia because they don't walk again. Haha my opinion yet again. Angela King NZROT, Assessor Outpatients, Directions Appraisal Team - REHAB PLUS 54 Carrington Road Pt Chevalier, Auckland Auckland District Health Board # Scanned by MailMarshal - Marshal8e6's comprehensive email content security solution. Download a free evaluation of MailMarshal at www.marshal.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] 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
Re: [OTlist] OTlist Digest, Vol 74, Issue 1
Maybe a more accurate word would be sympathizeunless the students were to become the patients it would be impossible to mimic the actual experience. I am thinking of it in more of a lightbulb moment that students get when they even for a short time feel something even remotely similar to what a patient may feel physically. I'd don't think it minimizes the patients actual expereinces...I think it is just near impoosible to address it with a short term activity. Diane R COTA/L -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of Ron Carson Sent: Thursday, August 13, 2009 20:32 To: Diane Randall Subject: 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 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
