This blog brought to you by: WWW.OT-ADVANTAGE.COM
Working in a healthcare facility as an Occupational Therapy practitioner one meets a variety of personalities. One may see the person that walks with coffee in hand, another who keeps to themselves when working with a client, or the social butterfly. And there may be the occasional person who becomes frustrated easily toward others! Whatever the case, everyone has the same end game; helping a client reach their goals.
Take a step back and look at how you perform...Read More
Tuesday, December 30, 2008
Friday, December 19, 2008
OT Holiday Assessment
This blog brought to you by WWW.OT-ADVANTAGE.COM
The holiday season brings great joy and a giving spirit within each of us. As you are wrapping your gifts, preparing for a jovial visit with family and friends, and hanging your decorations to adorn your home, remember to bring good tidings to your clients who cannot be home this holiday season.
Many Occupational Therapy practitioners work in an inpatient department. Whether it is long-term care, acute care, pysch, or inpatient rehabilitation your clients are in need of having a form of normalcy to their day. Using your creativity is essential, as you have Occupational Therapy clients with various functional and behavioral capacities.
Read more...
The holiday season brings great joy and a giving spirit within each of us. As you are wrapping your gifts, preparing for a jovial visit with family and friends, and hanging your decorations to adorn your home, remember to bring good tidings to your clients who cannot be home this holiday season.
Many Occupational Therapy practitioners work in an inpatient department. Whether it is long-term care, acute care, pysch, or inpatient rehabilitation your clients are in need of having a form of normalcy to their day. Using your creativity is essential, as you have Occupational Therapy clients with various functional and behavioral capacities.
Read more...
Saturday, December 13, 2008
Restraint Use for Clients with Alzheimer's Disease
This blog brought to you by: WWW.OT-ADVANTAGE.COM
Utilizing restraints is not an ideal alternative for use in healthcare facilities. On many occaisions, an Occupational Therapist may receive a referral for wheelchair positioning or to address another impairment, as a means to decrease the use of a restraint. Here is a good article that was written about how healthcare facilities can decrease the use of a restraint by staff and family education, attending to the client's needs in a timely manner, and education on what is considered a restraint.
Providing Restraint-Free Care
Please refer to your state and healthcare facilities mandates to gain knowledge of what is considered a restraint.
OT-ADVANTAGE.COM related articles:
Is a Geri Chair a Restraint?
Wheelchair Positioning for Geriatrics
Utilizing restraints is not an ideal alternative for use in healthcare facilities. On many occaisions, an Occupational Therapist may receive a referral for wheelchair positioning or to address another impairment, as a means to decrease the use of a restraint. Here is a good article that was written about how healthcare facilities can decrease the use of a restraint by staff and family education, attending to the client's needs in a timely manner, and education on what is considered a restraint.
Providing Restraint-Free Care
Please refer to your state and healthcare facilities mandates to gain knowledge of what is considered a restraint.
OT-ADVANTAGE.COM related articles:
Is a Geri Chair a Restraint?
Wheelchair Positioning for Geriatrics
Thursday, December 11, 2008
Taking Time Off During the Holiday Season
This blog brought to you by: www.ot-advantage.com
When it is holiday time, many Occupational Therapy practitioners want their hard earned time off. However, some treatment settings go by a seniority status or lottery. Trying to minimize your work week can be easy or difficult, depending on your OT treatment setting. Here are some tips:
When it is holiday time, many Occupational Therapy practitioners want their hard earned time off. However, some treatment settings go by a seniority status or lottery. Trying to minimize your work week can be easy or difficult, depending on your OT treatment setting. Here are some tips:
- Be Proactive: Find out if there are any registry Occupational Therapy practitioners or other OT staff that would be willing to work for you. You can also swap a day with another OT practitioner.
- PTO: You want time off, but you have not accrued enough PTO (paid time off). You may have the option of working a weekend day for the holiday. This has some advantages and disadvantages. Some of the disadvantages are: 1.) You may be the only OT practitioner working an 8-hour day on a weekend. 2.) You may not have another therapist to assist with transferring a client. 3.) You may need to perform OT treatments in the patient’s room due to safety concerns of being the only healthcare professional in the Occupational Therapy gym. 4.) If working in certain Occupational Therapy treatment settings, you may need to be aware of MDS reference periods. In this instance, you need to ensure you are treating OT clients where there is not a conflict with their reference dates. If you accidentally see a client and their reference period starts the following day or later, the client may be short the amount of minutes needed to categorize them in a specific RUG level (Resource Utilization Group).
For additional information on capturing minutes, follow this link - Plan Ahead: If you are beginning a new job, request holiday time off when you negotiate the terms of your contract. In this respect, you have your time off in writing and can relax around the holiday.
- Choose Your Time Wisely: Many OT practitioners cannot have it all. Choose a holiday you want time off for and work the other holidays or days around them. This will create a pleasant work environment and delegate the time among all the OT professionals.
Split Your Time: Your OT caseload may work out in your favor. For example, say you only have 4 hours of OT treatment time. In this case, you could start your work day a bit early and finish early. You can return home in time to continue with the holiday celebration. - Utilize Your Time Wisely: Remember that you are allowed to group your OT clients a percentage each week, usually up to 25% of their comprehensive Occupational Therapy treatment time for the week.
For ideas on group interventions, follow this link
Common Mistakes:
- RUG Assessment Periods: As previously stated, you may encounter a problem where you did not check the reference dates ahead of time. Possible problems that could occur are a client will not receive the necessary amount of treatment minutes and/or days to qualify them for their needed Occupational Therapy treatment time. A client must be seen 5 days in an assessment period, by at least one discipline to qualify them for a specific RUG level.
- Conflict with a Doctor’s order: Given the way the MD order was written, you need to ensure the OT client received the exact amount of treatment days. For example, some may see a client for 4x/wk and the order was written for 5x/wk. This is acceptable if the discrepancy is due to a recognized holiday by Medicare or another insurance company for the respective client.
- Call in Sick: This is not an acceptable way to receive a day off. In essence, you create more work on the other Occupational Therapy professionals working that day.
- Not Informing the Occupational Therapy Client: Many forget to tell the OT client about the change in their weekly schedule due to a holiday. It is easy to forget that an OT client becomes accustomed to their schedule; communication is welcomed when there is a change. Also, many OT clients look forward to their rehabilitation treatments, as it prevents loneliness around the holidays. Forgetting to communicate a change in their plan of care may create an emotional OT client.
- Fluctuate Treatment Minutes: Remember it is fraudulent to reduce a client’s treatment minutes, when the facility is being reimbursed based on the OT client’s category. Also, it is best to stay consistent with your treatment minutes, and not increase the Occupational Therapy client by 10-15 minutes each day to reduce the amount of treatment minutes on the day you want to leave early.
Occupational Therapy Warm-Up Ideas
This blog brought to you by: www.ot-advantage.com
A good start to an Occupational Therapy treatment can be initiated with a warm-up. Occupational Therapy practitioners choose their interventions focusing on the client’s immediate deficits. A warm-up can help an Occupational Therapy client with modulating their senses, preparing their muscles for exercise, or initiate different areas of the brain for challenging activity. Listed are some activities that may help as a client warms up for their OT treatment:
Review prior treatments plan of care: Each Occupational Therapy treatment is developed to increase a person’s function with a daily task. A client will better understand their progress if they identify with how their OT treatments are affecting their recovery.
For example:
A good start to an Occupational Therapy treatment can be initiated with a warm-up. Occupational Therapy practitioners choose their interventions focusing on the client’s immediate deficits. A warm-up can help an Occupational Therapy client with modulating their senses, preparing their muscles for exercise, or initiate different areas of the brain for challenging activity. Listed are some activities that may help as a client warms up for their OT treatment:
Review prior treatments plan of care: Each Occupational Therapy treatment is developed to increase a person’s function with a daily task. A client will better understand their progress if they identify with how their OT treatments are affecting their recovery.
For example:
- Review prior treatments plan of care. If you educated the client on how to use adaptive equipment for dressing, ask the client to name the AE and what its use is. This will allow the client to better understand their progress and identify how their OT treatments are affecting their recovery.
- If you recently fabricated a splint, have the client show how to donn/doff it and recite the wear/care schedule. This task informs the OT practitioner of the client’s ability to show return demonstration, their understanding of the splint and its use, and offers the clinician the ability to further educate if needed.
- Have a plan or schedule in place to delegate household tasks, if addressing IADLs. Each time your client attends an Occupational Therapy treatment, they will initiate the respective daily task; watering plants, making coffee, stowing groceries, or opening blinds or drapes. This may help a client follow a schedule, assist with accountability, address sequencing and organization of tasks, visual scanning, or balance.
- Ask the client to recite any precautions they may have (e.g., hip precautions, rotator cuff post-operative precautions, weight-bearing precautions).
- Stretch or move affected extremity through various planes to prepare for exercise. Due to spasticity, pain, or weakness AROM can help to prepare a client for higher level tasks.
- If addressing handwriting, have the client sign-in on a log, write the date, and/or check a box for the day of the week. This can be upgraded/downgraded accordingly (i.e., change utensil, write first name only, or circle a word to complete the log-in sheet).
- If addressing various sensory stimuli, have the client pick a warm-up task from a bowl. The tasks can vary from bouncing a ball, sitting on a theraball (with different types of support), manipulating textured or plain putty, washing hands with various textured soaps and towels, or jumping on a trampoline.
- If addressing vision, ask client to sort through a deck of cards or organize play money for a board game.
- When addressing cognition, have the client organize/sequence a simple photo task or a basic rote task.
- Comment if you have any warm-up ideas!
Pet Therapy for Occupational Therapy
This blog brought to you by: www.ot-advantage.com
Here is a great video to watch about spreading the word of how Occupational Therapy incorporates pets into treatments.
Watch Video
Good Dog Foundation Site
Therapy Dog International
Here is a great video to watch about spreading the word of how Occupational Therapy incorporates pets into treatments.
Watch Video
Good Dog Foundation Site
Therapy Dog International
Capturing Minutes for Occupational Therapy Treatment
This blog brought to you by: www.ot-advantage.com
If you are an Occupational Therapy practitioner or even a Level II student at a skilled nursing facility, you have probably found it difficult to strike a balance between giving quality treatments in accordance with meeting a Medicare RUG (Resource Utilization Group) level. Typically, when a patient is admitted to a skilled nursing facility from a hospital, and has Medicare coverage, the MDS coordinator sets reference periods. If you are new to this area of practice, the reference periods are critical when establishing how many treatment minutes a client can/will receive for Physical, Occupational, and Speech therapy.
To give you a crash course with reference periods, there are different levels a patient can reach, dependent upon their therapy treatment minutes, nursing intervention (i.e., IV antibiotics), and the period of time the patient will be receiving these. Furthermore, the assessment period becomes Medicare's crystal ball. They have preset reimbursement rates, given the set criteria. For example, if the patient is receiving 150 minutes of therapy a day during a reference period, Medicare will reimburse accordingly. If a patient is receiving 30 minutes of therapy combined (OT/PT/SLP) and IV antibiotics, Medicare will reimburse according to the designated RUG level as well. Generally speaking, the more therapy treatment time the greater the reimbursement.
What becomes even more tricky is coordinating a patient's medical status (e.g., patient is nauseated and cannot participate with therapy on the day of admit), the amount of time Occupational/Physical/Speech Therapy has to evaluate and treat the patient upon admission (evaluation minutes do not count), nursing assessment (e.g., wound care or IV antibiotics), and how all of this can be combined to determine a patient's RUG level. Usually, the MDS Coordinator and Rehabilitation Coordinator work together when setting assessment dates and the treating therapists assist in carrying out the plan.
Now that you have a small background on what happens when a patient is admitted to a skilled nursing facility, it is time to tap into a frustrating area for Occupational Therapy practitioners. Many times OT clinicians feel the pressure to see patients for 75 minutes of therapy a day, from their rehabilitation managers. Rightfully, the patient's Medicare coverage is paying your facility based on the reference period RUG level for the patient's stay. This is the key reason you cannot see a patient for 75 minutes a day during a reference period and then immediately taper them down to 30 minute treatment sessions a day. This is a fraudulent act. The reason being, the crystal ball that I previously mentioned, Medicare wants assessment periods set to pay for future dates of therapy. If a patient was seen for 30 minutes a day by Occupational and Physical Therapy combined during a reference period, Medicare will pay that designated RUG amount for X amount of future days.
Many patients admitted to a skilled nursing facility from a hospital setting, were likely receiving inpatient rehabilitation (3 hours of therapy a day). Therefore, their expectations may be to receive a few hours of therapy a day. As an Occupational Therapist evaluating a new client, it is your responsibility to determine how much therapy this client can benefit from. It becomes overwhelming thinking you should see a patient for 50 or 75 minutes a day, as well as see your regular caseload of Occupational Therapy clients. So, how do you maximize your time with a client and help them reach quantitative results? Here are some tips:
If you are an Occupational Therapy practitioner or even a Level II student at a skilled nursing facility, you have probably found it difficult to strike a balance between giving quality treatments in accordance with meeting a Medicare RUG (Resource Utilization Group) level. Typically, when a patient is admitted to a skilled nursing facility from a hospital, and has Medicare coverage, the MDS coordinator sets reference periods. If you are new to this area of practice, the reference periods are critical when establishing how many treatment minutes a client can/will receive for Physical, Occupational, and Speech therapy.
To give you a crash course with reference periods, there are different levels a patient can reach, dependent upon their therapy treatment minutes, nursing intervention (i.e., IV antibiotics), and the period of time the patient will be receiving these. Furthermore, the assessment period becomes Medicare's crystal ball. They have preset reimbursement rates, given the set criteria. For example, if the patient is receiving 150 minutes of therapy a day during a reference period, Medicare will reimburse accordingly. If a patient is receiving 30 minutes of therapy combined (OT/PT/SLP) and IV antibiotics, Medicare will reimburse according to the designated RUG level as well. Generally speaking, the more therapy treatment time the greater the reimbursement.
What becomes even more tricky is coordinating a patient's medical status (e.g., patient is nauseated and cannot participate with therapy on the day of admit), the amount of time Occupational/Physical/Speech Therapy has to evaluate and treat the patient upon admission (evaluation minutes do not count), nursing assessment (e.g., wound care or IV antibiotics), and how all of this can be combined to determine a patient's RUG level. Usually, the MDS Coordinator and Rehabilitation Coordinator work together when setting assessment dates and the treating therapists assist in carrying out the plan.
Now that you have a small background on what happens when a patient is admitted to a skilled nursing facility, it is time to tap into a frustrating area for Occupational Therapy practitioners. Many times OT clinicians feel the pressure to see patients for 75 minutes of therapy a day, from their rehabilitation managers. Rightfully, the patient's Medicare coverage is paying your facility based on the reference period RUG level for the patient's stay. This is the key reason you cannot see a patient for 75 minutes a day during a reference period and then immediately taper them down to 30 minute treatment sessions a day. This is a fraudulent act. The reason being, the crystal ball that I previously mentioned, Medicare wants assessment periods set to pay for future dates of therapy. If a patient was seen for 30 minutes a day by Occupational and Physical Therapy combined during a reference period, Medicare will pay that designated RUG amount for X amount of future days.
Many patients admitted to a skilled nursing facility from a hospital setting, were likely receiving inpatient rehabilitation (3 hours of therapy a day). Therefore, their expectations may be to receive a few hours of therapy a day. As an Occupational Therapist evaluating a new client, it is your responsibility to determine how much therapy this client can benefit from. It becomes overwhelming thinking you should see a patient for 50 or 75 minutes a day, as well as see your regular caseload of Occupational Therapy clients. So, how do you maximize your time with a client and help them reach quantitative results? Here are some tips:
- Start Early: Begin seeing patients at 7am to address ADLs. You may not be able to do the entire ADL, but you can initiate a portion each day (communicate with the nursing aid if you cannot complete a patient's ADL). Seeing 2-3 patients for an ADL each day, rotating the patients you see to address everyone, you will soon see carryover of treatment. This will also help eliminate the stress of seeing a patient for 50-75 minutes straight, who may not be able to tolerate that much time at once.
- Group Patients: Usually, a patient receiving Occupational Therapy can receive group treatment up to 25% of their regular treatment time for the week. Have set daily groups that your patients can benefit from. For example, set an adaptive equipment group up for 30 minutes on Tuesdays and address "How to Use Adaptive Equipment." Or have a weekly exercise group, home safety, homemaking, or community re-integration group. This will help utilize your time with a client for Occupational Therapy treatments, as well as aid a client in reaching a functional outcome.
- Dovetail: This is a term many Occupational Therapy Clinicians should become familiar with. Dovetail means you can see two Medicare Part A patients at the same time, but not charge them for a group treatment. Keep in mind, if you are having the clients do the same activity it is a group treatment. But if you are seeing 2 patients with different start/stop times this is considered a dovetail. For example, say you are treating John from 9am-9:50am and Jane from 9:30am-10:20am. Both are Medicare Part A clients receiving different types of treatment (e.g., e-stimulation, exercise...) and can be billed separately. This helps Occupational Therapy practitioners utilize their time more effectively, while still addressing goal-oriented tasks.
- Education: Much of our time as Occupational Therapy clinicians is spent communicating with family, staff, other clinicians, and the patient about the therapy plan of care or how to use equipment appropriately. If the patient is present, you can bill for this time. For example, educating restorative staff or family/patient on a splint wear/care schedule is billable time. Try to take advantage of this, as it will strengthen your documentation and justification for services, as well as improve the client's quality of care.
Keep in mind, all of the above tips and suggestions should be referenced in accordance with your facility's regulatory standards. Please consult with you rehabilitation manager or your policy and procedure manual to accurately determine how to best utilize your time with your client, in accordance with Medicare Part A guidelines.
NBCOT Exam Study Group
Since the NBCOT exam is a hot topic on the OT-ADVANTAGE.COM website, a study group was developed. Please go to 'search profiles' (http://ot-advantage.com/ota/searchprofiles.aspx). You will see 2 groups, one for the OTR exam and for the OTA exam. Feel free to add information on study tips, good study materials, blog, add documents, and more. Consider this your group. Comment below if you have other ideas on how OT-ADVANTAGE.COM can help prepare you for the BIG exam!
Rotator Cuff Exercises for Occupational Therapy
Blog presented to you by: www.ot-advantage.com
Here are some good exercises to incorporate in your Occupational Therapy treatment program for someone who has been referred to you s/p rotator cuff repair or rotator cuff tear. You can determine how to initiate/grade/progress the Occupational Therapy treatments but, these are great illustrations and descriptions of what to do. These are also good if you are in a bind and need some new exercises to teach your clients!
http://health.yahoo.com/musculoskeletal-treatment/rotator-cuff-home-rehabilitation-exercises/healthwise--ue4829.html
Here are some good exercises to incorporate in your Occupational Therapy treatment program for someone who has been referred to you s/p rotator cuff repair or rotator cuff tear. You can determine how to initiate/grade/progress the Occupational Therapy treatments but, these are great illustrations and descriptions of what to do. These are also good if you are in a bind and need some new exercises to teach your clients!
http://health.yahoo.com/musculoskeletal-treatment/rotator-cuff-home-rehabilitation-exercises/healthwise--ue4829.html
Group Intervention Ideas for Occupational Therapy
Blog presented to you by www.ot-advantage.com
If you are an OT clinician being asked to incorporate more groups or an OT student planning a group for a class presentation or for a fieldwork assignment, a question mark may be floating in your mind! It becomes difficult to create a group that can have influence on each client. One client may require direct 1:1 attention, another is quite high level and needs more challenge, and someone else may be the hater (never wants anything to do with therapy, but can really benefit).
So, how do you strike that balance? I have been an OT for 5 years and struggle with this at times. If you're stuck, don't worry. It means you're normal!
I'll give you some ideas that may work for you that I have used in the past.
Pediatrics:
Edible Playdough Group
Kids love to eat or just bite on things they play with. This is great if you have a client with latex precautions too.
Pincer grasp: Have your clients roll their dough into a snake and then pinch sections of it.
Coordination: Rolling the dough in the hands or pulling small pieces off of a roll.
Bilateral Integration
Proprioception: If the client can stand or sit at a higher surface than the table, they can knead or press into the dough.
Play: Need to see how a client interacts with other children and stimuli? This may help you out with your assessment.
Sensory Integration: If your client has difficulty with different textures this may be a way to grade your interventions (progress up/down). Maybe add other edible treats in there, like skittles, for them to pick out.
Postural Stability: Have the client sit on a theraball while manipulating dough.
Follow this link for recipes on making and storing various types of edible pladough: http://www.familycorner.com/family/kids/crafts/edible_play_dough.shtml
Adolescents:
Outdoor Sport Activity
Clients in this age range may present with more behavioral diagnoses. Providing an atmosphere for them to expend their energy, interact with others, while also succeeding is great. Finding a sport that can provide this may be difficult. Here are some ideas.
Softball: This is a sport that offers many positions for your client to feel they are contributing to the group, and offers them a chance to be successful given their strengths. One way to downgrade this group is to play catch and then progress to a larger group for a softball game.
Golf: While this is a more tame sport, it requires great attention and thought-process.
Volleyball: Sometimes this game allows for some wiggle room if you do not have enough players. A way to downgrade this if you don't want to use a volleyball is a balloon.
Relay races
*Remember you do not need to follow the game rules100%. Participation is key and games can be adapted.
Adults/Older Adults:
The choices in this area become vast, as you are addressing a myriad of diagnoses. Below are a few suggestions.
Home Safety: Show pictures of an unsafe environment and have the group discuss how the home can be modified. Present adaptive equipment and provide information on costs and/or insurance reimbursement. Try to make this interactive to gain and keep everyone's attention. Have handouts with medical supply stores, companies that provide home modifications, and invite family.
Cooking/Homemaking: This poses problems in several facilities because many do not have a stove, oven, or sink. Sometimes you really need to tug on your creativity strings. One idea is try making a fruit bouquet. Buy some skewers and fruit. Use cookie cutters to be creative with making shapes for the fruit and stick them on the skewers. You can take it further and have a styrofoam block to stick the fruit skewers in to make a bouquet. A higher level client can help with the item transport.
Exercise: Exercise is important while trying to increase a client's activity tolerance, coordination, ROM, and more. If possible, incorporate the exercises into a group that you may be giving to the client upon their discharge. This may help them make it part of their daily routine. This would also be a good time for education: issue theraband or educate them on what they can use at home for weights (i.e., canned food, bag of beans), tell them why exercising their arms and/or legs is important, and educate them on how to breathe when exercising. Any precautions a client may have should also be addressed (i.e., cardiac).
Leisure: This can be fun! Choose something many can benefit from like bowling, balloon volleyball, air hockey (improvise on this; instead of a puck use a large checker), jenga, or hangman.
PNF: Grading this task can be done creatively. Think of the PNF diagonals as your core and expand upon it by incorporating balls, sitting on a theraball, reaching in the kitchen, or gardening.
Use your clinical judgment when addressing groups. The best part of being an OT clinician or student is the use of your creativity. The way you document and expand on how your group addresses your client's functional performance areas will make you exceptional.
Also, do not feel pressured to incorporate groups due to productivity requirements, to manage a large caseload, or because of a client's payor source. While these are important, remember to do what is best for the client.
If you are an OT clinician being asked to incorporate more groups or an OT student planning a group for a class presentation or for a fieldwork assignment, a question mark may be floating in your mind! It becomes difficult to create a group that can have influence on each client. One client may require direct 1:1 attention, another is quite high level and needs more challenge, and someone else may be the hater (never wants anything to do with therapy, but can really benefit).
So, how do you strike that balance? I have been an OT for 5 years and struggle with this at times. If you're stuck, don't worry. It means you're normal!
I'll give you some ideas that may work for you that I have used in the past.
Pediatrics:
Edible Playdough Group
Kids love to eat or just bite on things they play with. This is great if you have a client with latex precautions too.
Pincer grasp: Have your clients roll their dough into a snake and then pinch sections of it.
Coordination: Rolling the dough in the hands or pulling small pieces off of a roll.
Bilateral Integration
Proprioception: If the client can stand or sit at a higher surface than the table, they can knead or press into the dough.
Play: Need to see how a client interacts with other children and stimuli? This may help you out with your assessment.
Sensory Integration: If your client has difficulty with different textures this may be a way to grade your interventions (progress up/down). Maybe add other edible treats in there, like skittles, for them to pick out.
Postural Stability: Have the client sit on a theraball while manipulating dough.
Follow this link for recipes on making and storing various types of edible pladough: http://www.familycorner.com/family/kids/crafts/edible_play_dough.shtml
Adolescents:
Outdoor Sport Activity
Clients in this age range may present with more behavioral diagnoses. Providing an atmosphere for them to expend their energy, interact with others, while also succeeding is great. Finding a sport that can provide this may be difficult. Here are some ideas.
Softball: This is a sport that offers many positions for your client to feel they are contributing to the group, and offers them a chance to be successful given their strengths. One way to downgrade this group is to play catch and then progress to a larger group for a softball game.
Golf: While this is a more tame sport, it requires great attention and thought-process.
Volleyball: Sometimes this game allows for some wiggle room if you do not have enough players. A way to downgrade this if you don't want to use a volleyball is a balloon.
Relay races
*Remember you do not need to follow the game rules100%. Participation is key and games can be adapted.
Adults/Older Adults:
The choices in this area become vast, as you are addressing a myriad of diagnoses. Below are a few suggestions.
Home Safety: Show pictures of an unsafe environment and have the group discuss how the home can be modified. Present adaptive equipment and provide information on costs and/or insurance reimbursement. Try to make this interactive to gain and keep everyone's attention. Have handouts with medical supply stores, companies that provide home modifications, and invite family.
Cooking/Homemaking: This poses problems in several facilities because many do not have a stove, oven, or sink. Sometimes you really need to tug on your creativity strings. One idea is try making a fruit bouquet. Buy some skewers and fruit. Use cookie cutters to be creative with making shapes for the fruit and stick them on the skewers. You can take it further and have a styrofoam block to stick the fruit skewers in to make a bouquet. A higher level client can help with the item transport.
Exercise: Exercise is important while trying to increase a client's activity tolerance, coordination, ROM, and more. If possible, incorporate the exercises into a group that you may be giving to the client upon their discharge. This may help them make it part of their daily routine. This would also be a good time for education: issue theraband or educate them on what they can use at home for weights (i.e., canned food, bag of beans), tell them why exercising their arms and/or legs is important, and educate them on how to breathe when exercising. Any precautions a client may have should also be addressed (i.e., cardiac).
Leisure: This can be fun! Choose something many can benefit from like bowling, balloon volleyball, air hockey (improvise on this; instead of a puck use a large checker), jenga, or hangman.
PNF: Grading this task can be done creatively. Think of the PNF diagonals as your core and expand upon it by incorporating balls, sitting on a theraball, reaching in the kitchen, or gardening.
Use your clinical judgment when addressing groups. The best part of being an OT clinician or student is the use of your creativity. The way you document and expand on how your group addresses your client's functional performance areas will make you exceptional.
Also, do not feel pressured to incorporate groups due to productivity requirements, to manage a large caseload, or because of a client's payor source. While these are important, remember to do what is best for the client.
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