November 8, 2021

Achieving Long-Term Goals is Complicated

Achieving long-term goals is complicated for people who have a chronic condition like a stroke.
It took five OTs a year to transform my relationship with food.  My in-patient OT made sure I knew how to make myself presentable when I went to live with my friend Arlene after rehab.  I would have been embarrassed to sit at Arlene's dinner table with sweaty pajamas and greasy hair.  My 
in-patient OT also addressed cold food prep so I could prepare my breakfast and lunch while Arlene was at work.  My home health OT addressed advance cooking skills I would need when I returned to my home.  Two rounds of out-patient OT prepared my arm and hand to maneuver a shopping cart around numerous obstacles at a grocery store.  A fifth OT provided certified driver training so I no longer had to spend two hours with paratransit to go to and from the grocery store.

Progress towards long-term goals is difficult to achieve for two reasons.  First, institutional autonomy does not allow communication between staff who work at in-patient, home health, and out-patient agencies.  Only the client sees all the steps towards a long-term goal.  I kept the momentum going by telling my OT "the next thing I want to do is ...".  Second, in the 16 years since my stroke no doctor recommended out-patient OT or PT.  They gave me a prescription for therapy when I asked for it, but they never asked how it helped me.  I had to go on-line to find out-patient clinics near me and ask friends if they would recommend a therapist they had gone to.
homeafterstroke.blogspot.com

2 comments:

  1. Continuity in care is everything!! You were wise to direct therapists in you want to accomplish. I asked for copies of my therapy and care (summary) notes before leaving the hospital and rehab center. It is your right. That way my care teams could continue my care.

    Funny, my doctors ask me is how therapy is helping me and if continued therapy will help. I guess they're all different.

    As far as finding a therapist goes, I had the office staff do the work (close to me, accepts my insurance, the type of therapy required, and would they recommend their mother there), but then I was totally new to the area too). It doesn't hurt to ask.

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  2. Amazing that your doctors skipped this recommendation. Here in Hospice (where any gains will obviously be temporary) we recommend OT and PT all the time, in the interest of safety for the patient (and sometimes also for the caregiver). Fall prevention requires some PT, navigating the kitchen requires some OT. I'm so sorry you've been treated by docs who didn't seem to know that.

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