It was a busy, and sometimes downright lousy week. I had 2 people that I was asked to see, cleared for home with family supervision, and then neither family would take them home. It is really sad to see someone who could be in an assisted living or adult day care go to a facility due to the lack of help at home. I hate being put in the middle of these family power plays where the caregiver child just doesn't want to do it anymore but won't say anything until the person is hospitalized. In a strangeness typical of this topsy-turvy week, I also had a lot of people insisting that they would take their parent home when they were very debilitated and largely dependent. The only bright spot for me was getting time to do some follow ups on Friday and changing a rec(ommendation) from rehab to home. That lady had cleared up physically and cognitively and did great in our gym, she was so happy to go home.
One of my fellows with dementia was interesting, but frustrating to work with. Terrible short term memory and executive function to follow through with tasks. Getting dressed took us a very long time. Mod assist x2 for LE dressing. After he was already dressed, he needed to use the bathroom... got him sat down, specifically said DO NOT GET UP and then positioned myself outside the door to detect movement since those directions are so rarely followed. I heard him up and moving toward the sink, so I went in to find him walking with his underwear pulled up but pants still around the ankles, totally oblivious to any lack of completion of the task.
This has been a frustrating week as well since it has felt multiple times like different groups were trying to undermine our therapy recs. Obviously, we're all part of the team trying to facilitate best d/c plans for the pt. However, it's hard to feel appreciated by the rest of the staff when you're doing an eval and the home care coordinator walks in to set up home therapy and oxygen OR the doctor comes in to review discharge instructions OR the case manager has already stated the plan is for rehab. It makes you feel like an ancillary service that doesn't really matter to people. That is a feeling that I truly hate. I've also been at odds with people lately who can't respect my decisions NOT to see pts. The most recent of these was a gentleman who had a blood sugar of 500+ and was off the floor for testing for several hours. I was told, Oh, they've treated him and tested him since then, it'll be much better than that. With all due respect, prove it. This is similar to when someone tells me to see a pt. who has dopplers pending to rule out DVT, because "we don't really think they have a DVT." I need to know that my pts are stable to work with, and need for people to respect my judgment when they don't appear so.
I've long been angry at my apartment complex for their slow response to ice and snow, worried that my elderly neighbor ladies would fall and break a hip on the poorly maintained sidewalks. Leaving the house Tuesday, I caught on some significant ice and did a "Home Alone" style slip and caught 4 steps on my back. Extremely unpleasant, especially as a user of bouncy public transportation. Was finally starting to feel better on Friday, and then I think I strained my back a little doing a 2-person lift. And then we went skiing on Saturday.
A note about skiing- I cannot do it. My husband loves it and progressed in one season from terrible beginner to black diamond goer (to my extreme worry). I have tried it once and spent the whole time falling. But I went, and it was really hard since I was already dealing with nagging pains. and then I remembered exactly how hard skiing is on your knees! Pizza wedging, turning, constant bends- it is no wonder you hear about these Olympians s/p ACL surgery and everything else. For me, it was very taxing mentally and physically, but an interesting learning experience (I can say that now that I am safely on the couch again).
It is an interesting time to be an AOTA member. I did the responsible thing and voted for all the positions (elections close March 3) and I also tried to review the proposals from all the candidates. It was interesting to see how many of the candidates had included a blog (many on the OT Connections service) and the number and kinds of updates they had. The truly interesting thing will be to observe how many people continue their efforts after the election. One of the great things about OTC has been getting more insight into the organization. President Penny Moyers is excellent about blogging and responding to forums, I also find posts by Brent Braveman (speaker of the RA) and "Ask" Molly (from OT Practice) to be good to follow. And with this continued debate on the future of the organizational structure based on the recommendations of the Participation Ad Hoc Committee, there have been some very informative responses from the decision makers. Incidentally, there have been several people who have initiated involvement on OTC to be part of this discussion, and the differences between experienced users of social network and others also provides interesting points for contemplation.
What this discussion is missing is input from the new generation of AOTA members. To my observation, these new developments with the COOL and the VLDC are designed especially for the newer OT practitioner members to enhance the member experience and offer leadership opportunities for unrecognized, busy members. There is a lot of uproar over these changes, and the decision makers need to hear ALL the voices in this discussion. So PLEASE express yourselves in the forum so that our demographic is represented.
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