goal-setting and treatment planning edward b. was admitted to an irf following a stroke 8 days ago ...
TRANSCRIPT
Goal-Setting and Treatment Planning
Edward B. was admitted to an IRF following a stroke 8 days ago
He is 74 yrs old and lives with his wife They enjoy line-dancing and Edward is an avid
bridge player They have lived in the
same 2-storey house for 41 years
Goal-Setting and Treatment Planning
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Write a 2 sentence summary of Edward’s functional status and write 3 short term goals for his rehabilitation therapy
7. Complete independence6. Modified independence5. Supervision4. Minimal assistance3. Moderate assistance2. Maximal assistance1. Total assistance
Shorter Term Rehab Goals
Longer Term Rehab Goals
Goal Setting
This is Edward’s functional status on admission.
What goals would you set for him to achieve at discharge?Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
7. Complete independence6. Modified independence5. Supervision4. Minimal assistance3. Moderate assistance2. Maximal assistance1. Total assistance
Goal Setting
x 1sd 2sd
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
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Score where you think Edward’s functional status will be at discharge from rehabilitation
7. Complete independence6. Modified independence5. Supervision4. Minimal assistance3. Moderate assistance2. Maximal assistance1. Total assistance
Goal Setting
x 1sd 2sd
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
So what will Edward’s functional status be at discharge?
7. Complete independence6. Modified independence5. Supervision4. Minimal assistance3. Moderate assistance2. Maximal assistance1. Total assistance
x 1sd 2sd
Goal Setting
Edward’s actual discharge scores - how does it compare?Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
Tracking Progress
Joan S. returned home after total knee replacement, she has been trying to lose weight but is still obese
She is 69 yrs old, lives next door to her son and daughter-in-law
Retired, she has become increasingly inactive butvolunteers at her local library
• Don’t have to observe all the items - just the ones you’re targeting.• Clearly demonstrates progress• Gain on transfers is the key change in ability, more than gain on UE dressing • Is bathing independently with devices a realistic goal?
05/17/08
03/03/08
04/05/08
Charting Progress
Shorter Term Rehab Goals
Longer Term Rehab Goals
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
0 = “unable”1 = “partial”2 = “faultless”
Summed FMA-UE Score = 45
A vague (uninformative?) score. Does it tell the therapist more than s/he already knew? Does it tell him/her what s/he needs to know?
How do you interpret the FMA-UE total score?
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
Transition Zone: 50% probability of “passing” vs. “failing” an item
Improving the meaning of the FMA-UE score
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
Shorter Term Rehab Goals
Longer Term Rehab Goals
FMA-UE “Keyform” Recovery Map
Original presentation: Velozo, C.A., Woodbury, M.L., Mallinson, T.R., Bateman, J.S. What has My Standardized Assessment Done for Me Lately: A short course on how to use assessment scores to guide practice. Presented at the American Occupational Therapy Annual Conference, Long Beach, CA, April 2008.
"You don't understand it. I don't understand it. J.B. doesn't understand it. Maybe he's
got something here."