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Goal-Setting and Treatment Planning

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.

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Goal-Setting and Treatment Planning

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  1. 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

  2. Goal-Setting and Treatment Planning _________________________________________ _________________________________________ _________________________________________ 1. _______________________________________ 2. _______________________________________ 3. _______________________________________

  3. Write a 2 sentence summary of Edward’s functional status and write 3 short term goals for his rehabilitation therapy 1:59 1:58 1:57 1:56 1:55 1:54 1:53 1:52 1:51 1:50 1:49 1:48 1:47 1:30 2:00 1:46 1:32 1:33 1:34 1:35 1:37 1:36 1:39 1:40 1:41 1:42 1:43 1:38 1:45 1:31 1:44 1:29 1:00 1:26 1:25 1:24 1:23 1:22 1:21 1:20 1:19 1:18 1:17 1:16 1:15 1:14 1:27 1:12 1:13 1:28 1:01 1:02 1:04 1:05 1:03 1:07 1:08 1:09 1:10 1:11 1:06 0:52 0:49 0:50 0:51 0:53 0:59 0:55 0:56 0:57 0:58 End 0:54 0:48 0:41 0:46 0:45 0:43 0:42 0:40 0:39 0:38 0:37 0:35 0:34 0:33 0:31 0:32 0:47 0:36 0:13 0:15 0:30 0:20 0:17 0:18 0:19 0:21 0:27 0:23 0:24 0:25 0:26 0:22 0:16 0:09 0:14 0:12 0:11 0:10 0:28 0:08 0:07 0:06 0:05 0:04 0:03 0:02 0:01 0:29 0:44

  4. Longer Term Rehab Goals Shorter Term Rehab Goals Goal Setting 7. Complete independence 6. Modified independence 5. Supervision 4. Minimal assistance 3. Moderate assistance 2. Maximal assistance 1. Total assistance 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.

  5. x 1sd 2sd Goal Setting 7. Complete independence 6. Modified independence 5. Supervision 4. Minimal assistance 3. Moderate assistance 2. Maximal assistance 1. Total assistance 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.

  6. Score where you think Edward’s functional status will be at discharge from rehabilitation 1:59 1:58 1:57 1:56 1:55 1:54 1:53 1:52 1:51 1:50 1:49 1:48 1:47 1:30 2:00 1:46 1:32 1:33 1:34 1:35 1:37 1:36 1:39 1:40 1:41 1:42 1:43 1:38 1:45 1:31 1:44 1:29 1:00 1:26 1:25 1:24 1:23 1:22 1:21 1:20 1:19 1:18 1:17 1:16 1:15 1:14 1:27 1:12 1:13 1:28 1:01 1:02 1:04 1:05 1:03 1:07 1:08 1:09 1:10 1:11 1:06 0:52 0:49 0:50 0:51 0:53 0:59 0:55 0:56 0:57 0:58 End 0:54 0:48 0:41 0:46 0:45 0:43 0:42 0:40 0:39 0:38 0:37 0:35 0:34 0:33 0:31 0:32 0:47 0:36 0:13 0:15 0:30 0:20 0:17 0:18 0:19 0:21 0:27 0:23 0:24 0:25 0:26 0:22 0:16 0:09 0:14 0:12 0:11 0:10 0:28 0:08 0:07 0:06 0:05 0:04 0:03 0:02 0:01 0:29 0:44

  7. x 1sd 2sd Goal Setting So what will Edward’s functional status be at discharge? 7. Complete independence 6. Modified independence 5. Supervision 4. Minimal assistance 3. Moderate assistance 2. Maximal assistance 1. Total assistance 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.

  8. x 1sd 2sd Goal Setting 7. Complete independence 6. Modified independence 5. Supervision 4. Minimal assistance 3. Moderate assistance 2. Maximal assistance 1. Total assistance 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.

  9. 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 but volunteers at her local library

  10. 03/03/08 04/05/08 05/17/08 Charting Progress Longer Term Rehab Goals Shorter Term Rehab Goals • 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? 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.

  11. 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? 0 = “unable” 1 = “partial” 2 = “faultless” Summed FMA-UE Score = 45 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.

  12. Improving the meaning of the FMA-UE score Transition Zone: 50% probability of “passing” vs. “failing” an item 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.

  13. FMA-UE “Keyform” Recovery Map Longer Term Rehab Goals Shorter 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.

  14. "You don't understand it. I don't understand it. J.B. doesn't understand it. Maybe he's got something here."

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