As a home care OT, you are the patient's closest access to immediate medical attention when you are making your visit.  With increase in the frailty and vulnerability levels of the patients being discharged from the hospital to their homes, the burden falls on the healthcare providers serving them at home to identify when the need for more advanced help is required.  Knowing the normal parameters for vitals along with the signs of distress will make you a valuable source of information when you contact the primary care provider who will then direct the patient's next steps. 

Learn more about lung sounds and heart sounds to help you know what might be going on
https://www.easyauscultation.com/lung-sounds
Hospital readmission rates 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3802532/

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Episode Notes

When you encounter a patient that you are struggling to find an effective intervention for, you need more than equipment and standard exercises.  In this episode, I review 3 recent patients that needed more than just the typical interventions.  These 4 intervention tools are ones you keep in your mind and share with others through touch, instruction and explanation.  

1. shoulder isometrics
2. diaphragmatic breathing
3. mindful meditation
4. soft tissue mobilization

Learning more about these interventions may just change your life as a therapist and will definitely change the outcomes for your patients.  I recently listened to a great online learning course that gave me some great ideas to use for cognitive rehab and I was surprised to hear such powerful results from mindful meditation.  I read more about it in the article below that you may find very interesting.   
-an online course by Cristina Klymasz
https://summit-education.com/course/GNEUCK.1/neurological-disorders#/onlinevideo/6-ceus
-harvard medical school researcher Sara Lazar
https://www.washingtonpost.com/news/inspired-life/wp/2015/05/26/harvard-neuroscientist-meditation-not-only-reduces-stress-it-literally-changes-your-brain/

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Unraveling the mystery of OT's role in Hospice and Palliative care in the home-based therapy setting.  There is a clear path for OT intervention in Hospice that is often overlooked.  I discovered in my preparation for this podcast that I should be advocating for OT to continue with the patients that I have transitioning from restorative intervention to hospice care.  

• recognizing when a patient is ready to transition to hospice
• making an impact that delivers caregiver and patient quality of life
• 5 roles of hospice and how similar they are to OT role in patient care
• identifying occupation at end of life can be a challenge but OTs are skilled at this

article on hospice and OT: https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/PA/Facts/FactSheet_PalliativeCare.pdf
https://ajot.aota.org/article.aspx?articleid=1886466

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Tried and true tips for success with a patient that is "difficult" to engage in a plan of care.  From the initial conversation that will create a sense of partnership to the final minutes of your session, you can find a way to turn your most oppositional patient into one that is looking forward to you coming back the second time.  

Engaging a patient in their plan of care can be more challenging than you would think when they are used to a substandard baseline or if they are accustomed to relying on a caregiver.  I have entered many settings where my initial thought is, "There isn't much I can do here."  A change in perspective and engagement empowers the patient and gives a clear direction to the therapist. 

• handling objections to therapy
• listening to prior experiences with therapy
• getting their "story" on recent medical events
• asking just the right questions to find their trouble areas
• developing an effective plan of care for the patient you encounter, not just the one on paper
• ideas for simple HEP for the patient resistive to exercise/activity

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

So you have your first patient and you are ready to set up the first visit.  Now what?  Listen to my method for the initial contact to the patient, to developing the initial therapy plan for them.  I keep it simple and unique, personable and joyful for me and the patient.  Patient driven therapy is what it is all about. Every therapist has there own approach and this is just an example of how I have found it to flow most effectively and make the patient feel the most comfortable.  

Take the stress out of your session by avoiding the tendency to over plan and overthink.  You just need to start with exceptional clinical observation and assessment of functional movement, endurance and some of the basic vital signs that start to put together a clear picture of the patient you are working with.   A holistic perspective to treatment is your best approach.  Lead with humility and being a guest in someone's home and being a clinician will flow out more naturally and with greater confidence.  

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

EPISODE NOTES
In this introductory episode, you hear how I worked through the phases of clinical practice in pediatrics for 10 years and transitioned to geriatrics and then I almost quit being an occupational therapist all together because I felt so stuck and uninspired.  Here how I changed my perspective and made a complete mindset change.  Twenty years of clinical practice combined with lots of self-discovery, have taught me the principles of being the OT I always wanted to be.  It's a choice. 

This first episode gives you a picture of the therapist that I have been and the OT that I have become as I worked with all age categories. After 20 years, I am just finding my "home" and I want to give the necessary insight to anyone who might be considering a transition to home care because we need you.   I had so many questions when I started and I didn't have much support.  I hope to be a source of encouragement and insight for anyone who needs it.

A FB group for ideas on non-clinical work: https://www.facebook.com/groups/NonClinicalJobPostingsForRehabProfessionals/
OT potential FB group
https://www.facebook.com/otpotential/?__xts__[0]=31.[40401617%2C%22intro_card%22%2C%7B%7D]

If you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching
Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining