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A Voice in the OT Wilderness

Mandates - inflating the costs
March 16, 2010 3:43 PM by OTCM
My perspective on mandates encompasses more than legislation or rules that are written to support or "clarify" (as if!) legislation. I think of mandates as being decrees made by powerful systems trying to bring some semblance of order to chaos. As a case Read More...
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Unchain my mandated heart
March 13, 2010 11:13 AM by OTCM
As a case manager, I draw on resources wherever I can find them. The trouble is, many resources lie with people who have been too conditioned by the constraints of mandates to see new opportunities. Here's an example in which Medicare "habituation" created Read More...
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Mandates: the fool's gold lining
March 9, 2010 12:25 PM by OTCM
Despite some good experiences, I believe there are significant flaws in mandates. The concept has merit, but the applications are a different story. Mandates can have unintended negative consequences. Efforts to comply with mandates can lead to cookie-cutter, Read More...
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Mandates and new OT practice opportunities
March 5, 2010 9:59 AM by OTCM
The specialty OT practice of case management has different constraints than "traditional" OT practices. Those differences can free up thinking about how and where OT services belong. The case example I introduced in the previous blog entry occurred several Read More...
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A case example in support of mandates - part 1
March 2, 2010 1:27 PM by OTCM
One of the most interesting cases of my practice as a disability case manager (DCM) provides an example of how a mandate for OT services proved valuable. My client was an 18-year old I'll call MB. MB survived a traumatic brain injury (TBI) at the hands Read More...
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An argument in favor of mandates
February 27, 2010 10:46 AM by OTCM
I believe that mandated services have some merit. In large systems, services can be forgotten or overlooked by busy - and often overworked - people who also can't know everything about everything. The larger the system, the more likely there are multiple Read More...
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Mandating OT services: Yes? No? Sort of?
February 22, 2010 6:03 PM by OTCM
What is your opinion about mandating OT services? Do you believe OT can survive as a profession - in the U.S., at least - without mandates? What recommendations about mandates would you make? Have mandates affected your OT job(s) specifically and/or your Read More...
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Fast Forward
February 19, 2010 10:28 AM by OTCM
Occupational Therapists can be practicing case management without having "case manager" as part of their official job titles or responsibilities. In broadly-stated terms, case management involves looking beyond the immediate situation, considering what Read More...
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The Silence of the Clamps: Day 2 of OT
February 15, 2010 3:00 PM by OTCM
It was really hard for me to let my mom "go along to get along" in her first OT session. But as a "Secret Shopper," I had to give the staff of "Restive Acres" a chance to show me what they could do. Mom and I were trying to decide what card game to play Read More...
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The benefit of the doubt has no benefits
January 15, 2010 12:51 PM by OTCM
You know from my 9/8/09 post what I think of the state of long-term-care (LTC) facilities in general. You also know that I believe many LTC-based OTs seem to be selling our profession short. My experience with the LTC my mom was in did nothing to mitigate Read More...
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Nostalgia ain't what it used to be
January 11, 2010 4:58 PM by OTCM
My mom's hospital discharge planner asked me if I had a preference for the sub-acute rehab. facility my mom should be sent to. I named the facility I'll refer to here as "Restive Acres." Over the course of 20 years, I had had three different associations Read More...
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Health care's a crap shoot - with emphasis on the 'crap'
December 21, 2009 4:43 PM by OTCM
”The moment they learned she's someone important they f[ound] the file[.]” - Bill Moyers Journal (PBS) transcript, 11/13/09 In the U.S. health care system, there is increasing emphasis on expecting people to take more responsibility for their own health Read More...
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From Limbo to Purgatory
December 7, 2009 5:39 PM by OTCM
Last time , I asked you to reflect on the concept of "informed consent" as I tell you the story of my mother's medical crisis. This installment asks you also, to reflect on the challenges of creating effective Advanced Directives. If you reflect on your Read More...
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Trick or treat in a Hall of Mirrors
November 23, 2009 4:34 PM by OTCM
"I can explain it to you, Joey, but the understanding is up to you." - Dennis the Menace (by H. Ketcham), 11/23/09 What guidelines do you use when seeking informed consent from your clients? I have often thought about the challenges inherent in the concept Read More...
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Saturday night’s alright for fightin’
November 9, 2009 8:10 PM by OTCM
Back in August, I blogged about my mother and her attitudes about death. Recently, we had the opportunity – if you can call it that – to examine the subtleties of her perspective, and how it is reflected in her advanced directive. Mom was taken to the Read More...
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