Lab 8 Goals Writing PDF

Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab...

Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab Lab 8 Goals Writing Goal—Narrowly defined end result of therapy to be achieved in a specified time. Goals are usually designated as long term goals (LTG) or short term goals (STG). Outcome—Anticipated end result of therapy, given the client’s characteristics, expected length of stay or therapy duration, and resources (funding, social support). Plan of care—A document prepared by all members of the rehabilitation team (including the patient) that describes the interdisciplinary treatment goals, interventions, and time frames for a specific episode of care. Estimate Outcomes and Set Collaborative Goals: Outcomes are chosen in part according to expected length of stay or anticipated number of outpatient or home-based sessions and resources available. Goals aims in general the patient to engage in occupations that allow them to participate in valued roles within their home, school, work, and/or communities through improvements related to: (1) function (remediation of impairments) (2) occupational performance (independence in activities of daily living [ADL], work, and play) (3) health and well-being (symptom status improvement and prevention of disability) (4) quality of life (purposeful participation in community life, emotional well-being, balance of activity and rest, and life satisfaction)  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab For setting the therapy outcomes the therapist should consider: (1) In what broad ways will this client’s life, health, and functioning improve as a result of therapy at this point in the recovery or adaptation process? (2) How long will it take to realize these benefits? Long- and Short-Term Goals Long-term goals (LTG) reflect what will be achieved by the time the patient is discharged from treatment or discharged to the next level of care on the continuum. In occupational therapy, long-term goals always relate to expectations of the patient’s functional skills and/or resumption of roles. Short-term goals (STG) are the small steps that cumulatively result in long-term goal achievement. Short-term goals are based either on expected improvements specific to client factors or impairments that ultimately contribute to improved function or on the patient’s improved ability to perform portions of the functional task. Essential components/charachteristics of goals: Specific: Dressing is too general while putting a shirt on is more specific, for STG you might need to be more specific: buttoning the shirt for example Measurable: you need to be able to measure whether the goal was achieved: dressing is not measurable, while putting a shirt within 2 minutes is measurable. Has a time frame: for STG you might use days or sessions:within the coming 6 sessions, by the end of this month, within the coming 2 weeks. LTG usualy achieved by the time discharge and could require months.  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab Criterion based: identify the level of performance required for success, for example completing the task successfully 4 times out of 6. This descirbes a frequency (times), duration (seconds, minutes) Condition based: has a definition of the task setup, context, Describe how the patient will do the task: sitting, standing. Descirbe the amount of the provided assistance/adaptations: independently, wirth supervision, standby assistance, minimal assistance, moderate assistance, maximum asisstance, using an assistive device Realistic: doable given the timeframe, resources,and patient's ability and motivation Client-centerd: you need to involve the patient, use the COPM for example LTG must be functional/occupational based (self care, leisure or work skills) while STG could be either functional or at the client performance componet level (ROM, strength, …etc) Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab Suggestions for Collaborating with Clients to Set Meaningful Occupational Therapy Goals Incorporate life history information into the assessment process so that you are able to get a glimpse of what the patient has found meaningful and important during the course of his or her life events. Appreciate that patients’ ability to identify and advance their goals for therapy will be influenced by where they are in recovery and adaptation process. Consider the broad continuum of care (inpatient to home health to outpatient to work reentry) as you aim to match the “right” goals with the “right” time frame by asking, “what does the person both value and need from occupational therapy at this point in his or her recovery?” Appreciate that most patients are unfamiliar with occupational therapy services and what we have to offer them and, therefore, are unable to independently generate goals for therapy. Acknowledge the influence of cognitive function on a person’s capacity to set meaningful goals. If you are unable to agree with the patient of broad therapy outcomes (if the patient wants an unrealistic goal), try to agree on short-term goals.  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab Linking Long- and Short-Term Goals to Anticipated Rehabilitation Outcomes P.B. is a 20-year-old man with C8 tetraplegia beginning multidisciplinary inpatient rehabilitation. The following examples of outcome and long- and short-term goals are not meant to be exhaustive lists of intervention plans but rather to illustrate the linkage between global outcome projections and therapy plans. Projected outcome of rehabilitation stay: In 8 weeks, P.B. will resume self-maintenance roles, requiring no more than occasional physical assistance from family members to manage in the home environment. Examples of long-term occupational therapy goals (to be achieved in 8 weeks): 1) P.B. will perform upper body dressing independently and require no more than moderate assistance for lower body dressing. 2) P.B. will use adaptive equipment to feed himself independently. Examples of short-term occupational therapy goals (to be achieved in 2 weeks): 1) P.B. will don a pullover shirt with no more than general verbal cues. 2) P.B. will participate in the evaluation of various types of adaptive equipment for self-feeding and use selected aids to feed himself independently after set up by therapist.  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab LTG need to be functional while STG can be functional or at the impairment level. Long-Term Goal: Independence in Lower Extremity Dressing Examples of Short-Term Goals Based on Examples of Short-Term Goals Based on Task Impairments Analysis Trunk flexion and BUE forward reach adequate Client will be able to properly place trousers over for LE dressing feet for donning. Cognitive-perceptual skills adequate for Client will be able to spontaneously dress LLE positioning clothing during LE dressing before RLE. Endurance adequate for safety and independence Client will be able to pull up trousers from a during LE dressing standing position. Demonstrate compensatory methods and Client will be able to demonstrate proper and appropriate use of adaptive equipment for safe, long handled shoe horn and complete LE use of independent LE dressing sock donner dressing in 5 minutes without SOB. BUE, both upper extremities; LE, lower extremity; LLE, left lower extremity; RLE, right lower extremity; SOB, shortness of breath.  Jordan University of Science and Technology Faculty of Applied Medical Sciences Department of Rehabilitation Sciences OT 203– OT Fundamentals Lab Practice *Form groups of 4 students and work on the following case: Case Example Mr. J., 60 years old, had an ischemic right cerebral vascular accident with resultant left hemiparesis 12 years ago. He also was diagnosed with a slight carpal tunnel syndrome in his left hand two years ago. At this time, he had no pain related to that diagnosis. He fractured his left little finger four years ago but it has fully recovered. J was characterized as an individual with severe chronic stroke accompanied with significant learned non-use (heavily dependent on the non- affected upper extremity). Using the COPM the therapist found that the most important and difficult functional activities for MR. J are: Washing his right side of the body with his left hand during bathing, cutting vegetables during cocking, putting a shirt on (buttoning), doing light home maintenance (driving screws for example), and playing cards. Write 5 long-term goals fulfilling the characteristics discussed in the lab (measurable, criterion-based, specific…etc). Write at least 3 short-term goals for each long-term goal. Treatment Goals