Goal-Setting and Treatment Planning Edward B was

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 _________________________________________ 1. ____________________ 2. ____________________ 3. ____________________

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

Goal Setting Longer Term Rehab Goals Shorter Term Rehab Goals 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. This is Edward’s functional status on admission. What goals would you set for him to achieve at discharge?

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. x 1 sd 2 sd

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

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. x 1 sd 2 sd

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. x 1 sd 2 sd Edward’s actual discharge scores - how does it compare?

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

Charting Progress Longer Term Rehab Goals Shorter Term Rehab Goals 8 /0 3 /0 03 8 0 / 04 0 5/ 8 0 7/ 1 5/ 0 • 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.

How do you interpret the FMA-UE total score? 0 = “unable” 1 = “partial” 2 = “faultless” A vague (uninformative? ) score. Does it tell therapist more than s/he already knew? Does it tell him/her what s/he needs to know? 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.

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.

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.

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