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I have just been explaining to a new OT on the block why mother needs a handrail for outside steps: mother's failing ability to judge risk is part of it. At first not seeming to get it at all, the OT then outlined how she had heard that people with dementia would rearrange their bookshelves out of alphabetical order. ???!!! No doubt some do; but this does not quite reflect the grasp of the condition I would like an OT to have. The OT is coming to do the preliminary assessment, so I've got what I wanted; but seriously? I know she's new, but… Would you say anything to her?

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She'll be in for a shock, then :)
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If I understand this right.... when you say OT, you mean occupational therapist? There is something seriously wrong with this person's training if she does not understand about why your mother needs a handrail....... that does not even take a rocket scientist to figure that out. Some people are book smart but have NO common sense. This is an example of incompetence! I hear your frustration but have experienced what you are saying!. It is like doing an evaluation for dementia in 5 minutes...... that right there shows you incompetence.
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Maybe she was confusing Autism and Dementia! LOL!
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Thank you everybody, very useful. Having reflected on this afternoon's conversation (and got over my surprise) it occurs to me, too, that this young lady could have come from any number of settings - maybe she just didn't have many elders among her previous charges. They can't cover everything, after all. Don't worry, I'll be nice to her!

PS You're right, of course, about their needing to assess patients/clients individually; but the other thing creeping in is that now, when the Community teams fill in their forms, they have to explain how the cost of the visit, adaptation or other recommendations can be justified: unless there's some sort of preventive value, the assistance for independent living may not be given. So: falls risk - no assistance given, patient fractures hip, patient costs NHS £xx,000; assistance given, patient safe and well, cost to NHS £x00 instead and everybody's happy. Hence the minor tussle about getting her to appreciate why the falls risk had increased with the dementia.

The thing is, they don't tell you that. So when they're dealing face to face with little old ladies who play down every symptom… see if you can guess what happens. Me, I just love The System!
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Ashlynne I take my hat off to you that you didn't slap him. Oh well indeed. Oh well what a pity she had a moron for a doctor...
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Just before my mother went into the NH I saw her doctor respecting her condition and what was best for her. He said "Oh well, she's had dementia for years, long before you came to care for her". Huh? I just thought age was making her more narcissistic, mean and nasty. Asked why he'd never told me his response was "Oh well, she was always with you {shrug}" and pretty deaf at that! IDIOT! It wouldn't have changed things but I'd have been more able to understand her despicable behaviour.
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In fairness I think they have to actually see the patient attempt to cope with the stairs to accurately analyze what functions are deficient. As Teepa Snow demonstrated, it can be visual limitations, it can be motor control losses, or it can be a failure to process spatial information. All patients are different, all assessments will be different. OT and PT can only be successful if the patient can remember what is taught.
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Sorry Brandywine cant resist. "because that was all the author knew"
Cynical old nurse!!!!!!!!!!!!!!!1
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yes, doctors and the healing professions are clueless on a lot of things. Dementia being one of them and the other clueless on depression. Even in the NH I find that they are clueless. One just has to educate them. When I was studying to be a nursing assistant, there was only 2 paragraphs on dementia in the book.
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CM I don't think you need advice on this one. Your opinions are usually pretty strong but I imagine you will find a way to sugar coat it. I think I would just tell her Mum is senile and does not know what she is doing most of the time.
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I think you can say something to her without being critical or smarmy...don't want to tick her off. But you can say, you've learned alot about the disease on your own and hope that she can work with you and your mom on things/tasks that will be most practical and helpful for everyday living and help mom master those skills or adjustments to better her life quality.
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That is a hard one. Over and over again in the ten years I cared for Coy we encountered therapists, nurses, and even doctors who were clueless about dementia or the kind of dementia Coy had or that there even were different kinds of dementia! When it seemed appropriate I tried to grab a teaching moment. An ER doctor, for example, seemed very glad to have the brochure I gave him, explaining briefly why certain drugs were not to be given to people with Lewy Body Dementia. The hospice staff admitted they had not dealt with this disease and they were very open to printed material and my explanations.

It didn't always work out that I could contribute to their understanding, but I tried when I could. The various visiting OT and PT who came were good at the therapy but didn't know anything about dementia. There visits were valuable, but a bit frustrating.

Let us know what you do and how it works.
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