Examples of Treatment Plans

JN

Long Term Goal: Pt will demonstrate safety awareness with regards to hip fracture and corresponding weight bearing status while completing ADLs by August 3, 2012.

Pt: JN

Dx: Hip Fracture

STG:

Pt will demonstrate ability to recite 5 out of 5 safety techniques as explained in an OT educational handout by July 27, 2012.

Methods Rationale Treatment Approach/ FOR/ Guiding Theory Activities
OT will create a handout that explains the surgery that the pt underwent, precautions after that specific type of surgery, and safety techniques that the pt can implement.

 

Pt has demonstrated a decline in safety awareness with regards to her L hip fracture post-surgery.   OT intends to improve her attention and safety awareness in order to prevent further injury to the affected hip.   The purpose behind this treatment plan is to promote optimal healing of the hip fracture in a timely fashion. Theory:

MoHO, because the outcome will be affected by the pt’s volition to participate in the treatment plan, the habituation of the safety techniques, and mind body performance.

 

FOR:

Cognitive Behavioral, because the pt’s thoughts, physiology, emotions, and behaviors will be addressed in the handout and will affect follow-through with the treatment plan.

  1. OT will review the handout with the pt on a one-to-one basis.
  2. OT will lead a questions and answers session after reviewing the handout.
  3. OT will request that the pt review the handout in order to verbally recite the safety techniques explained in the handout.

 

 

 

DC

Long Term Goal: Pt will demonstrate increased dynamic sitting balance at EOB for 5 minutes while participating in ADLs with the use of assistive devices by August 10, 2012.

Pt: JN

Dx: Hip Fracture

STG:

Pt will participate in EOB balance activities as directed by OT to increase dynamic sitting balance for improvement of ADL participation for 2 minutes consecutively with no rest breaks by August 3, 2012.

Methods Rationale Treatment Approach/ FOR/ Guiding Theory Activities
OT will encourage the pt to participate in alternating elbow lean exercises at the EOB.

 

The activity discussed in this treatment plan is intended to improve ROM and strength within the pt’s trunk, hips, and UEs. By improving in these areas, the pt will be able to tolerate and increase participation with ADL activities. Theory:

EHP, because OT is assisting the pt with increasing his task performance range by improving with strength and ROM in his trunk, hips, and UEs.

 

FOR:

Biomechanical, because OT is emphasizing the improvement with strength, endurance, and ROM.

The elbow lean exercises at EOB involve the pt sitting at the EOB in a 90o-90o-90o position then leaning from side to side to rest the elbows on the bed. OT will be close to the pt at all times to provide external feedback and support when the pt demonstrates signs of fatigue or improper positioning during the activity.

 

 

 

JC

Long Term Goal: Pt will complete UB bathing and dressing with SBA and adaptive equipment by August 10, 2012.

Pt: JN

Dx: Hip Fracture

STG:

Pt will verbalize and demonstrate hemi-techniques for donning and doffing UB clothing with the use of adaptive equipment by August 3, 2012.

Methods Rationale Treatment Approach/ FOR/ Guiding Theory Activities
OT will explain and demonstrate hemi-techniques to the pt. OT will then encourage to pt to adopt these techniques for everyday dressing of his UB. The pt demonstrate R hemi-paresis of the UE and LE. By using hemi-techniques, the pt could become more independent with everyday ADLs. Theory:

EHP, because OT is helping the pt increase his task performance range by providing him with skills to accomplish more within his current context.

 

FOR:

Rehabilitative, because this is a compensatory approach to help the pt regain more independence in his everyday life. A compensatory approach was selected, because of the extent of his hemi-paresis.   Strength and ROM may be attained at a later date, but in the meantime this is a more practical and functional approach.

  1. OT will demonstrate how to don and doff a T-shirt using verbal and tactile cues 5 times.
  2. OT will ask the pt to recite hemi-techniques that he found useful.
  3. OT will introduce and educate the pt with a button-hook and a long handled reacher.
  4. OT will assess pt and provide assistance when it’s needed.

 

*This will occur during every treatment session until 8/3/12.

 

 

CK

Long Term Goal: Pt will improve ROM in RUE to increase participate in UB ADLs by August 10, 2012.

Pt: JN

Dx: Hip Fracture

STG:

Pt will increase end range AROM with R shoulder abduction from approximately 35o to approximately 100o by August 3, 2012.

Methods Rationale Treatment Approach/ FOR/ Guiding Theory Activities
Pt was capable of obtaining 35o AROM at his evaluation date. OT will facilitate activities and modalities to help the pt increase ROM in RUE. The pt demonstrated a decreased ability to abduct his R shd greater than 35o during his OT evaluation, so OT plans to use evidence-based approaches to help him increase his AROM for improvement with UB ADLs. By improving the pt’s ability to perform ADLs the pt will be more independent with his daily life, and more prepared for life at home, which he stated was his plan after being discharged from PFHC. Theory:

EHP, because OT is assisting the pt with increasing his task performance range by improving with strength and ROM in his trunk, hips, and UEs.

 

 

FOR:

Biomechanical, because OT is intending to focus on the pt’s ROM, strength, and endurance.

  1. OT will introduce electrical stimulation, ultrasound, and moist hot packs.
  2. Based on the PAM that the pt is most interested in, the OT will use that PAM at the beginning of each tx session then initiate PROM, AROM with no additional resistance, and low resistance strengthening exercises to assist the pt with increasing his AROM.
  3. OT will measure the pt’s AROM with a goniometer at the beginning and end of each tx session to determine the efficacy of this tx approach.

2 thoughts on “Examples of Treatment Plans”

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