Reasons for Discharge
- Goals have been met
- A fx’l plataue has been reached
- Max benifit for skilled services has been achieved.
- Discharge to a higher level of care is required
- LOS has expired and an extension is not possible
Discharge planning begins when…
W/ the initial evaluation/ All interventions should be planned w/ consideration of the expected, planned discharge enviornment.
Directive group leadership
Occurs when the OT is responsible for the planning and structuring of what takes place in the group
- Style is needed when group members have limited skill (parallel or project level)
- Selects activities, provides clear verbal and demostrative instructions.
- Group maintenence roles and feedback is provided by the OT
- Leaders goal is task accomplishment.
Facilitative group leadership.
OT practitioner shares responsibility for the group and for group process w/ memebers.
- Ego-centeric or cooperative groups
- Collaborate w/ group members to select the activities to be used in a group.
- Members and leaders share instruction throughout the group process
- Group maintenance roles and feedback are provided by members w/ the leader facilitating the process.
Advisory group leadership
OT practitioner functions as a resource to the members who set the agenda and structure the groups functioning.
- Mature groups
- Members select and complete the groups activity w/ leadership advice, if needed.
- Group maintenance roles are independently assumed by group members.
- Feedback occurs as a natural part of the groups self-directed process.
Parallel Groups
- TO enable members to perform individual tasks in the presence of others.
- To minimally interact verbally and non-verbally w/ others even though task does not require interaction for successful completion.
- To develop a basic level of awareness, trust, and comfort w/ others in a group.
Project Group
- To develop the ability to perform a shared, short-term activity w/ another member in a comfortable, cooperative manner.
- To develop interactions beyonf those that the activity requires.
- TO enable members to give and seek assistance.
Egocentric-coopeative Group
- o enable members to select and implement a long-range activity which required group interaction to complete.
- To enable members to identify and meet the needs of themselves and others.
Cooperative Group
- To enable members to engage in a group activity which facilitates free expression of ideas and feelings.
- To develop sense of trust, love, and belonging and cohesion.
- To enble members to identify and meet soci-emotional needs.
Mature Group
- To enable members to assume all functional socio-emotional and task roles w/in a group.
- To enable members to reinforce behaviors which result in need satisfaction and task completion.
Parallel group leadership
- Provide unconditional positive regard to develop trust
- Activiely fill all leadership fucntions.
- Reinforce all appropriate behaviors
- Provide structure
- Faciliate interaction.
Prallel Group Activities
- Members perform activities independently of others but in the prescence of others.
- Interactions are not required to sucesfully complete the activity.
- Activities should be similar or utilize common tools or materials to facilitate interaction and sharing.
- Activities shouls be relevant to a persons ability, age, gender, and interest to increase interaction.
Project Group Leadership
- Select and structure activities that can be shared by two or more members.
- Fulfill all of the members needs while encouraging them to give and seek assisance and interact beyon the activities requirements.
- Reinforce cooperation, mild completion, sharing and interactions
Project Group activities
- Task is short-term and requires the particiaption of two or more people.
- Task is shareable and requires interaction to sucesfully complete.
- Group interaction, not project completion is emphasized.
Egocentric-cooperative Group Leadership
- Less of an active direct leader
- Facilitate and allow members to fulfill functional leaderhip roles to function independently.
- Provide guidelines and assistance as needed
- Reinforce members meeting nees of self and other
- SERVE AS A ROLE MODEL
Egocentric-cooperative Group Activities
- Activity allows 5-10 people to work together
- it is selected and impletmented by members
- It is longer-term requiering more that 2 meeting to complete
Cooperative group leadership Role
- Act as an advisor not a direct leader
- Leader and members are mutually responsible for giving feedback, identifiying and meeting needs, and reinforcing behavior.
Cooperative group activities
- Activities facilitate and allow for free expersion of ideas and feelings.
- Activity is secondary to need fulfilliment and may not produce an end product.
Mature Group Leadership
- Act as a peer, an equal, a group mmeber
2. Fill in only if and when needed to maintain a group.
Mature Group Activities
- Activity requires a number of people to work together,
- Requires an end product or has an inherent time limit for completion
- During the gorup actvitiy may be stopped for memebers to explore what is going on within the group.
Boutinniere deformity
Flexion of the PIP joint and Hyperextension of the DIP
Swan Neck
Hyperextension of PIP joint and flexion of DIP joint
Functional Position for Splinting
Writst 20-30 degrees of extension
MCPs 45 of flexion
IPs 20-30 Flexion
Thumb ABD
Resting Postion (RA)
Wrist 10-20 extension
MCPS 15-25 of flexion
IPs in slight flexion
Thumb palmarly ABD
