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1. STG - Pt. Will attend all scheduled therapies throughout the day, modified independence and minimal verbal cues, using alarms and calendars, by 1 week.

2. Treatment Idea - Therapist will educate the client on how to use the alarm on his phone as a way to remind him of specific tasks and have the client demonstrate back setting specific alarms.

3. Type of Intervention - Education, Occupation

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LTG: Patient will do LB dressing (pants) with min A and AE including a reacher, while complying with shoulder precautions, sitting in an upright position in a chair, in 2 weeks.

Treatment idea: Patient will don on/off elasticated pants while sitting in a chair, with assistance from the OT and verbal cues about shoulder precautions.

Interventions: Occupation and Education including proper dressing techniques and shoulder precautions.

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Goal: Client will perform UB dressing, mod I with adaptive equipment ( button hook) seated in a chair with backrest by end of 4 weeks.

Treatment activity: client will don button down shirt using one handed dressing  Technique. The occupational therapist will educate the client on how to perform the technique and provide feedback to best complete it. In addition, the OT will eduacate client on shoulder precautions.

Type of intervention: Ocupation- dressing; Education-dressing method, treatment precautions.

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1. Mr. Rodriguez will transfer min assist to bed/ chair using balance techniques by two weeks.

2. Treatment activity: Practice balance by taking turns with grandchildren on standing and putting matching playing cards on a board

3. This is an occupation falling under the category of leisure  since he is doing something he enjoys by spending time with his grandchildren.

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Goal: Mr. Rodriegez will dress UB sitting EOB, using a one handed technique mod A in 1 week

Treatment idea: therapist will teach client on handed techniques for donning shirt and assist the donning of his shirt at beginning of day when he will be getting dressed for the day

OT intervention: Occupation and education

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Goal: Pt will I perform LB dressing using a one handed technique with S while seated on a supported chair by 10/26.

Treatment Activity: Pt will don loose fitting pants using a one handed technique, with the guidance of an OT, following appropriate shoulder precautions.

Intervention: Occupation- IADL, education

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Goal: client will perform UB drezsing, Mod I, seated on a chair with  ithe backeestusing one handed dressing technique

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Goal: Client will don his shirt using one handed dressing technique while sitting in a supportive chair with Min A while following shoulder precautions, by 2 weeks.

Treatment idea: Therapist will educate client on proper ways to dress himself using one handed UB techniques while abiding to shoulder precautions in order that the client will eventually be able to dress independently.

Type of intervention: education – teaching client one handed UB techniques while abiding to shoulder precautions and occupation – ub dressing

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LTG: Patient will don on/off a t-shirt using a one-handed dressing technique with Minimal A, while following proper shoulder precautions, sitting up right in chair in 2 weeks.

Treatment ideas: Client will practice taking on/ off a loose fitted t-shirt, while following specific steps from the OT.

Intervention: occupation and education including one-handing dressing technique as well as reminders about shoulder precautions.

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STG: patient will toilet with MOD A from OT using DME three out of five times, by one week.

Treatment idea: this is an occupation and the reasoning is that the client will be able to independently toilet with DME.

Type of intervention: education and ADL training

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STG- Mr. Rodriguez will perform UB dressing with mod A using a one handed dressing techniques, while sitting, by 3 weeks

Treatment idea- Educate the patient about how to dress using a one handed dressing technique and practice the techniques while simultaneously keeping in mind shoulder precautions because he is S/P L sh. hemi-arthroplasty

This intervention is an occupation and education

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Goal:

Client will perform UB dressing while sitting in a supportive wheel-chair, using one handed technique, with Min A,  by 3 weeks.

Treatment idea:

Occupational therapist will practice UB dressing using one handed technique with the patient in the morning when he is getting dressed for the day.

Intervention:

The occupational therapist will educate and train the patient to UB dress using one handed technique, while bearing in mind the shoulder precautions.  This is occupation- dressing UB in the morning, education- shoulder precautions, ADL- dressing and self care.

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LTG: Mr. Rodriquez will perform UB dressing of his button up coat, using a one handed technique and adaptive equipment, with Mod I, while sitting in a chair by 4 weeks, to increase independence.
Treatment Idea: Occupational therapist will in his room, sitting on a chair, teach Mr. Rodriquez one handed UB dressing techniques. She will additionally teach him how to perform one handed buttoning in order to increase his independence when getting ready to go on an outing. Additionally she will educate him and continually remind him of his shoulder precautions
Type of intervention: Education (one-handed dressing and shoulder precautions), training, occupation

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LTG: Mr. Rodriguez will perform LB Dressing with Modified Independence by using one handed dressing techniques, adaptive equipment and increased time by November 5, 2018

Treatment Idea: Occupational Therapist will educate the patient on shoulder precautions, one handed dressing techniques and adaptive equipment that will increase independence

Type of OT intervention: Education and occupation

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STG: Patient will bathe with Min A from OT, using a shower chair, utilizing one handed techniques, three out of five times, by one week.

Treatment Idea: Occupational therapist will train the patient on the correct one handed technique to bathe with minimal assistance, using only right UE.
Type of Intervention: Education/ Training

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LTG: Pt will don/dof his button down shirt, with mod I, at the edge of his bed, using a long handed equipment in 3 weeks time.

Treatment idea: occupational therapist will do upper body dressing with a long handed equipment in his room while getting dressed in the morning. OT will educate pt on shoulder precautions prior to treatment. Pt will be seated at edge of bed due to poor balance and endurance during treatment activity.

Type of interventions: education- OT is educating the pt and family members of the shoulder precautions. Occupation- teaching the pt to dress with mod I is an occupation.

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Goal: Client will perform UB dressing using a one handed technique while sitting in a supported chair and complying with shoulder precautions, Min A in 2 weeks.

Treatment Idea: Occupational Therapist will educate patient and family members on a one handed dressing technique while complying with shoulder precautions.

Type of Intervention: Occupation - Ub dressing, Education - patient and family members

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GOAL: Pt. will perform a one handed tub transfer technique with Mod. I using a tubtransfer bench with grab bars near wall, by end of 4 weeks.

TX IDEA: Therapist will perform tx sessions in the AM when pt is most alert, with education on L UE precautions, and going over one-handed techniques with a transfer tub bench. Have pt. write down precautions and reminders about WB of the affected extremity, on a notepad, for reference when he is discharged home, due to impaired memory.

TYPE of intervention: Education of precautions, memory aids, ADL'S (self care).

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Goal: Client will don an duff UB dressing with Min A, using one handed dressing technique with verbal cues while sitting in a supportive w/c (2weeks).

Treatment Ideas: The therapist will come to client`s room when it is time to change for his UB dressing and the therapist will demonstrate the proper one handed dressing technique complying with his shoulder restrictions. Then the client will practice the technique alongside the therapist (therapist will give verbal cues when needed).

Types of Intervention: Occupation, Education (teaching him the one handed dressing technique while complying with his shoulder restrictions)

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Client will take a shower with Mod Assist using AE (such as shower/tub bench),one handed techniques and complying with shoulder restrictions , while sitting on shower bench  by 2 days .

Treatment activity: Shower in patient’s  bathroom at a time that best suits patient. Education :one handed techniques how to bathe oneself with one hand and while adhering to shoulder precautions. Education regarding AE- using shower/tub bench safely decreasing risk of LOB

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Client will transfer from w/c to toilet, min A, complying with shoulder precautions, with min verbal and visual cues (demonstration), by two weeks.
Treatment idea: OT will come to the client’s room in the morning. OT will educate the client on shoulder precautions and the importance of complying. Then, in client’s bathroom OT will give client visual demonstration and verbal cues for the steps and mechanics of the transfer. Client will then practice the technique.
Type of intervention: education (on shoulder precaution and transfer techniques), occupation

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LTG: Client will Mod I dress UB, sitting, using a one handed technique, in a month.
Treatment idea: therapist will work with patient to dress ub at the appropriate time of day- in the morning. OT will teach the client how to preform the one handed technique. Throughout the therapist will ensure that patient is adhering to precautions so he does not hurt himself. Therapist will also educate the family on how to correctly perform one handed dressing so they can assist when the therapist is not around.
Type of intervention: Occupation= dressing UB at the correct time( in the morn)
Education= teaching client and family how to perform one handed dressing technique.

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Goal: Pt will perform LB dressing, Min A, while sitting in a supportive chair using one handed techniques and AE (reacher, dressing stick) and following shoulder restrictions by 1 week
Treatment Idea: educate patient and family members on importance of following shoulder precautions and use of AE. Provide client with visual charts and train family members in dressing techniques to compensate for memory impairments.
Type of intervention: occupation- dressing LB
Education- educating pt and family members

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Goal: Client will perform upper body dressing using one handed dressing technique, Min A, while sitting in a supported chair, by 4 weeks.
Treatment ideas: OT will come to the client in the morning to complete upper body dressing and teach the client a one handed dressing technique while complying with shoulder precautions.
OT Intervention: Occupation, education (one handed dressing technique and educating the client about shoulder precautions).

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Client will toilet with mod A, while sitting in a 3 in 1 commode, using long handled equipment for toileting ( ex: bottom buddy) by 2 weeks.

Treatment Idea: In patient’s bathroom in morning, 1st educate him on shoulder precautions and how to use long handled equipment to wipe himself, so he can be more balanced when toileting.

Type of Intervention: Occupation, education ( Teaching him how to toilet with adaptive equipment, while complying with shoulder precautions/ restrictions)

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Goal: Client will dress UB, Mod A, with min verbal cues, while sitting in supported chair, using one handed dressing technique and complying with shoulder precautions, by 1 week.

Treatment idea: Dressing in client’s room in the morning using large cardigan. OT will educate client on shoulder precautions. Next, OT will demonstrate how to use one handed dressing technique while complying to shoulder precautions and then client will practice technique. (OT will provide verbal cues when necessary).

Type of intervention: education (one handed dressing technique and shoulder precautions) training, occupation.

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Goal: Pt will get out of bed, mod A, using side lying to sit transfer, complying with shoulder restrictions, in 3 days.
Treatment Idea: OT will help him get out of bed first thing in the morning, demonstrating the side lying to sit transfer for bed mobility.
Type of Intervention: Occupation, education (teaching him how to properly get out of bed while still complying with his shoulder precautions)

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Goal: Client will donn and doff LE dressing, while seated in a supported back chair, using a dressing stick, and complying with shoulder precautions, Min A, with mod vc and touching assistance, by 4 days.

Treatment idea: Dressing in client’s room in the morning, using large shorts. OT will educate client on shoulder precautions and importance of staying seated while dressing, due to balance problems. Client may use a visual dressing chart with steps and precautions to address the deficit in memory.

Type of intervention: education (shoulder precautions, dressing stick), occupation

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Goal: PT will don pants with min assist, using one handed technique and complying with sh precautions, sitting edge of bed, by one week

Treatment idea: In the patient’s room in the morning, teach him shoulder precautions and how to use one handed technique to put on his pants and practice with him using loose pants.

Type of intervention: occupation (for LB dressing), education (for one handed technique for donning pants, shoulder precautions).

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Goal: Client will dress UB and LB, Mod A, while sitting on a supported chair using a one handed technique and complying with shoulder restrictions by 1 week. Treatment idea: OT will practice UB and LB dressing using a one handed technique on a supported chair due to his impaired and balance. OT intervention: education, training, occupation (one handed technique, educate about shoulder precautions)

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LTG: Mr. Rodriguez will bathe UB and LB with Mod A, while sitting in a shower chair, using long handled bathing equipment (ex: long handled sponge) by 2 weeks.

Treatment Idea: For first session, have pt perform pendulums (front and back, side to side, and in a circular motion) for LUE, while lying on mat with Left arm hanging over, in rehab room. OT provides physical positioning and stabilization due to decreased balance and memory. Also, remind pt to breathe in and out, using energy conservation techniques to help with his endurance. Once he progresses with his balance and endurance, he can perform pendulums standing up. This will encourage movement in his left shoulder without him actually moving his shoulder (passive) until MD allows for AROM.

Type of intervention: preparatory task (preparing him for occupation of bathing by performing passive movement of LUE until MD clearance for AROM) and education on breathing techniques.

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Goal: Pt will dress UB, Mod A, while seated bedside in a supported chair, using the one-handed dressing technique, complying with shoulder restrictions, by 2 weeks.

Treatment idea: Practicing donning a t-shirt, bedside, as client sits in a supported chair, (after OT educates the client about shoulder restrictions), while providing verbal and tactile cues throughout his performance.

Type of Intervention: Occupation and Education: since the pt has difficulty maintaining appropriate precautions during performance of occupations considering his  process skill and memory impairments, educating him about his shoulder restrictions and what actions he must avoid is crucial for his compliance with Dr.’s orders. Additionally, educating his family may be beneficial as well due to the client’s aforementioned deficits; so they can remind/monitor him.

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Goal: Client will don his pants, S,  while sitting on a chair, using a one handed technique and reacher and complying with shoulder restrictions by two weeks

Treatment Idea: Occupational Therapist will do dressing with him in his room and make sure he is sitting due to impaired balance and show him how to don his pants using the one handed technique before he performs it on himself. Additionally, the OT will educate the client on how to use the reacher to obtain his pants if it is not in hands reach and to apply it to the one handed technique of donning pants.

OT Intervention: Occupation and Education ( one handed technique and reacher)

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Pt will don t-shirt, max A, using one handed technique and complying with shoulder restrictions  by 2 days.  Treatment idea:  dressing in his room  in the morning using a large t-shirt.  Type of intervention: occupation, education (for shoulder precautions and one handed technique).  Julie Kardachi

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Pt will don t-shirt, max A, using one handed technique and complying with shoulder restrictions  by 2 days.  Treatment idea:  dressing in his room  in the morning using a large t-shirt.  Type of intervention: occupation, education (for shoulder precautions and one handed technique).  Julie Kardachi

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Goal: Client will perform UB dressing, while complying with shoulder precautions, Mod A, using visual reminder, sitting on a chair with lumbar support and utilizing a one handed dressing technique in 1 week.

Treatment idea: OT will perform PROM on clients L shoulder while encouraging the client to take deep breaths to manage his pain and then the client will perform AROM of his L E/W/H and RUE, according to MD orders and educate the client on maintaining shoulder precautions, writing them down with him and hanging them in his room as a visual reminder. OT will teach the client how to perform a one handed dressing technique with a large t-shirt  that goes overhead prior to getting dressed for the day in his room while sitting in a chair with a lumbar support due to impaired sitting balance.
Type of intervention: preparatory method, education, training and occupation.

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Client will don his jacket (excluding zippering) min assist, complying with shoulder restrictions with verbal cues and a visual aid reminder on safe technique, by two weeks.

Treatment idea: Therapist performs passive range of motion in the patient’s shoulder as per MD orders. Type of intervention: Preparatory Method and Patient/family education through teaching relaxation and breathing strategies to patient and patient’s family prior and throughout the PROM (i.e. deep breathing, visualization).