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That a CNP patient is achieving a desirable result.
1. Maintaining life roles: including work
2. ...
Fill in
1. Maintaining life roles: including work
2. ...
Fill in
"Objective" functional signs
- Thread starter 101N
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I think work is the only one you can objectively document. Everything else is just what the patient says. Performing around the house chores, exercising, enjoying time with family and friends, getting out of the house, walking, etc. Can't measure any of it... well actually if they have a fitbit we could measure all of the above. I just came up with my new pain invention! Yes
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Patients cook for me and knit. Others farm, do yardwork.
And as a measure of work you take their word for it, but i bet 101 demands a paystub to dole out a tramadol.
And as a measure of work you take their word for it, but i bet 101 demands a paystub to dole out a tramadol.
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He's not the only one.
Exceptions: legacy patients, the retired elderly...
Exceptions: legacy patients, the retired elderly...
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Gainful employment, participating in life roles (father, son, mother, grandma, etc), hobbies, general appearance (clean, make-up applied properly, well-kempt), mental status, speech.
Try this: ask them to bring in spouse, children, care-giver, etc and ask *THEM* how they think the patient is doing---very useful collateral info.
Some other good conversation starters: "What have you done for fun lately?" "How do you know the medicine is working?" "Have you ever tried taking a little less for a while and seeing what happens?" "What are your goals?" "What if your pain stayed exactly the same as it is today with or without medicine--what would you do?"
Other things to try: Set mutually agreed goals and chart them in the medical record. It's very "rehabby," but keeping the visits focused on goals instead of dose or NPS ratings makes a big difference...
Try this: ask them to bring in spouse, children, care-giver, etc and ask *THEM* how they think the patient is doing---very useful collateral info.
Some other good conversation starters: "What have you done for fun lately?" "How do you know the medicine is working?" "Have you ever tried taking a little less for a while and seeing what happens?" "What are your goals?" "What if your pain stayed exactly the same as it is today with or without medicine--what would you do?"
Other things to try: Set mutually agreed goals and chart them in the medical record. It's very "rehabby," but keeping the visits focused on goals instead of dose or NPS ratings makes a big difference...
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Best IME question I've ever seen was on a patient disabled for 5 years at time of IME. s/p C2-7 neck fusion.
When was your last vacation? Answer: 8 months ago I took a 4 day trip to Cabo.
When was your last vacation? Answer: 8 months ago I took a 4 day trip to Cabo.
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Several surveillance companies work as contractors for disability policies. They do full background checks, neighborhood canvases, video, internet, etc. Robinson Group does great work. All just a click away.
