Hi guys, hope clinics is going well for everyone.
At the CP attachment, I realized that I’m not just dealing with the patient’s lungs but with geriatric issues as well. Most of the patients I see are elderly chaps & ladies, so balance such that the risk of falls is essential to assess for. Thus, all the geriatrics stuff as well.
I’ve been seeing an elderly chap this week, who initially came across to me as quite a stubborn person. He came into hospital with the use of a walking stick and he has been the sole carer for his wife whose health condition is not very well. He has been admitted to hospital for a femoral aneurysm repair, with a Hx of COPD, and has been staying in hospital for nearly 3weeks. The family feels he has not quite as ready to return home as yet. They would like him to regain his independence first as he would be the sole carer for his wife when he returns home.
He is currently ambulating with his WZF, though independently with that, I thought that training him with his W/S would be a good idea of training up his balance, progressing his ex tolerance as well as gaining back his level if independence in terms of a W/A. However, when I talked to him about it, he was not keen on trialing his W/S and he refused to do so as he feels he already knows how to use it. Luckily, his nurse overheard me talking to him, and so tried to help me convince him. I realized that caring for his wife was a great motivating factor for him so I used that as a means to get him to mobilize and do some LL strengthening ex’s and he cooperated.
However, a couple of days later when I saw him, he was deemed on walking with his WZF and not at all with his W/S. He claimed he was fine not using his W/S and he doesn’t think he needs physio treatment as he feels he is ambulating fine with his WZF. I tried offering home physio for him when he gets d/c, but he refused. Despite all the persuasion, with no consent, there was nothing I could do about. Ultimately, it’s the patient’s choice, its not what we want for them, it’s actually what they want for themselves given the options made available for them. Thus, I realize that sometimes you have to compromise with your own goals and the pt’s.
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An interesting situation, and one in which I think we will find ourselves as physios more often than we think! Your story reminded me of a couple of situations I had on a prac and the realisation that a lot comes down to ones ability to find the key which will make all the difference, which is why i think healthcare is a team thing. As we all have different ways of doing things some tactics will work with some people and for others another person will be able to find that "key"ingredient to make things happen. (And in other situations nothing works because it is in the end the patients choice!!) But having seen in prac when working with other students how effective different people can be with the same patient we should never be shy to ask for input from others in the team!
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