It does not surprise me really, but this placement has reiterated the importance of communication, motivation skills, and particularly the appropriate and select use of words.
On a couple of occasions now, I have had a particular patient who is very pessimistic, negative and low in confidence regarding her ability to participate in the exercises for our soon-to-start session. Dare I ask "how are you today?", I am bombarded with all that is wrong with this patient. To the patients credit, we are not seeing her at her best, she is away from her home/family/comfortable environment, and desperately wants to get home again, of course she is not going to be herself. GIven that, I have quickly learnt to adjust my use of words, and time them appropriately. Its important obviously to ask the patient if they have any pain, but not focus or pander to the pain overtly. I have also found that education regarding the patients presentations can play a large role in physio Rx. If the patient has some misunderstandings regarding their pain etc (as happens often in our gero ward with plenty of dementia) this can cause unnecessary grief and anxiety about physical activity and moving. I have found that my patient at the start of the sessions was extremely concerned about moving because of her pain in the lower back region and hip. With a little dementia, she often forgets that this pain is a normal response of her OA, which has flared up because of her recent fall. By educating her and ensuring she has adequate pain relief, I have found that our sessions still have a little hesitation to begin with, but are conducted relatively smoothly with the patient understanding that if she was to do nothing at all 1)she would physically decline with immobility, and 2) she would be stuck in the gero rehab for longer. Motivation, education and a hint of empathy and humour, has allowed our sessions to become something that i think the patient now enjoys and understands the benefit of.
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