Hi everyone,
I have a patient on my cadio placement that continually refuses Rx from physiotherapy. She is severely limited in her mobility and physio could vastly improve her prognosis for the future regarding independence. She has severe dementia and thus does not listen to reasoning that I try to evoke to her regarding the importance of participating. My question to you guys is do you have any strategies that you would like to pass on that may help in convincing this lady to partake in Rx? Also, is it ever ok to procede with Rx in a patient who is refusing when they have dementia and don't know what is best for themselves?
Cheers
Brent
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3 comments:
Hey Brent,
I think there has to be some line where you can treat the person anyway, although it would be difficult if she was forceful.
Thinking about it, maybe trying to negotiate with her, asking her to spend 20 mins with you before she has a rest, and promising her a cup of tea or something at the end of that, bribes are always good.
Otherwise maybe getting a family member or someone to tell her she has to do her physio, even getting them to write it down so you can show it to her might help.
Hope these ideas help Brent, and good luck,
James
Hey Brent,
Like James mentioned, I would talk with her family, if possible. You could let them know the importance of physio and have them speak with her (your patient) about participating in the physio treatments. Having them write a reminder to her may help as well. They could possibly give you strategies to use with your patient as well, that work for them. Trying to make the treatment more social may help, putting in alot of chatting in between the exercises.
Have you discussed this patient with your supervisor or the other medical staff? How are they getting her to be compiant to treatment? Possibly getting techniques from them to help with compliance.
Hey brent,
Yeah i have had a similar patient. She has dementia and refuses treatment, so I have been approaching it from a different angle. I need to progress her mobility, and currently she can walk approximately 15-20 m before needing a rest. There is a small courtyard and garden about that distance from her room, so I walk into her room and say "I'm heading into the garden to have a sit down and to get some fresh air. Do you want to come?" More often than not, she jumps at the chance.
I'm sure you don't have a situation as ideal as that, but just an idea to think outside the square.
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