While on my gerentology placement I am treating an 80 year old man who underwent an AAA repair 8 weeks ago, he has an extensive PMH including COPD. At the moment his main problems are he becomes very SOB on exertion and has a decreased exercise tolerance and deconditioning due to his extended stay in hospital. He lives alone in a one storey house and has a very supportive daughter who helps with his shopping and anything else he needs. During one of my treatment sessions with him he became very upset and teary when talking about being stuck in hospital as he just wanted to go home and thought he would have to stay in hospital forever. When I saw how upset he was getting I realised he must not have been made aware of what the plan for him was as I knew the goal was to discharge him home. Before he could go home however he needed to be weaned off oxygen and improve his exercise tolerance.
I realised it was important for me to be very clear with my patients about what the expected outcome for them was. After he became upset I explained clearly to the patient that the reason he was still in hospital was because of his deconditioning and SOB and that’s why it was important for him to comply with physiotherapy to allow him to return home as soon as possible. Once he understood that he would not have to remain in hospital forever and the goal was to get him back to his home he was much happier. I now know how important it is that the patients understand fully what the plan is for their treatment and expected outcome is to give them hope and also improve compliance with their therapy. Also this situation has taught me not to assume the medial team will explain the expected outcome to the patient or they may misunderstand what they have been told so it is important for physios to clarify with the patient their expected outcome and plans for treatment.
2 comments:
Yes i agree with you very much. By explaining to the patients their medical progress and explaining to them the rationale for every decisions, it will provide the patient with a sense of control over their condition. Which is why I think that team meetings or ward rounds is really important for us to attend cause we then can explain to the patients what the medical plans are (within limits of the responsibilities of AHP).
It was perfect that you were there, A.F. Great job! You identified with the patient's frustrations and had appropriately explained to his relief. I agree that it is so important we observe the patient as a whole, and always put ourselves in their shoes to identify with their situation. That way, we could get better patient compliance and more easily build rapport with them. Thanks for sharing! =)
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