Non compliant patients

A patient of mine has recently been admitted to hospital for some investigations and a possible surgery pending the outcome of the investigations. She is quite elderly but was previously independently mobile and living in her own at home, with family members coming in 2x a day to help with cooking and some ADLs.

A few days ago I was aiming to do a mobility assessment on her because she was new to the ward and I needed to document her current mobility status. I checked her obs, bloods and medication before going in to see her and these indicated that everything was stable. So I went in and introduced myself to the patient, only to have her tell me that she felt sick and didn't want to move.

I explained that my job was to see how she was getting around and compromised with her that we didn't have to walk if she felt ill and we could just transfer to a chair. She adamantly refused but with some assistance from my supervisor we managed to coax her to sit over the edge of the bed. It took 2x max assist to get this patient to SOOB even though her status prior to admission was independent. I asked her to sit and hold herself up without me supporting her and she started to fall backwards even though she was clearly capable of sitting independently.

Everyday since then, I have had this patient verbally abusing me and refusing any form of simple ambulation or any transfers. However I found that if I liased with nurses and planned my treatment around showering and toileting times, I can "trick" the patient into transferring and mobilising a little because it is something she needs. It is not optimal but its the most I can get from her at the time being. From this I have learnt that trying to coax non-compliant patients into treatment can sometimes require less effort than I previously thought.