Uncooperative Patients

I am currently on a general surgery ward and treating a patient who is very non compliant with physiotherapy. He was previously living with his wife and independent with all ADL’s but since his operation has been refusing to ambulate and has the idea in his head that when he gets home every thing will be back to normal and he will be able to do everything he used to do. When treating this patient he will usually consent to chest physio but will refuse to ambulate or even sit out of bed at times. This makes progressing him and preparing for discharge very difficult as he has been in hospital for about 3 weeks and is therefore very deconditioned. On a couple of occasions I have been able to convince him to ambulate but usually he will just become very agitated with me and refuse. When my supervisor has attempted to treat this patient he has received the same reaction. This has really frustrated me as no matter what strategy I use with this patient to convince him to ambulate he refuses as he is under the impression that everything will just fall into place when he gets home. I have now realised there is nothing I can do if the patient refuses to ambulate and all I can do is keep trying. I have also found this patient is more likely to be compliant if I see him when he is sitting out of bed rather than lying down and also if I plan with the nurses to attempt to ambulate him when he is about to have a shower. In the future I will attempt to treat this patient when he is out of bed but if he still refuses to ambulate there is nothing I can do except come back later and try again.