Sunday, November 16, 2008
independence vs safety
I treated an 83 y.o. lady who was admitted for rehab after having a cerebellar stroke. She is mildly affected by the condition and is independent with her ambulation with no aid. Prior to admission, she lives alone in her own home and is independent with all ADLs. I decided to assess how well her balance is and so I did a Berg Balance Scale on her. Her score was 44/56 and therefore is a falls risk. Without me even suggesting to her any walking aids, she said to me that she doesn't want to be walking with any frame or stick and wants to be on her feet for as long as she can. I have no worries about her ambulation indoors (as she is walking around the ward by herself) but I am worried about her outdoors mobility (with the uneven surfaces and environmental factors). Prior to her discharge, i talked to her about her outdoor mobility and how it is very different to indoors. I also did the dynamic balance assessment (external displacement) on her to show her that she couldn't save herself appropriately if she is nudged by someone in the shopping mall or on the streets. I also told her that she will have a risk of being hospitalised if she does have a fall. I know that she doesn't like the idea of walking aids so I gave her a brochure which includes a range of 4WW which she could use as an outdoor walking aid to improve her safety. I am not sure if she went to get one in the end but I know that I have done all that I could in terms of educating her regarding her safety outdoors. I have also referred her to day therapy for more rehab.
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2 comments:
We can only try educate pt on what is best for them in terms of safety but they have to make the change themselves, good idea giving her a brochure
Elderly people tend be very staunch in what they want and how they want to be portrayed> there seems to be a stigma attached to walking devices. As long as you did what you could to educate her and advise her then that is your responsibility achieved.
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