I am currently treating a patient who had a pontine stroke a few years ago. As a result she has ‘locked-in syndrome’. She is in her late 20s. She is now wheelchair bound and the only voluntary control she has is a small amount of elbow flexion/extension and head control. She can laugh and smile and mouth yes and no.
My treatment involves manual stretches, foot mobs and tilt table activities for trunk control. We also work on sitting balance. When I read her notes I felt I would be able to cope with the treatments quite well, but was a little apprehensive about communicating with this patient. My first treatment sessions with other neuro patients had essentially been 1.5 hours of rapport building and I was concerned that it might not be so easy with this patient. I read in her notes that she communicated via lightscribe.. which frankly just freaked me out! I was imagining some high tech device which flashed lights which I would have to interpret..
When the patient arrived I took a deep breath and went to meet her. She smiled and typed the word ‘music’ into her keyboard, which prints and speaks whatever she writes (this is the lightscribe I was so scared of!). When we worked out how to put the radio on, we got to work and I found that communicating with her wasn’t difficult at all. Whilst on the plinth, a series of yes/no questions allows her to tell me what hurts/when she’s uncomfortable or just to make chat; all without the lightscribe, though knowing it was available if required really helped.
I soon realised that her approach to our meeting had made me comfortable with the situation and able to interact appropriately. I was annoyed at myself for being so worried initially. In the future I will have more confidence in my abilities to adapt to new situations and hopefully I will be the one making the other person feel at ease! I also really appreciated the extent to which the allied health team can go to ensure a pt is able to communicate – not being able to communicate can be the biggest frustration for pt post stroke, but this pt (whose disabilities are quite severe) was completely at ease and I suspect some of that is because she is able to communicate so well.
1 comment:
You're right Amber, communication is so important when treating a patient. It is very difficult to build rapport if you can't have a conversation. If something is bothering the patient it's really important to them to identify what it is, even though it is a bit of a guessing game. By ignoring the patient's attempt to communication will only make the patient more frustrasted.
Post a Comment