During my gerontology outpatient placement I came across a treatment technique that was new to me but very effective with the older population. I had two patients present to the clinic that week that had completely over worked themselves and were not going to be able to complete a physiotherapy session. The first of these two patients decided to increase his walking from 15 minutes to 45 minutes as he was “feeling good”, another decided that she was also feeling much better and decided not to walk with her frame for two days following a # NOF.
My management for these patients simply was to offer them a cup of tea and then try to educate them about the need to follow the program and instructions that we had provided. Both of the patients agreed that they had probably done too much but were not aware of the potential problems they could encounter being so fatigued.
In one sense it was great to see that out treatment and the effort put in by the patient was making improvements however this enthusiasm needed to be reigned in. It is quite a fine line between encouraging elderly patients to continue being active after a fall and keeping a lid on that activity when their confidence returns.
I have learned from the experience the need to explain to the patient the benefits of the planned treatment but also to clearly outline the potential problems if they over do their exercise. In more general terms this experience has allowed me to consider how something as simple as an exercise program might have positive and negative impacts on someones life.
2 comments:
Patient education is a vital part of the treatment. And yes, there are many patients that tend to overdo their exercises to the point of fatigue. In my gerontology placement I had a patient with Parkinson's disease. He tends to walk until fatigue as well and he's had some balance issues before, so I got him to do some sitting exercises like writing to target his micrographia and folding paper as well. He enjoyed this and still felt that he's still doing exercises even while sitting.
In regards to gerontology i think education is vital. I often encountered that the pt thgought they were too old for training, exercises etc. Their focus has drifted from prevention which is a necessity for the elderly.
Really need to communicate that it is not too old to exercise and the prevention of falls is vital.
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