Currently, whilst on my gerontology placement I was performing a subjective assessment on a female patient that was submitted with decreased mobility resulting in concurrent falls. At my placement the aim is to orientate treatment with respect to the patient's goals. When I queried the patient as to her goals she told me that she wanted to go up. Go up where I thought. I made it plain that I didn’t understand and she clarified by stating she wanted to go to heaven. She didn’t want to live independently anymore instead she wished to move into a hostel, specifically into respite care. I initially didn’t know what to say and said something about her hopefully having plenty of time and that with physiotherapy we can ideally increase her balance so that she feels safe to go home again. Since then I have tried to encourage and motivate her and be specific about how each exercise will help her function.
I found it completely different being on a gerontology placement after a musculoskeletal placement, because you have to approach older patients with a completely different perspective. You have to consider their quality of life and previous level of function to a greater extent whereas with outpatients you assumed that a patient was functioning independently and generally enjoying life.
However my question is, how do u reply to that? Should you be encouraging and tell them that they hopefully still have many years to live (depending on the prognosis of the patient) and that they shouldn’t give up, when the patient feels they have already lived their life. Alternatively, do you just respect their wishes and let them remain in that mindset. Has anyone been in this situation before?
1 comment:
Hey Mel, I had the same experience on my cardio placement. Very confronting and I struggled to come up with an appropriate response. I think that listening was of huge importance in these situations because often these patients felt like they had become a burden. I felt like giving them a little more time than other patients made them feel less of a burden and as though people still cared and wanted as opposed to HAD to help them...but that's just been the patients I have experienced.
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