Depressed geriatric pt

This blog concerns a patient I saw whilst on my gerontology placement. I was set to see her with my Curtin supervisor and demonstrate a thorough geriatric assessment. Upon reading the patient notes, I found that this lady had become a widow earlier that year and since then had become less mobile and less motivated and had increased her alcohol consumption significantly. The medical staff had noted that she was suffering from depression and this was very evident in speaking to her. When I entered the room, the patient obviously didn't want to see anyone (commenting "and what are you going to make me do?") and in my initial questioning I was able to gather that she was in quite low spirits. I spent most of the first session talking to her as I felt it was important to develop a good rapport with the patient if I were to get her to do anything and the only intervention we did was a short walk before she needed to sit down due to dizziness and fatigue.

My Supervisor commented afterward that it would have been more effective to do little questioning and get the patient up and going for a more effective session. I felt, however, that had I done this the patient may have found me pushy and, in my opinion, it would have been less likely that i would have gained cooperation in future treatment sessions.

In future sessions, I found myself getting the patient to do a little bit more every day and her making great progress, as well as developing a great rapport. In contrast, most of the other staff found her difficult. 

I learnt from this situation that sometimes it can be effective to allow the patient a little more time to tell you their background and not be too pushy in order to have a good treatment outcome. Having said this, I will keep in mind that not all patients have the luxury of a longer stay in the hospital and sometimes you will need to get them up and going straight away. some patients may also use your not so "pushy" nature to their advantage...a few things to think about I guess.