I had a conversation with a patient the other day that made me stop and think. At this point in my career as a physical therapist, I spend my days in the case management realm. On that day, I called a patient in a skilled nursing facility to talk about how she was doing in therapy and what her plans were for discharging. After years of working with patients, I know these conversations will either be pleasant, pleasantly confused or not happy to hear from me. But I am ok with that because I know my intentions are genuine and I just want to help.
I called this lady in particular because when reading her therapy notes, I could see that she wasn’t interested in participating in therapy, but the problem was, she was planning to discharge home with her equally elderly spouse and she required Alot of help to do things like get dressed and get on and off the toilet. This plan does not add up to a safe one and may have led her to go home, fall and head right back to the hospital, only to land herself right back in the skilled nursing facility. I’ve seen it happen time and time again unfortunately.
When she answered the phone, I introduced myself and asked her how things were going. She of course said just fine, but I knew better from reading the therapy notes. I tried to gently talk about how I noticed she wasn’t wanting to do therapy, but that she still needed a lot of help. I told her I wondered how she and her husband were going to manage once she went home. She said that she was tired of everyone being in her personal business! In that moment, I knew that I was dealing with either someone who didn’t understand what the purpose of therapy was, someone who was in denial about their own circumstances or perhaps someone who just didn’t want to deal with it.
As a therapist, this is just tough. In my treatment days, I remember thinking with some of my patients, why do I want this more for them, than they want for themselves? It was frustrating and sometimes heartbreaking. Do people just get to a certain age and decide they just don’t care anymore and just want to be left alone. Are they threatened that they won’t be able to return to home?Is it because people don’t really understand the method behind our madness or maybe they just don’t trust us. I imagine it is all of these reasons and more.
At this point in the conversation, I knew that if I wanted to make any positive impact on this woman’s life, I would need another approach. So I adjusted and did what I could to relate to her frustrations and offered solutions that would help her become more accepting of the help she needed to get better, but unfortunately it fell on deaf ears, so to speak. I couldn’t persuade her. She ended up telling me that she and her husband were hiring a private caregiver so she would be fine. The sad thing is that I knew better because there had been conversations with her spouse that indicated they didn’t have the funds for something like that. He sounded stressed but just wanted his wife to be able to come home as that was her wish. I just let this go and told her that I would jot in my notes what she told me and I wished her the best of luck and hoped she felt better soon.
These are the defeating moments as a healthcare provider. Wanting it more than your patient. I had to take a step back and remember that I can only help those who want to be helped and I have to respect their personal decisions.
I’m not sure what exactly I am trying to accomplish with writing this article except that I hope someone reading this will recognize that healthcare providers really do care, more than you may realize. We are educated and experienced, more than you realize. And often times, we think about you long after our conversations and hope you took just one little thing away that may help you down the line. So if you or your loved one are ever in the position of this lady I spoke to. Take a moment to trust. Take a moment to realize that if you are willing, we may actually be able to help you and may be the ones that can help you to go home, where you want to be.
Signed,
Humbled therapist
