Whilst on my neuro placement I learnt the importance of veiwing each patient as an individual and how something that may be of benefit to the majority of patients will not necissarily be of benefit to some individuals.
I was treating a patient who had recently had a lateral medullary stroke with vestibular involvement. This patient was a middle aged Dr and was well aware of her condition and the importance of physiotherapy. She asked many questions and was eager to get up and about but the dizziness and vertigo prevented her from doing so. She made excellent progress in the first couple of days and pushed herself as hard as she was able. Despite these efforts she was still unsafe with her gait and required 1x minimal assistance whilst walking with a zimmer frame.
After the first few days she was eager to go home and was continually asking when she was to be discharged. Her doctors had ascertained her safe to go home and her discharge was then dependent upon her 'physiotherapy review'. I did not think that she was safe to return home and discussed this with my supervisor who agreed that she should not be going home with her current mobility level. However over the next few days her progress began to plateau as she continued to request to return home.
I then reveiwed her situation with my supervisor and we agreed to discharge her as she had a large support network within her family and she was a practising Dr and was well aware of her condition and the importance of attending outpatient physiotherapy. We discharged her with a refferal for out patient physio and exercises and management for her rehabilitation.
With the majority of patients that i have been able to see I would not have recommended that they return home but in this case the patients social history and background played a significant role in allowing her to go home. I then realised the importance of each patients individuality and how we as physiotherapists, or students, should not treat the condition but they patient themself.
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1 comment:
i think that this scenareo can apply to any aspect of physiotherapy, whether it be in neurology or in a sports physio situtaion. Each patient has different circumstances and having a clearer idea of these will definately improve the quality and effectiveness of our interventions.
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