Have you ever had one of those days where you doubt yourself and ask whether your treatments are effective?
I experienced that today.
This patient I am seeing presents with L dystonic upper limb (which basically means it has a mind of its own) and does not respond to stretches, SIMMs, weight bearing activities, posture correction and to the individuals will. I suppose it is also because this patient has a progressive neurological condition and most likely will ultimately never return to pre-morbid status. Or maybe I don’t know much about management of dystonia, which I will endeavour to read up on.
Another patient has been receiving treatment even before I heard of the profession. This patient has now reached a status where max assist is required for transfers, feeding and sessions consist of maintenance stuff such as stretches etc.
With patients who have progressive neurological conditions, I think it is important not to expect too much out of physio treatment as the ultimate aim is to maintain or improve their QOL and where possible, work on the functional task that they have difficulty with. Having said that, we also need to do the best we can for them and not “leave them in the lurch” and assume that whatever we do will not be of benefit to them. Sometimes, it is all they need to add some spice into their lives.
But when will it be time to stop adding those spices and realize that we can no longer help them?
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2 comments:
Hey Dav,
I really know what you mean with wondering sometimes whether your treatment is effective or not. I have asked myself the same questions and also discussed this with my supervisor. I think this is especially true in the area of neuro when gains made may be very slow and small and sometimes you may wonder if you’re doing anything at all………The fact that in neuro, things take a lot longer than other areas has been something I’ve been realizing and that this is OK!!! Sounds like your hearts in the right place though and I’m sure just your patient contact has a positive affect!!
Hey Dav,
I agree with Zak. Neuro rehab is a long process and sometimes our role is to maintina QOL. You may not feel as though you are making a difference but just think about what will happen to your patients if they didn't have physio. How fast will they deteroriate?? It's like building a master piece. It can take months, even years to build a master piece and just as much work to maintain it but it only minutes to tear it down.
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