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Some Patients Are a Pain in the Rear

February 3, 2009

I have a particular patient right now that has no desire to perform exercises. None whatsoever. Zip. Zilch. Nada.

So, I’m supposed to see this guy for 50 min a day five days a week. Which is impossible if he wont do anything. I usually manage about a half hour but feel awful about billing it because he doesn’t really do anything in that half hour. He’ll ride the bike for about 5-10 min. Then we’ll walk down and fill up the water jugs. Between everything there is rest because he becomes short of breath and we do work on breathing activities and relaxation techniques.

But how long can we fill water jugs, putting on pillowcases, and ride a bike for a few minutes and still call it skilled intervention? I’m not thinking long. I’ve tried exercises. He rarely will do them. Once in the last two weeks he’s done them. Most times he doesn’t want to see me in the first place. He really needs cardiac rehab but you can’t make someone do rehab if they don’t want it.

But what really gets me is the push from another therapist to do skilled things with him. Seriously, I’ve got that message already! I’ve been told repeatedly to have him “sweep the floor” and such. “make it functional”. Yet, yesterday, she was unable to see him full minutes because he’s a pain! He doesn’t want to participate. Then another therapist tells me she saw him working with his occupational therapist and thought he was doing worse today and that’s why he’s not interested. I say, there’s no difference. Every day he tells me he has a headache and everyday he’s short of breath. There is no change, every day is like this.

The only therapist who see’s what I see is the one who passed him off to someone else! He has three therapists- physical therapist (me), occupational, and speech.

This is a guy who is able to get in and out of bed, toilet independently, transfer alone, and ambulate alone. Other than cardiac rehab, I have no reason to be seeing him. So if this continues, I’m discontinuing physical therapy with this man. I’ll either discharge or someone else can try with him. Unfortunately I’m thinking he’ll still not do cardiac rehab which means we still have no real reason to see him. So discharge is the appropriate answer, but if anyone else works in long term care, you’ll know that other people will see this as crazy and push for more therapy rather than less.

4 Comments leave one →
  1. Chris Brown permalink
    February 4, 2009 12:29 PM

    Doesn’t sound like much fun at all!! Good luck with the situation?? Do you find that there’s always one client like this every so often??

    • February 4, 2009 4:05 PM

      There is usually one who is a pain but this guy is setting the record for being the most abnoxious. Refusal again today and I didn’t bother to tell my boss he refused. She can yell at me a different day but today I don’t want to deal with it! I asked one of the other girls to try later, but I’m guessing she wont have any luck either.

  2. robfitness permalink
    February 4, 2009 5:00 PM

    It does seem like it could a very uncomfortable situation. I know this sounds silly but have you tried talking with him and maybe he’ll open up more to you? Or have you tried that and that didn’t work either. I do wish you the best with the situation. Maybe to release some frustration you can do some KB swing and beat Luke’s record 🙂
    Hope to get my 25 KB next week. Now I have to figure out what I’ll name him 🙂

    Now as far as the trainers go, still not happy and it’s not an easy adjustment. Come March 1st I’ll only have one, Cyndee. That’s if I choose to continue on with her. Believe me this is hard and I am not to happy about this. Then again I’ve probably said that in my posts as well. I told Brad the other day that If I wanted a women trainer I would have hired a women trainer to begin with. Not that i am a chauvinist or anything, it’s just when it comes to training I prefer a man.

  3. February 6, 2009 3:37 PM

    I’ve tried that, too. But his doctor came in to see him so he did come to therapy today. We’re trying some things for pain right now. But still, waste of my time really. The doctor wants him to stay for four more weeks.

    I understand that Rob, about the trainer. I’d have a hard time with a woman as well. But I am a chauvinist and don’t feel a woman would be as good of a trainer in the way I want to be trained. I want a woman to train me the same way a man would be trained. I don’t buy any fitness books for women and if they say for men I’m much more likely to buy them. I think most people, women and men, see women as fearful of getting bulky so give women half rate programs. Just my opinion that I think women would more likely do this to other women than men would be as trainers anyway.

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