Earlier this semester I was on a muculo inpatients placement (THR TKR etc). I came across some significant cultural differences. A pt who had undergone a THR had a particularly long stay post-op for several reasons.
She seemed to be of the mind set "I've just had a big operation - now I'll rest until I feel better" which pretty much contradicted everything we wanted her to do. When transferring we had to use 4+ people (and she wasn't a big lady) simply because she would not help at all (I'm talking If we wern't there she would have been on the floor.)
She also spoke very little english so education was difficult, and we often had to wait til her family was present to treat her.
In addition to these factors we discovered that for over a year prior to her operation she had not walked more than 15 m and that anytime she wanted to stand up her family would haul her out of the chair. So when trying to get her to sit to stand she was frustrated saying "I haven't been able to do this for a year, why should I do it now." It was also hard to stop the family from assisting her too much with transfers while she was in hospital.
It took a lot of work and patience, probably from her as much as us, to get her ready to go home. (and we suspect her family would go back to doing everything for her). I guess my question is how to get around a culture who tend to give too much assistance like this as it ends up worse for the patient in the long run.
1 comment:
Hey meges, ive has this same situation happen to me when i was on musculo prac too with pts who had undergone similar operations. It does seem that sometimes different generations or cultures have their own perspective on how they will best recover and persuading them is not easy! I guess the only way i managed to get some compliance was to suggest that the exercises need to be done in order for them to go home. Many pts dont understand the goals for discharge that are set so explaining them (with the assistance of a translator or family) can also help. The role of physio is just as important for the family to understand so they can be guided in giving the best home care for the pt too. Ultimately you can only do your best and hope that the family learn something from your treatment sessions too.
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