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Life of a PTA

Excuses, Excuses

Published September 12, 2014 2:31 PM by Allison Young

Over the past few years, I've written many-a-blog on the subject of patients refusing therapy. I've discussed different approach techniques and tactics, depending on the patient, which might help improve compliance.

This week, I was the recipient of (arguably) the most creative "decline" as to why a patient could not do therapy. As I approached this 80-year-old woman who was seated on the edge of her bed, and requested we "go for a walk down the hall," she simply declined stating she couldn't possibly due to her "pregnancy." Granted, the patient has a dementia diagnosis but even so -- that was the first time I heard that particular excuse in skilled nursing therapy.

This experience had me thinking about other creative types of refusals I've received from patients over the years and I thought it might be interesting to share:

The Procrastinator: These are the patients who request for therapy to come back an hour or two later than their scheduled session. Only to do this all day long and ultimately not work with PT at all.

The Possum: Patients who feign sleep despite the fact that you can see their eyelids move as you call their name.

The King/Queen of Pain: The patients who state they cannot participate in therapy because they are in 10/10 pain as they casually walk across the room to answer their phone.

The Avoider: These are the patients who will participate in every activity the facility has to offer (bingo, puzzles, prayer circle, even OT and Speech)... other than PT. Typically never in their room and very hard to track down for therapy.

Mr./Mrs. Popularity: On occasion we'll see a patient who has so many visits from family and friends, therapy literally has to take a number just to fit in an hour's worth of skilled services.

This is obviously a generalization and many times patients display a mix of "all of the above" behaviors. With all my patients, I spend time educating on the benefits of physical therapy and conversely, the risks of not participating -- whether we make it to the therapy gym or not. Do any of these patients sound familiar to you? What is the most colorful decline you've ever received?

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