Making Their Loved One Better
Yesterday I was talking to a non-PT friend. I was describing some of my severely impaired patients. I told my friend I don't understand what those families think I can do. They want their loved ones to have a therapist but I have little to work with. My friend's response shocked me. She said those families wanted me to make their loved one better.
According to her, those families don't see the impairments and unresponsiveness. They see someone they love who used to be alive and moving around now sleeping in bed. They think mom or dad, grandma or grandpa is simply going to wake up and start walking around. Since I'm the physical therapist, it is my job to make that happen. Well, doh. That just never occurred to me.
When I look at patients, I see them in terms of motor function, cognition and type of stroke. From the minute I start assessing them, I'm already thinking about disposition planning and rehabilitation potential. I know the science. I know the therapy. In my mind, it's straight forward. I try to wake people up. I try to facilitate movement. I balance each person's potential with the amount of time I have available.
It should have been a no-brainer to me. Families don't think that way. I know that. But I didn't stop to think how they expressed it. Most families see their loved one isn't doing so well. It's not normal to lie motionless in bed. Having therapy come in and work with the patient means something is being done. Getting therapy, even just PROM, means the problem is being addressed.
Now it makes more sense when families are insisting someone who is lethargic and total assist get out of bed. Being out of bed is more normal. It helps people wake up. They aren't asking because they can't see how impaired their loved one is. They are asking because they do see it. They are equating being out of bed or getting therapy with getting better. If mom or dad is getting therapy, then there is a chance things aren't as bad as they seem.
Family members don't see things the way I do. They just want me to try. And they want me to try every day. It must be a terrible feeling to stand by and watch someone you care about after a severe stroke and know there isn't anything you can do to fix it. That's why I hear how stubborn someone is or how someone else is a fighter when neither of them will even open eyes. It's coping mechanisms. And they don't want me to quit. I guess if they tell me something is normal behavior, it helps to explain the clinical conditions.
Understanding doesn't help me much. I won't feel as frustrated the next time I have one of these patients. It doesn't change what I have to offer. I can't make a damaged brain do something it doesn't want to do. At least I know the answer to my question.