Showing posts with label falls. Show all posts
Showing posts with label falls. Show all posts

Friday, January 27, 2012

Peace

Back to my blog home page: http://travelingotr.blogspot.com

Peace is something many of my patients cannot capture.

I see several reasons why people can't reach this place:
  • Pain
  • Lack of sleep
  • Psychosocial or behavioral issues
  • Impaired cognition (decreased insight/attention/high distractibility)
  • A general lack of self awareness.
  • A simply "bad day!"

It's a difficult task for each of us at times to be peaceful. It was especially so for Tom yesterday. He arrived the day I returned to work last week following a total knee replacement at the smacking young age of 93.


Most of the time we don't see total knee replacements done in the 90's unless the person is very active with good physical strength and sharp cognition.  This guy checked out out fine on all the above.

Tom came in planning to leave on day #2. However, a team meeting with him and his daughter delayed his departure because of impaired posture, balance and activity tolerance, all of which put him at risk for falling and doing more damage. When he would go from sit to stand, you could hear a chorus of crepitus throughout his body.

crepitus: a medical term to describe the grating, crackling or popping sounds and sensations experienced under the skin and joints (thanks, Wikipedia).

My dear Lizzie had been on an all night performance of byyyyy-by-by-by-byyyyyy up and down the halls of the nursing facility. Poor residents. This happens occasionally when she stays up for about 24 hours and then sleeps 24 before getting back on track.

Tom, of course, got no sleep. He was new and every sound was unfamiliar, including that of a 99 year old lady singing all night. The natural progression of not wanting to be in a place like this,  listening to noise all night, terrific knee pain and overall frustration was the inability to participate in meaningful treatment.

"I can't do a thing. I want out of here. I can't take a shower until the staples are out, and it's making me crazy!"

Plans to take him to the gym for exercise? Out.

"I'll tell you what. You want to feel clean and fresh - I'm going to get some warm, soapy water and some linens. I'll be right back."

He gave himself a great clean up, just the way he does at home. (Many seniors can't make the step over the tub to take showers later in life.) I rubbed some lotion on his back and did a little manual therapy on his neck and shoulders (full of spasm which, I'm sure contributed to his feeling "out of sorts.")  I had the ability to assess his independence in bathing and dressing, his sitting balance edge of bed, his upper body range of motion and strength as well as his memory, sequencing, and safety awareness.

During this process, he began to talk. He was from the Midwest, too. He had loved to travel and spend time outdoors. He had built his own fishing boat. He was a terrific man!

Freshly bathed and dressed, his temper had softened. He smiled. He even felt up to some exercise.  He had returned to a place of peace.

I left him feeling peaceful as well.

How lucky that we, in our service to others, help transport others past their times of turmoil and reach a personal peace that sweeps us through our day.

Wednesday, December 21, 2011

It's Not Always What We Say

Back to my blog home page: http://travelingotr.blogspot.com

I go in to wake Ann from her afternoon nap. She will sleep from lunch to dinner every day. Because we are trying to get her stronger and functionally mobile to return to home, though, we have to make sure she doesn't stay in bed for dinner, too!

I gently put my hand on her arm. After a few seconds, I rub just a little. I know she is a person who does not mind being touched. If she was, I would have to use a different method!

She stirs. I tell her in a voice just loud enough for her to hear, "Ann, it's time to wake up. Almost dinner time."

She pulls back the covers and puts her warm hand on my forearm. She feels warm and wonderful! We start a daily conversation that I enjoy so much.

She speaks to me in Finnish, and I have no idea what she is saying. I speak back in English, which at times she understands, and at others, well, I'm really not sure.

She begins to rub my forearm while we talk, the way a grandmother would give comfort to a child.

Some people get frustrated with Ann because she won't speak English. I see that in her cognitive decline, she is losing her second language. She is reverting to the language she spoke as a child.

I allow her to slowly get up and assist her to the wheelchair. This is when the elderly are most at risk for falls, right after sleeping when they start to stand up.

She is awake now, still speaking Finnish. She signals the time, then says, "Morning?!"

"No, Annie," it's late afternoon. Time for dinner. It's Tuesday still."

She holds my hand for a moment and looks in my eyes.

We both smile.

I am keenly aware that it doesn't matter what language we speak to each other. The most important language is that of love and respect for each other that flows between us. Together we share a short moment in time that fills both our hearts and enables us to move on to the end of the day.

It's not always what we say....