Accepting Help

Currently I am experiencing and enjoying a RITH placement. Working with clients in their homes has presented numerous learning experiences and opportunities to enhance interpersonal communication skills.

As an (almost) physiotherapist we have gained a wealth of knowledge with respect to areas such as falls risks assessment and management, rehabilitation exercises, assistance/care packages available for home help and potential aids available to name just a few.

Having eagerly presented the opportunities available to clients I have at times been surprised by the level of resistance to accepting additional help in the home, making modifications that will ease access, removing rugs that present a falls risk as typical examples.

Two issues stand out to me:
Firstly it is important to recognise the reasons behind the decisions taken by the client - for example older people are often more resistant to any type of change, too proud to accept what can be perceived as charity, denial of the existence of a problem, a want to be fixed by someone else with no recognition of the need for self involvement in the recovery process.

And secondly it has become clearer to me that the way the physiotherapist (or indeed anyone) presents this information to the client has some bearing on the outcome. However, having determined the reasons behind the decision taken by the client this can then influences when and how you re-present the information.

For me this has involved trying to further develop wide reaching communication skills (I have seen some truly high level communication skills modelled by clinic supervisors in somewhat delicate situations)

-to ascertain why or what they do not like about the proposed change
-to attempt to make the client think that the idea was theirs. For example, having given a client a booklet to read about the risk floor mats present , asking the client if they can see anything in their home that may present a risk and letting them suggest the change.
- and finally and possibly most importantly RESPECTING the right of the client to make that decision even if you believe it to be the wrong decision.