Nursing Home Patients

During this year across placements in the hospitals and my personal experiences I have been disheartened to observe the attitude of many nurses and allied health professionals to the nursing home residents in the hospital setting. What was most apparent was the view that all we needed to do was get them back to a level of function so the nursing home would take them back and do that as quickly as possible with as little input as possible. With respect part of this attitude has developed because of the shortage of nursing and allied health staff within the hospital system and the large caseload they have to cover.
I believe that physiotherapist have the training to offer the elderly population a great deal that would improve their quality of life as they enter the twilight years. Yet these skills that we have are not being utilised by the nursing homes or low care facilities and those that do employ a physiotherapist are using them basically to do mobility assessments for the clients care plan.
Obviously there are multiple factors surrounding this issue, the pay scales in the care facilities do not encourage physiotherapist to work in this area, the allocation of funding within the nursing home - carer v physiotherapist to suggest just a few.
I hope that if I work in the hospital environment I will be able to manage my time efficiently to enable quality time to be spent with some of these elderly clients.

confused patients

My last placement was a gerontology placement where a lot of my patients had dementia and were confused. I found this hard initially as it is important with demented patients to make the exercises very functional so they comply and do them correctly.

One lady I had loved sitting in a chair. So instead of doing ten sit to stands (which she didnt understand the point of) I would set up 2 chairs (10m apart) and get her to walk to the chair and sit down, then she would see another chair 10m away and I'd ask her to go sit on that chair. She didn't remember that we had just sat down on one chair so she would be happy to do this exercise up to 20 times in one session.

Making an exercise functional for the specific patient is very useful in dealing with demented patients I have found. Otherwise if they don't understand what you want from them they are likely to by uncompliant or even aggressive.

the boring part of physio

on my last prac I was doing gerontology. I found that all I was doing was walking patients and doing basic exercise programs for them. As they were very elderly there was no high level exercise or anything too challanging. after the second week I found this to be be very mundane and boring. most of the patients didn't like exercising and as a result hated coming to physio, making my job vey hard. They would often be very difficult with me come physio time, and I would spend a good part of the session persuading them to come down and exercise and the benifits of exercise. After a while this became wearing on my enthusiasm for physio as a profession. I feel that we are too over qualified for a lot of the things that we do in the hospital system, and that we receive little respect from patients themselves.
I voiced this opinion to some of my peers and many were in aggreeance with this belief. I also spoke to my friend who is a physio and she said that it is just one field of physio, and that it is important to try other parts of physio before making a judgement based on my experience on prac as a whole.

I think it is important to ensure we don't become disheartened by the profession if we have one bad experience on prac, and to continue to stive to find an area that you find exciting and challanging. In the future I will remember this advice and try to maintian my positive attitude in all situations.