Hands Off

Hi guys
i am currently on my neuro placement and one of my new patients is fiercely independant he does not like recieving help for any tasks or even like to see that you are guarding him if he does he will knock your hands away and become quite frustrated. This is also the case with any treatment techniques you are trying with him he does not like you to put your hands on and guide him in any way as he sees it as a negative thing where you are incenuating he is unable to do the technique properly or independantly and he doesnt want to be seen as an invalid. His wife also rang the physio department to tell us he had tried to climb a ladder on the weekend even though there is no way he is at this level yet.

I found this quite difficult for me to handle especially the first time i saw him as obviously it is better to be safer and guard them closely if you have never seen them before and do not have an accurate idea of their safety and functional mobility. Also with neuro alot of the techniques are very hands on and facilitation is required to insure the correct movements patterns etc.

'I think sometimes as physio's we forget that we are invading peoples personal space and since were so used to touching people often forget that they may not be so used to this, especially if it is the first time we are treating them and they are unfamiliar with us. I have learnt from subsequent treatment sessions that it is best to explain exactly why im putting my hands on before i place my hands on the patient, ie to feel the movement that is taking place is or to faciltate certain muscles or just act as a guide and that it is not because i think he is incapable in anyway. I also make sure that if i start the task with guidance i take my facilitation away as long as it is appropriate so that he spends time doing the technique by himself and this way he doesn't get so upset . Since he likes to be so independant he is going to keep trying to do things at home which are beyond his current capabilities but the important thing is to practice some of these higher level activities in the clinic so if he does try and do them at home he has at least spent sometime practising at the clinic and will hopefully be a bit safer.