I went on my first 2 solo home visits this week, which weren’t as bad as I thought they would be, but the first one didn’t really go to plan! I haven’t had much experience working with children, especially younger ones, which has made for an interesting first 2 weeks in paeds. On my first solo H/V this week, I arrived early due to an earlier client having cancelled, only to find that the child was asleep, and the mother unwilling to wake the child up straight away. I didn’t ask the mother to wake the child up because I felt really uncomfortable about being in someone else’s house on my own, trying to tell her what to do. So I waited for about 20 mins until she finally went and got the child, only to have to wait another 15 mins for the child to have her lunch. Eventually we did about 15 mins of walking practice, which was the goal for the session, however it was supposed to be about 45 mins. I did manage to do some treatment, and instructed the mother as to what I was trying to do, as she was going to do more walking with the child after I left.
In hindsight I should have asked the mother to get the child up earlier, as I shouldn’t have had to wait in order to treat her as I had other stuff to do and didn’t have the time. Having established a good rapport with the mother, and being the therapist, it would have been appropriate to ask for the child to be woken up in order to do some treatment. Despite being students, if we are going on home visits on our own then we are the treating PT’s, as and such we are in a position of influence, and our time is just as precious as the normal therapists. We should feel confident about entering someone’s home in order to provide treatment, but we should also be aware that we are in the child’s home, where they feel safe, and should respect their right to refuse treatment. Even if the girl I saw had been woken up earlier, it probably would still have been difficult to get any treatment done with a sleepy, hungry child.
I think that in this particular area (i.e. paeds) it is also important to know when to cut your losses and give up on trying to treat someone who doesn’t want treatment, because we can’t force them to comply with treatment. We have to remember that they are just kids, most of whom have very busy schedules going from one therapeutic setting to another. They aren’t always going to conform to either our treatment plans or our timetables, and we can’t get angry at them for that.
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2 comments:
Similarly, I have little experience working with children and none working with children in a home setting. I think you have reflected on the experience well. Home visits to elderly people are usually a highlight of their day!!
It is difficult as a student on short placements to create a working relationship with a family. I suspect the more contact therapists have with families, that the interaction would become more cooperative.
Regards
John
Yes, I think building a good rapport with the parent in these situations in vital, as you have appeared to have done.
I you were only a little early, the parent should have the child up ready for physio when you arrive, so that the most can be made of the session. Successive visits may be easier though once it is established how important your time is. Well done
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