Healing Hands...I recently had to contribute to a discussion board post for my class participation. Here is an excerpt from my post.
I am currently working at a SNF, and have already seen a variety of diagnoses that are commonly seen in this particular demographic (i.e. strokes, Parkinson’s, rheumatoid arthritis, global weakness, dementia, etc.). However, I recently started providing therapy to a client who has both fibromyalgia and RA. Luckily for this client, she isn’t limited in much other than her hands. Nevertheless, her joint pain limits her from participating in occupations she enjoys such as writing letters to friends and family members. I can sympathize with her because I enjoy handwritten letters as opposed to an email, it’s more personal that way. I can also empathize with her because I know that her pain is excruciating and it honestly reminds me of my mother’s reactive arthritis when it flares up. As a child, I remember my mother being bedridden due to these episodes, and my client experiences similar tear-jerking moments like my mother. My fieldwork educator and I have been working hard to provide hand strengthening activities as well as pain management techniques to improve the functionality of the client’s hand. Her grip strength has slowly improved, but the little improvement has motivated her greatly to work harder in therapy. I recently had the client play a game that simulated writing. When I explained how it mimicked writing, the client was ecstatic that I had taken her occupation of writing letters into consideration. I told her we would eventually get to the real thing but we had to continue strengthening her hand muscles and slowly get back into the practice of writing. My reasoning: “I want you to be successful with writing, but the only way to be successful is if we take it one step at a time and build up both your strength, endurance, and manage your pain symptoms.” From that point on, my client trusted me and did what I asked of her. Her hand strength is progressively improving and she can tell the difference. I am so happy to see how motivated she is to continue with occupational therapy, and I cannot wait to see her first handwritten letter. -Lauryn E. Hill, MOTS
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One small step, one large leap...I apologize that this post is late. The story is still good regardless of the date!
On this day, I was working with a client who has severe dementia and is nonverbal, meaning she doesn't say more than a grunt or moan here and there. I had been working with her for two weeks at this point, mostly splinting, but today was the first time I did a feeding activity with her. It was early in the morning and my client was ready to eat. I had already splinted both of her hands, so the rest of the time we focused on seeing how much she would eat. Her appetite was spotty nowadays, according to the nursing staff. Normally, my client keeps her eyes closed, but today she peered out from beneath her eyelids to examine her plate for a few seconds before returning them to their caves. We were taught in school to lead your client through a situation when they have no sight. Even though my client still had hers, she obviously didn't use it very much and I wanted to make the experience as pleasant as possible and reduce the "shock" as much as possible. As the feeding session began, I would ask my client if she wanted eggs. No reply. I would ask if she wanted sausage. No reply. Finally I hit the jackpot -- would you like some oatmeal? My client peaked at the oatmeal, closed her eyes while simultaneously raising her eyebrows to signal she was willing to taste the hot cereal. I warned her it was coming and she slowly opened her mouth. Mmmmm... After that, I couldn't get food onto the spoon quick enough! By this point also, my client was no longer interested in her eggs or sausage, rather she only wanted the biscuit with jelly. I fed her nearly all of it and she was already starting to fill up. I had one last shot to get more protein into her stomach before she waved the white towel at me. Of course, with each bite I provided a prelude to the upcoming spoonful so my client was not caught off-guard by anything. Unfortunately, I made the mistake of switching out the jellied biscuits with a sausage and egg mixture -- boy, did she not like that! Her eyes flew open and her mouth turned into a grimace. She slowly chewed on the mixture, trying to determine whether to swallow it or spit it out. Not only was my mistake written all over her face, it was plastered across mine. I'm sure my eyes looked like saucers and my mouth formed into a hard line. After a moment, I finally told her, "I'm so sorry, I should have warned you I was switching it up. I messed up didn't I?" I looked down to get the napkin ready to put to her mouth to let her spit the mixture out when she replied, "You sure did." BOOM. And just like that, I was shocked that I got a response, but I was floored that she VERBALLY replied to my mistake. Aside from the nurses who worked with her 24/7, I was the first therapist to hear her make a verbal comment to someone in her current state. Talk about pumped up. I was STOKED that she even bothered to give me a verbal reply. Although it may not seem like much, it made me feel as though we were on a new level as student-practitioner and client. I was steadily building trust and rapport -- at least enough for her to verbally say something to me! Anyway. Back to the story. As I stared at her (in disbelief, of course), I told her, "It won't happen again." and yet again, she stunned me: "It sho' won't." O____O <--- literally my face Not only did she respond to me today, she responded to me TWICE in the same conversation! (Bonus: She didn't spit the food out either, woo!) Of course, nobody was around when all of this happened, but I definitely told everyone about it as soon as we cleaned up her food tray -- it was just too cool not to share it with someone! Once again, this may not seem like much, but when someone is selectively nonverbal (meaning they choose not to talk), then that is a major accomplishment to get that person to say a few words to you. It was encouraging and I hope to continue to build confidence and rapport with my clients every time I work with them. Even if it's unintentionally done. Stick around for more funny episodes from my fieldwork experiences! -Lauryn E. Hill, MOTS "Until we meet again, may God bless you as he has blessed me."-Elvis PresleyIt has been a rough day.
As I'm working with one of my clients this morning, I get the news that one of my sweetest clients has passed on from this world. It came as quite a shock because when I last saw him (on Friday) he was in good health and working hard in therapy so he could be independent when he returned home. He would have been discharged on the 20th and then returned home on the 21st. Would have. . . For the rest of the day I felt dazed, like a zombie walking around with an emotional weight on her heart. I know it may seem silly to be attached to someone who would only be in rehab for 21 days but I had made a connection with this man, and I feel that the feeling was mutual. I'll call him Marley. From the first day we met he immediately loved my name because it reminded him of the African American-Caribbean soul singer of the 90s. Marley would share thrilling stories about his trips to the Caribbean and how his memories from those adventures influenced his life in Memphis. When I would transport him to and from his room, if he ran into someone he knew in the hallway, he would talk with them as if they had seen each other yesterday and introduce me to them like I was his family member. Truly, he was a beautiful soul, and it makes my heart sad to know I will never have the chance to tell him goodbye. Although I struggled with this all day, I tried to see the silver lining: Marley was an upbeat, easy-going guy and I should take on that same nature because life is too short. I prayed that the good Lord would take Marley under his wing and care for him. I know he is enjoying Caribbean vibes in heaven right now, and he is no longer suffering. I miss him already, as I'm sure his family and friends do too. I prayed that they will all be comforted during these tough times. God, watch over my Caribbean angel. Making people laugh is the greatest feeling!The title says it all - I love making people smile and laugh!
One of my clients is "blissfully demented," meaning she is perfectly content sitting in her chair, not interacting with others, her eyes closed and listening to everything going on around her. She normally doesn't make noises other than little grunts and groans, but today I heard her chuckling at the conversation going on around her. And not a soft chuckle either, it was a deep, hearty chuckle. The other therapists and I were joking with one of the clients about his flirtatious nature and apparently my client found our jokes to be comical. She let us know with a deep chuckle. It caught me off guard and I snapped my head up to look at her, only to be further surprised to find a real, gentle smile on her face! Now, my client is a gorgeous woman, and as she sits quietly in her chair, she looks austere yet dignified. But when she smiled, it was amiable and motherly, and you could literally feel the warmth radiating from it. It reminded me that her true self is still there behind the dementia. I feel that a lot of healthcare professionals, myself included, forget that dementia patients are more than just a body, they still have their personalities intact. I had been working with my client for 2 weeks, but this was the first time I had experienced a true "response" to what was happening in her environment. It was refreshing, and honestly gave me that "pep in my step" to finish out the rest of my day. I am so grateful to have had this experience because it will be something I can draw from in the future when I feel discouraged for not getting a response from a client. I need to remember that it takes time to build a relationship with people, especially with a therapist who is often times associated with discomfort and strenuous work. Going forward I need to remember to not expect it to happen in the first go-around because people are complex and require time to build trust and rapport. But when you do establish that relationship, just like this instance with my client, it is worth all of the toiling. Until next time! -Lauryn E. Hill, MOTS |
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AuthorI am an occupational therapy student at The University of Tennessee Health Science Center in Memphis, TN. The purpose of this blog is to demonstrate competence in my graduate-level program through journal reflections pertaining to one of the four main competency areas. Through practice, I hope to become consistent at journaling so that I can help my future clients to the best of my professional ability. Archives
August 2017
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