In an increasingly ageing population, the Australian healthcare system faces and treats many
elderly clients who a
ive with accidental injuries. As a physiotherapy student confronted with
Rosa, a patient who has been diagnosed with an intracapsular hip fracture, there are several
factors that I feel will pose as a challenge to me in the future when working with older adults.
The most prevalent issues include emotions and memory which is evident in the patient’s ability
to adhere to medical advice and treatment.
Emotions
According to the case notes, it has been highlighted that English as the primary language used in
Australian healthcare has caused increased frustration due to the unfamiliarity to Rosa. This
frustration is furthered when she is not able to receive optimal care from the nurses nor have a
peaceful sleep at the hospital. After reading and reflecting upon Rosa’s hospital records, I feel
like I would find it difficult to interact with someone who is highly angry and under high stress.
Working with adverse emotions has been difficult in the past for me especially with my highly
strung father where small stimulants such as bills/fines
ude neighbours would result in him
eing overly upset and negative. I find it difficult to convey my advice, which is mainly
focussing on positive aspects, to someone in such a negative mindset which i
itates and
frustrates me. Ultimately this is likely to impact my future encounters with neurotic and highly
strung older clients which may affect the level of empathy I express to them, ultimately resulting
in compromised care delivered. However, in order to prevent and manage potential i
itation and
frustration when working with such patients, I could engage in mindfulness activities such as
minute meditations, stretching and controlled
eathing before and after the consultation as a
mechanism to relax myself in future practices. I can also engage in ranting or de
iefing with a
friend/senior member of the health team to release any agitation I have before my next
consultation.
Memory
Rosa’s case notes also inform me about her cognitive function deteriorating over time in
particular her memory. Her deteriorating memory is a sign of dementia as stated in the hospital
ecords by the neurologist. However Rosa dismisses this assumption and claims to have no
problem with memory. This will be a challenging situation for me as the primary objective as a
health professional is to treat and help rehabilitate the patient. Thus in a situation like this, it is
likely Rosa might forget the advice and medications I recommend therefore will likely fail to
adhere to the treatment plan. She is also likely to forget the conversations that took place in our
consultations in which motivation is an important driving factor for a client to adhere to the
treatment plan. Possibly having to repeat and trying to ignite an inner drive for Rosa to lose
weight, part take in the exercises recommended by the physical therapist and attend consultations
will likely frustrate and annoy me. This situation reminds me of my encounters with my
grandmother who has a deteriorating memory. Reminding her to take all her medications and go
for walks was initially i
itating as I was not able to completely focus on any activities I was
doing as I had to ensure she did not miss any tablets and that she was not lost on her walk.
However, over time it has become a part of my daily routine thus does not annoy me as much as
it did. It is also likely I may become emotional and slightly attached to elderly patients who show
similar cognitive impairments as my grandmother. To manage such situations with clients, it is
vital I maintain my professionalism by reestablishing boundaries and discussing the patients case
with a senior consultant. I also should clearly outline the implications of the potential outcome if
the patient fails to comply with the treatment plan to trusted members of the patient to ensure the
client’s health is being supervised.
Conclusion
In order to best prepare myself for encounters with Rosa and likewise patients it is important for
me to discuss and collaboratively work with a senior consultant to make sure I am on the right
track. I would also like to partake in workshops or training to work with older clients to be more
experienced and better equipped for my future practice. I think attending this training will help
improve and rectify the challenges I anticipate in the future. Although it has been difficult for me
to work with people under significant stress and anger issues, taking part in therapeutic
mindfulness activities will help me relax in between consultations to ensure I maintain my cool.
Likewise, when dealing with clients with memory impairments, it is important I uphold my
professional identity by depicting equal care to all patients eliminating any bias opinions,
therefore delivering optimal health care.