This was my first experience of a person who had (for want of a better word) obvious dementia. I've seen plenty of people with early stage dementia who forget the odd thing, but this is different.
A bit of background.
As a student I never treated a person with dementia, I had lectures on dementia and heard stories of people with dementia, but nothing can really prepare you for the patience you need, the communication difficulties and the struggle with any form of rehabilitation when they just decide they don't want to.
The amputee I was treating was also blind which did not help, as they believed they were at home and all the noises of a ward further added to his confusion. They forgot that they had an amputation and when being asked to stand they would try and place the end of the stump on the floor. You cannot weight bear through cut bone and he was at a huge risk of falling.
As a physiotherapist treating this patient has been difficult I will admit, I was not prepared for the different challenged involved and the complete change in expectations of a session. Sadly this patient has deteriorated mentally whilst at hospital due to a urinary tract infection, and whilst writing my notes on a session for him which to sum up simply said "completed 5x sit to stands using a rota stand, patient declined any further rehab continuously" was really difficult, I felt like I had achieved nothing. Luckily I have really supportive senior staff and after discussing this with them they were really positive about how much I had managed to complete, which made a huge difference to my view on it.
The single most useful tool whilst treating this person was their "My name is" booklet, It was great! for those who don't know, it is a book with things they have done in their life, the job they used to do, what they enjoy, who their family are and it is brilliant, I would look in it have a read and then throughout the discussion just chat about things that interested my patient throughout the session, it significantly improved his willingness to take part and made the sessions much less stressful. If you are ever in need grab it and have a look.
This person really opened my eyes to the struggles of caring for people with dementia, and the incredible patience and perseverance the staff within the NHS have. I will never forget the struggles and challenges presented to me whilst treating this person and I believe I have become a better physio for it.
Liam
