Stares 2 rotation 3

Stares 2 rotation 3

Situation:

Mr J was my first patient from admission, during my first week at Carinya. He was an 81 yo male, three months post CVA (stroke). He had extensive left sided involvement. His main problems were impulsivity, left neglect, poor coordination and timing, as well as poor balance. He was functioning independently, despite looking a little unsafe. To achieve his goal of returning home, I decided the main areas of therapy focus should be improving safe, functional, independent mobility and ambulation. In this reflection will review my treatment planning and execution over the first two weeks of Mr J’s rehab.

Task:

Rehab this patient aiming for the optimal goal of returning home. As this was my patient from his admission this would involve laying the foundations of his rehab program at Carinya.

Action:

Rather than form a comprehensive treatment plan, the document I filled out on assessment was more of an overall look at what I planned to address. As I had no clear frame work to follow, I tended to formulate treatment plans daily. Although I feel I had many fresh ideas, they would usually come to me sporadically and I would try them out for something different as I went along. This meant Id often changed treatment aims from one day to the next or even within the one session. One day I might be doing some strength work, followed by some balance work, the next day Id focus the whole session on something functional such as a transfer or ambulation.

Result:

By the start of the third week I started to feel as though I was running out of new Ideas and I had to go back and revisit some of the old activities I had done. I also began to feel that the patient did not have much of a sense of achievement or progression.

Evaluation:

As Mr J was very impulsive and was always excited to try anything new, I feel I was spurred on to try new things all the time for fear of the sessions becoming boring. In hind-sight, this may have been to the determent of the patient. The sessions lacked direction and flow. Now, although I feel the patient has progressed, I feel he has a decreased sense of just how far he has come.

Strategies:

· Formulate long term and short term goals in the initial treatment plan, rather than general goals.

· Further refine this in your own notes breaking down goals into daily, weekly and monthly aims. -Perhaps using a grid style document to achieve this.

· Have one particular focus for each session.

· Make some aspects of the program documentable on a daily basis, some sort of quick test such as distance cycled in a certain time on stationary bike or distance of functional reach test.