As a healthcare practitioner I am concerned about the wellbeing of my clients. I am often asked about treatment options and I inform clients of my recommendations, or if I deem their issues to be out of my scope then I refer to the appropriate medical professionals. I discuss with my clients how their current lifestyle and activities may be affecting their posture and how subtle changes can improve their overall sense of wellbeing. I observe how my clients move and monitor movement patterns, and recommend changes. Further advice may be a follow-up clinic treatment or some self-administered soft tissue/joint mobilisation techniques, and a couple of exercises to improve joint stability etc. I typically do not advise anything too intense as I know most people are time poor and although beneficial, the exercises are usually put on the back burner. My recommendations are based on knowledge gained throughout my 12 years’ experience in the industry, from formal training, and from results achieved with other clients over the years.
Understandably, motivation levels in individuals can vary, some clients are more inclined than others to change their current situation and I want to share a story of one such client, let’s call her Gloria…
Gloria, who is in her late 70’s, has been a client of mine for the past four months. She was referred to me after discussions with her physiotherapist daughter who resides overseas. Her daughter was worried about her mother’s mobility issues and wanted me to conduct a functional movement screen and come up with a strategy to help improve her mother’s quality of life.
Accustomed to treating a wide range of clientele, I was looking forward to meeting Gloria and seeing how I could assist given her situation, as it had been explained to me by her daughter. Upon meeting Gloria, it was immediately apparent that her mobility issues were more serious than her daughter had understood them to be. This is most likely a reflection of the distance and time spent apart from one another.
Gloria’s stooped kyphotic stance and sideways trunk lean that was aided by a walker, was consistent with her attempts to reduce joint pain following a right side hip and knee replacement. After our introduction and discussion about her health history, it was apparent that Gloria was apprehensive about her ability to improve after suffering a fall several months earlier. The fall not only affected her self-confidence, but also confidence in her physical ability to safely go shopping, visit friends, or even clean her house.
I understand that this stage in her life brings about both gains and losses in mobility and other functions, but my role in Gloria’s rehabilitation is to minimise these losses in regard to her mobility. In doing so, she then stands to gain confidence in herself overall, and in her ability to safely get around. Gloria gets frustrated during sessions, which consist of both soft tissue treatment and movement based exercise, but doesn’t realise that many of her limitations are probably due to normal age related physical and cognitive change. I try to keep our sessions as simple as possible and limit the goals for that particular day. I ask Gloria what her priorities are and we go about working on the highest ones. If she cannot conduct a certain movement or exercise, then we find an alternative that gets us to the same goal. This gives Gloria a win every time she comes for treatment. It is interesting listening to the tone in her voice change from when she first walks in, to when she leaves. She leaves appearing a lot more positive and although with the aid of a walker, also with a spring in her step.
The psychologically limiting effects of worrying about further falls can be as debilitating as physical injuries, so it is important that I provide a place where Gloria can relax, feel safe and comfortable. I believe we have fostered a great therapeutic relationship and I feel I have given her a realistic perception of her progress by not taking away the security of her walker, but instead trying to improve quality of her gait whilst using it. By not giving her the unrealistic notion that she will be able to walk unassisted after our treatments, Gloria has been able to think more rationally and appreciate the subtle physical and confidence enhancing changes that have improved her quality of life.
Working with Gloria has been a rewarding experience that has provided many lessons and great returns. I feel I have made a real difference in Gloria’s life and although she sometimes doubts her abilities, she genuinely appreciates what I am doing which she communicates in her feedback.