not much done?

Patient was a 60 year old lady who is a R-hemi. She had been admitted the night before with an undisplaced fractured R ankle. She previously ambulated with a quad stick but is unable to transfer at present. According to the nurse, she has a fear of falling and is not willing to use her quad stick at all. The nurses are having huge problems with her transfers. I went to see her and found that she was either unable to extend or flex her knee. I did suspect that she did not understand what I wanted but I tried demonstration and moving her limb to show her what I wanted and she was still unable to move her r knee. I did the same with her L and she was able to demonstrate what I wanted so I believe that she was either unable or unwilling to move her R knee. However, I did not know if she was unable to move her R knee prior to her fracture.
I brought her a zimmer frame for better balance and she agreed to try standing. Initially she was like a dead weight, however with some encouragement, she managed to stand with one minimal assist. Her R hand had very high flexor tone and she required assistance to get a grip on the zimmer frame with her R hand. In the standing position, we were still unable to get any movement at the knee. Since it was too painful and probably not advisable to put any weight on the R foot, she had to take her weight through her arms in order to hop or pivot on the L leg. However, due to the involuntary control in her R arm, this was not possible. I ran out of ideas and so consulted my supervisor to see if I had really exhausted my options. She agreed with me that the best we could do is to get patient to stand for the nurses to get the wheelchair or commode behind her. We then went to the nurse and she was happy enough with what we managed to achieve. The nurse shared that they had problems even getting her standing so although I felt that I did not achieve much with the patient, it was significant enough for the nurses.
I was glad to have such a patient that really challenged my problem solving skills. It also made me realise that some things such as transfer can seem like a very basic intervention yet it can have a very significant outcome both for the patient and for the team providing services to the patient. With this perspective, I can go into future practices without stressing too much about doing a proper treatment session when a lot of times the assessment will already form part of your treatment for the day.