I have not been on my neuro prac yet but I’ve had the opportunity to see a patient who suffered from head injury on my rural prac. On reading the handover notes, it seems like walking was an important functional goal for the patient. Although the handover notes did state swimming as a long term goal, my supervisor and I both thought that the patient should be contented if he could walk normally.
However, when we saw the patient, he was more abled than what the handover described him to be. The issue with this patient was that the facility I was at could not afford to offer him ongoing services. Hence, we wondered about the future management of this patient.
I was not sure how much services the patient could access. For instance, for patients who are at falls risks, they would come in for about 6 sessions to get them to a level where they could participate in one of the community groups before eventually doing their exercises on their own. Yet with this patient, he is already at a good functional level but because he is such a young patient, I feel that he has more potential which might go undiscovered should he just continue with maintenance exercises at home. There are no suitable community classes for him and limited resources for his needs. I guess this is the dilemma of people who cannot access the necessary healthcare. At least this patient is functional but he probably will not be able to attain his full potential due to the above mentioned reason. This makes me wonder how many do we actually rehabilitate these young patients who have a neurological deficit which will probably stay with them for the rest of their life? I will probably get a better insight into this when I start my neuro prac.
Coming back to this patient, I started to explore the possibility of him swimming. It so happened that the Paralympics was on at the same time I had these thoughts. It occurred to me that many of the participants in the swimming event could not even walk. Therefore, it would be highly possible that this patient would be able to swim after all. Yet I note with regret our limitations as physios as we are probably not trained enough to help this patient achieve such a goal. As it was my second last day at the facility, I was not able to attend the meeting where his rehab plan is discussed but I would suppose I will be better equipped to answer these questions when it comes round to my neuro prac.
Monday, September 22, 2008
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