Demenz Find out what I mean here!
As seconds turned into minutes.
Minutes to hours,
and hours to days,
He had already forgotten
How he’d gotten himself into those hospital cottons.
His simple questions echoes louder than most would
His memories faded with each sunrise and each sunset.
Was ist fur ein baf?
Wohin gehe ich?
Was is das fur ein Karosserie?
Kannst du mir sagen was passiert ist?
His face laced in confusion
No recollection
As he laid, looking at his body.
The writing of the above Poem was inspired by an elderly German male whom I treated during my general block. The title of the poem is Demenz, this is the German word for dementia. The reason why my assignment was based on the patient is due to the fact that his mental condition made me consider how the patient felt about not having any say in decisions that were made for him. This reflection will explain the above poem as well as discuss the ethical considerations that I faced while treating the patient.
Empathy can be defined as the ability to understand and share the feelings of another person, from their point of view (“Empathy | Psychology Today”, 2018). During the treatment of this patient I felt sorry for him as he was not able to remember anything. This is reflected in the first 3 lines of the opening quintet of the poem. I attempted to make the reader aware of the fact that the patient has been in hospital for a long time. The last two lines of this quintet then brings across the concept of the patient being unable to remember how he got there.
As individuals we are all responsible for our decisions. In the case of my patient, he was unable to make any decisions for himself. He also did not have any family members in South-Africa, therefore the multi-disciplinary team made a decision to refer him to a step down facility. I found it difficult to understand how to be empathic in this scenario, as I did not know how the patient felt about this. According to what we are taught at University, an individual with dementia or Alzheimer’s should be involved in their own decision making for as long as they are able to. The step down institute refused to accommodate the patient due to his nationality. In the poem this is highlighted by the patient saying “Wohin gehe ich?” this means “where will I go to”. This brings up the question of human right ethics, “does the patient not deserve access to healthcare due to his birthplace?” According to the World Health Organisation the right to healthcare should be exercised without any form of discrimination (2018). In South-Africa all individuals have the right to healthcare, regardless of their nationality (“Know your patient rights”, 2018).
As health professionals we are expected to be consistent in our treatment and understanding toward our patients. However, it can sometimes be difficult to maintain these characteristics of a professional when the patient does not remember any of the exercises that he has been taught. The couplet in the poem attempts to emphasize the fact that the patient was unable to recollect simple things. I found myself being frustrated with the patients repeated questions about his catheter, body and explaining why he was in hospital. Therefore I decided to translate those questions into German in my poem, because regardless of what language he spoke, I was deaf to his concerns. Individuals who treat patients with Dementia are often subjected to high levels of stress and thus feel frustrated (“Alzheimer’s Disease”, 2018).
When treating someone with Alzheimer’s or dementia it is important to be patient and show compassion towards the patient. It is also important to remember that this is part of the disease progress and not the fault of the patient (“Ways To Show Empathy For Alzheimer’s Patients | C-Care Health Services”, 2018). I am now aware that when treating a patient with Dementia, it is useful to make use of visual, auditory and physical cues in order to help the patient to remember his exercises. -Music therapy in dementia
This reflection discussed some of the ethical considerations that a physiotherapist may face when treating a patient with dementia. However it is important to remember that we as physiotherapists sometimes need to take a step back and listen to what our patients are saying, sometimes being comforting and supportive may improve the patients mood and quality of life immediately. We often see our jobs as “fixing a problem”, taking a step back can make us realise that this problem may need to be solved in a more empathetic and caring manner.
References
Alzheimer’s Disease. (2018). Retrieved from https://www.physio-pedia.com/Alzheimer%27s_Disease
Empathy | Psychology Today. (2018). Retrieved from https://www.psychologytoday.com/intl/basics/empathy
Human rights. (2018). Retrieved from http://www.who.int/topics/human_rights/en/
Know your patient rights. (2018). Retrieved from https://www.news24.com/Archives/City-Press/Know-your-patient-rights-20150429
Ways To Show Empathy For Alzheimer’s Patients | C-Care Health Services. (2018). Retrieved from https://www.c-care.ca/blog/alzheimer-patients/ways-show-empathy-alzheimers-patients/