As much as we do not want to admit it, family is everything! It may seem as though it is nothing at times but having a supportive family is medicine on its own.
I worked in a rehabilitation center for my neuro block and i have had so many instances where patients are non-compliant and depressed until a family member comes to visit them or they are allowed to go home for the weekend. Everything literally changes. Patient’s mood and attitude to therapy changes and thus their overall rehab changes too.
I had a patient with right CVA, left hemi. She presented with increased tone on the left side. No movement on the affected side. She had no muscle activation on the affected side. She struggled to do bed mobility which was her highest level of function for 3 weeks at the rehab center. She wanted to go home so badly. She would cry every single day during therapy that she wants to go home and at times she would refuse physio. Referred her to a social worker for counselling but it did not help. I did not understand why she wanted to go home so much that she did not even care about her rehab improvement. I arranged with the doctor to allow her to go home for the weekend. The doctor agreed, called the family to come in for family training. The family came and she went home for the weekend.
The following week she came back from home very happy. She came back a very different person. She was so keen for physio and had goals to achieve within the remaining weeks with me, It was beautiful. I asked her what changed and she said she wants to go home walking and independent because she wants to be the same mother and wife she was before the stroke. She said she wanted to do it for her family, they need her. Rehab continued, during the week she tells me she wants to go home again the coming weekend but she wants to tell me a secret. She told me that she fell at home over the weekend trying to help herself off the bed but she did not tell anyone at the facility because she knows they will never allow her to go home again until she is safe. Then I had to make a call whether to keep the secret, allow the patient to go home risking further injuries or tell the facility what happened and keep her until she is safe. The patient has been doing very well after going home, she started having active movements on the affected lower limb. Now if i keep her and not allow her to go home she will go back to the state that she was in previously, which is not good for her recovery. Tsouna-Hadjis, et al., (2000) states that patients with moderate/severe stroke and high levels of social support attained a significantly better and progressively improving functional status than those with less support. She needed the social support to keep the mood going. However, going home meant putting her at risk of falling again and actually coming back injured.
I did not know what to do with this patient. I had to make the call again to the doctor if she was safe to go home again for the weekend or not. I had to give feedback by Thursday to the doctor. I decided to explain to the patient that I really want her to go home because she needs to be home to recover and make good progress on her rehab. However, I am concerned about her safety at home and that if anything happens to her over the weekend it will be on me. She begged me not to tell the doctor but I thought I must let the doctor know for her own safety. I informed the doctor and as expected, they said she cannot go home again until she is safe. She cried so bad, she did not even want to see me after ward rounds and refused treatment as well. I felt so bad. I did not know if the call I made was right or not. The next two weeks the patient was on and off with rehab. She was not compliant, consistent or keen for physio like she was before. She would always say that she wouldn’t be missing her family if it wasn’t because of me. However, she was safe at the facility, no risks of falling and sustaining injuries although her progress was not improving as it would if she was permitted to go home over the weekend.
Therefore, I have realized that sometimes all a patient needs is their family to recover. Patients go through a lot of trauma with different conditions and that includes emotional trauma. Approximately one third of individuals living with stroke in the community will develop post stroke depression and may experience associated reduction in quality of life, decreased functional recover increased social isolation and mortality (Salter, foley & Teasell, 2010). They get emotionally bruised and they need to be emotionally attended. However, we as professionals miss this aspect of patients’ well-being. We are so focused on the patient’s physical well-being so much that we forget the most important aspect which is their emotions. Tsouna-Hadjis, et al., (2000) states that high levels of family support,instrumental and emotional are associated with progressive improvement of functional status, mainly in severely impaired patients, while the psychosocial status is also affected. At times patients don’t recover because they are not emotionally and mentally well which consequently affects their physical recovery like my patient. The World Health Organisation defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.(1946). In improving the patients’ physical well-being we must not forget other components of health, we must treat holistically and take into consideration social support especially for stroke patients.
Therefore, that experience has thrilled me so much. It has opened my mind and has changed my approach to clinical or professional service at work. Yes I will help the patient return to their previous level of function in all ways possible but the approach to that will be different. I will reach out to patients holistically, I will look at all their spheres of life. But also their safety comes first, their physical well-being, social well-being, emotional wellness and etc.
References
Photos Retrieved from: https://int.search.tb.ask.com/search/AJimage.jhtml?&n=7848baad&p2=%5EHJ%5Expv063%5ETTAB02%5Eza&pg=AJimage&pn=4&ptb=ED0C0398-180B-4D56-88D8-8A99A2FEC981&qs=&searchfor=family+support&si=1365143&ss=sub&st=sb&tpr=sbt&ots=1566749069734&imgs=1p&filter=on&imgDetail=true
Tsouna-Hadjis, E., Vemmos, K. N., Zakopoulos, N., & Stamatelopoulos, S. (2000). First-stroke recovery process: the role of family social support. Archives of physical medicine and rehabilitation, 81(7), 881-887. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0003999300784085
WHO (1946), retrieved from; https://www.who.int/about/who-we-are/frequently-asked-questions
Salter, K., Foley, N., & Teasell, R. (2010). Social support interventions and mood status post stroke: a review. International journal of nursing studies, 47(5), 616-625. Retrieved from; https://www.sciencedirect.com/science/article/pii/S0020748909003940
One thought on “Family is everything!”
Hi Katlego. Thank you for sharing your writing piece. It is definitely a relatable topic that often happens in hospital environments. I have been in a similar situation and I realized we do not always realize what the next patient is going through. It was a tough decision that you had to make but you did what was beneficial for the patient in the long run although she may have not realized that in the moment.
Content: i like how you started the writing piece with basically what the writing piece is about because it tells the reader what is about to follow. This was a topic which I personally found rather interesting in – that is why I enjoyed reading about your personal encounter in a situation like this as the situation I was in was similar but had a different end result. Your topic definitely coincide with the options that were given and spoken about in class – I definitely understand your dilemma and at the end of the day, the patient has human rights which have to be respected. (you could possibly clearly state which human right may have been violated and support it with references) – this will give the reader a clearer understanding
argument: you have made fairly good points coming from both individuals involved in the situation throughout although not all of them are supported with references as this could then make your writing stronger. You could also mention the patients perspective on the whole situation more in depth and how you could have gone about the situation when trying to explain to the patient that she will not be able to go home – to make the argument stronger
references: based on the references you have – some of the intext references are not written correctly – just double check on google how it should be correctly formatted throughout your piece. You could also add more references what other people in similar situations have done or what should be done – here is another link which you could use to help your piece https://www.omicsonline.org/family-support-in-stroke-rehabilitation-2329-9096.1000e104.php?aid=19475
writing: there are a few grammatical errors I have picked up while reading your piece
-line 5 – chages* should be changes
-line 6- what does “whatsoever” mean?*
-line 17 – she tells* me should be told
-line 25 – do not think you should start a sentence with “and”
– met* should be meant
you should not be so hard on yourself, you did what was right for the patient! and now for future references, you will know what to do and what is considered right
I hope that this could be of some help,
All the best with your final submission
Erin