Home Visits

I don’t share too much about clinic because it’s a little hard to do without breaking confidentiality and a lot of it is just our typical day to day. This week, however, I got to shadow on home visits. I was quite excited because I’ve actually really missed working with peds but also neuro patients. I got to see chest PT back in action, be involved in a little cardio-pulmonary rehab, see my first patient with Parkinson’s plus, and assist with a lady post stroke. Though often not interested in performing exercise, it seemed quite meaningful to the patients and families to have these services. It is also quite an uncommon service in Kuwait. As with my time in Jamaica, people who experience a stroke or get sick in some way are treated as ill and laid up in bed. The push to get up and move in a less than ideal circumstance is not really a position here. So it’s really important and wonderful that FSRI offers in home services to patients like this.

What I was really excited about was some of the progress I got to witness first hand. On the drive (the downside of home visits is traffic), I had been brainstorming ideas with the therapist I was with. We were talking about how a lot of people here don’t really have hobbies when they get older as the culture is to have others to take care of things. The reason this was significant, was because we were discussing task specific training in patients post stroke. The lady we were about to see was not motivated and could get quite aggressive with her caregivers and the PT when they tried to engage her in activities. I was sharing that I was truly surprised at my experience in Jamaica (I was on a service trip to work at a stroke camp/intensive rehab a year ago) when we had some of the participants engage in a task that was meaningful to them and something they had performed many times before versus learning a new exercise all together. The lady was doing quite well during our session as compared to previous visits and we were trying to use me as a new voice and face to engage her. It didn’t work at first other than her seeming to be ok with me moving her legs for some stretching and range of motion. When we got her sitting up, she finally made contact and spoke to me. She was wondering who I was. Her Daughter helped with some translation, though previously this woman also spoke good English. With the PTs excited looks as this was a rarity for the patient to speak to anyone other than a particular son, I got her to reach for one of the cones we brought to practice some weight shifting and hand use. After restacking it I could tell she wasn’t really interested and we had lost her presence. In the meantime, we had learned she was actually a phenomenal cook. I asked the PT if we could get a bowl of rice. The nurses eagerly brought some. We placed some in the lady’s hand and she immediately started feeling and rolling it. There is very high respect for food here so there was no chance she would intentionally waste it. Though we made a little mess, every time we place the rice in her more involved hand we could get her to reach for the bowl to return the rice. My favorite part was that she would flick off the little bits to get every last bit back in the bowl just as I’m sure she had thousands of times before. After about 6 times, her attention had faded and our session was already running over, so we have it a rest. It may seem insignificant but it was the most she had done in any session and I knew the family would be talking about it at their gathering later that day. The PT was also extatic and was inspired to take her to the kitchen at their next session to see what she might do. Though perhaps only a small improvement, it would mean everything to this family if she was able to participate in their family meals and for the patient to have some connection with something that brought her joy. I love helping people do something they, or no one, expected. It’s empowering to empower someone and having a moment like this definitely was the highlight of my week and reassures me I have chosen a line of work I am privileged to participate in.

 

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