Topic One - Communication

S – Prior to visiting Mr X I had checked out his notes to give me an insight into the pt prior to seeing him. It proved to potentially be quite a challenging situation with the pt speaking minimal English, being partially deaf and also having a ‘Do Not Resuscitate’ form filled out by the family which indicated he may not be the most communicable pt. He did not have severe cognitive problems but did score a 7.5/10 on the AMTS.

T – To successfully assess & treat the pt clarity of communication was essential and not confusing the pt was key. At the initial assessment discussions had to follow a logical path and also show the pt that PT intervention would improve his situation.

A – From the start constant eye contact and clear succinct communication was used. This ensured the pt was focused on me and also that the discussion was to the point and didn’t confuse him. I lowered myself down to his level and ensured that I was not speaking in a condescending tone during our session.

R – At times it was not so much the pt understanding me that was the issue but me understanding him. It turned out his ability to understand English was much better than his ability to speak it. The pt did understand what I was saying most of the time but it was not always that easy. At times he would just simply say yes which didn’t make sense with the question asked and I then had to rephrase and simplify it.

E – The session took a lot longer than any other assessment I had carried out but after this furthering questioning would be a lot simpler. I was challenged to think on my feet at times when he couldn’t understand and in couple of instances I had no way of asking him the question I was after without potentially doing a 10minute short course in Italian. Avoiding complicating questions and making them simple yes or no answers and definitely avoiding the dreaded leading questions….a tired pt will say whatever you want them to say to get you out of their space.

S - With a pt that is easy to communicate with asking all the additional questions that are relevant is so much of an issue but if I can avoid them with other pts like this gentleman the session would be a lot quicker and put the pt more at ease, thus making for a much more enjoyable session.