During FW, you come in contact with so many patients whether through your supervising OT or through the rest of the team. When I arrive at site, I am always curious to know how a patient is doing from the last time I was there, especially if you have not seen them in a while. One pt. stands out in my mind. The pt. is being helped in therapy for joint disease and edema, he also suffered from dementia but you could not tell it. He laughed and joked and tell stories, interacted appropriately with the therapist and myself, would need some redirection to task but could complete the session. He unfortunately was sent back to the hospital (not sure why) but eventually he returned to rehab last week. Oh the difference dementia makes! He had declined so much in cognitive ability. During treatment he couldn't do half of what he could do before. As a matter of fact, he was getting so agitated and was ready to leave. The OT changed activites four times and could not get the pt. to particpate/complete the activity. He even tried to get out of the wheelchair; he could move the wheelchair with the brakes locked! Not sure if he would have become combative if we had not ended the treatment.
So treatment will change from a physical dysfunction to a pyschoscial one. We will now work on what he can understand and do and incorporate the physical in it as well.
Found an article about occupational therapy and dementia, improving the quality of life. http://www.medicalnewstoday.com/articles/56942.php
Second thought As a patient's cognitive ability declines whether it's dementia or another disease, is it often that a patient abuses a therapist?
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