Expectations of Actions, Not Results

I recently entered the home of an 88-year-old woman that, as Dr. Kyle Ridgeway, PT, DPT mentions in a recent post, “everyone dreads.” She is ornery – but I would be too. She cannot hear well, yet has no hearing aids, so is shut off from TV, radio and most conversation on the phone – which prevents her from talking with her children who live 3,000 miles away. Most of her friends are dead. She has grown accustomed to living alone, yet now she has visitors daily (strangers from an home care agency) to address venous ulcers. She mentioned that she has had falls in the past, prompting a PT referral which triggered a visit from yours truly. She spent the first 20 minutes of my visit yelling at me about how disgruntled she is with her doctors, the upkeep on her home, the daily intrusions… These are all variables that I have no control over and they will certainly confound any progress that I try to make with this patient, but my expectations need not change. After all, I only have expectations of myself – to simply walk into each home being courteous, respectful, reflective, quiet (when appropriate), and poised.

Before I left her home, I apologized for interrupting her day and openly empathized with how challenging and disruptive my visit must be. She (surprisingly – in turn) apologized to me for being “such a grumpy old lady” – she was now empathizing with me. In one hour, something special had happened: not only was I able to stand in her shoes, but she was also able to stand in mine. We developed something mutual, something to share.

Today, I plan to enter her home gently and to kneel beside her chair again, as I did the first day. I plan to yell at her politely, but slowly, so she can hear me. I plan to let her complain as long as she needs to before steering the conversation toward something that could be recognized as physical therapy. I plan to serve as I can as a purposefully courteous, respectful, reflective, quiet (when appropriate), and poised medical professional. Hopefully, she is willing to give something back and join me again in that space where therapy might happen.

Time will tell – after all, the outcomes are out of my control.


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