It’s no secret that the best caregivers possess the soft skills of connecting with their patients. As a physical therapist with over 22 years of practice, I try to find ways to do this with each person in my care. This ability to connect with patients became even more vital during the pandemic, as strict visitation guidelines to prevent the spread of infection made our patients very lonely.
With many years working PRN, I’ve realized that I have about 30 seconds to establish trust with a patient. So I start by taking ownership of the session, simply introducing myself, stating that I am their PT for the day. I’m not “from physical therapy.” I am “your PT.” I also briefly discuss the game plan for the session so there are no surprises.
I’ve realized that the universe tends to place me in spaces where I’m needed often. I may work with someone who will benefit from my exact set of skills, my patience to listen, or the ability to navigate the system to get them to the right resources to help them best. Sometimes the reason is much simpler, like a common interest, or simply the ability to read someone and deliver exactly what they need in that moment.
I recently worked with a patient who was not that much older than me. We got into a discussion about college and music, and we discovered that we love many of the same bands! So whenever I worked with her, I took to playing music from my phone during our sessions. One day, she asked to hear the “busy” song, and I knew exactly what she meant. She wanted to hear Hairdresser on Fire by Morrissey, a song I happened to have in my iTunes collection. It was fate!
During another recent session on a weekend, I had a patient who simply didn’t want to do anything. In reading her, I felt that she was really just scared. I talked her into doing some bed exercises. I quickly realized she needed to be changed. After summoning some help, I ended up getting her to stand up multiple times in the process of getting cleaned up. And then since she was already standing, I convinced her to get into her wheelchair. Her hair was an absolute mess. Her reward for all the hard work she did for me? I braided her hair. I left her not a scared woman, but a happy lady who felt pretty for perhaps the first time since she was admitted to the hospital. It was a win for both of us.
One of the most rewarding things I get to do is to help someone reduce their pain. Shoulder pain is often a big problem for the very old with “end stage” shoulder arthritis and also for those with hemiparesis, when there is either limited structure left of the rotator cuff, or there is no muscle tone to approximate the joint. Tape to the rescue! I’ve got several methods to do this, but taping often reduces pain levels significantly, turning anguish into smiles and relief. Sometimes I’m the PRN that figures this out.
I made friends with a lady in an assisted living facility where I once worked. One of the beautiful parts of working in these settings is that you get a building full of adopted grandparents! She was a patient who benefited greatly from my shoulder taping skills. I learned early on in geriatrics that older people love to impart knowledge gained from their years of life experience. It’s always fun to see their faces light up when you let them indulge.
This particular lady was very helpful as my older daughter made the transition from little girl to tween. I guess my daughter had been particularly moody lately as a 5th grader, and I was venting a bit. She asked if I had thought about the possibility that she may be getting ready to start her cycle. Whoa! I had not thought of that. But I got prepared that day, had another talk with my daughter, and made sure she had supplies and was ready. Thank goodness for my friend, because the event for which we had planned happened just a few weeks later. I was so grateful for her insight.
My best story, though, is from my many years working in a skilled nursing facility. I had this patient I had been working with for well over a year to heal a wound. We alternated between diathermy and high volt e-stim to stimulate healing, and with e-stim, you turn up the intensity until the patient feels it. He was very hard of hearing, and we worked out a system where he would hold my hand, then squeeze it when he felt the buzz.
We developed a friendship over time. I greatly admired his adoration and devotion to his wife. She had severe dementia, but was more mobile than my patient, as he was non-ambulatory, yet mentally intact. She lived next door in the assisted living. But my patient made a point of having dates with her once a week. It was so very sweet! I loved that our staff made it happen.
He was also a very handsome fellow. He looked just like Victor Kiriakis from Days of Our Lives. He had never seen the show, and eventually I was able to share his likeness with my patient. He joked that he looked better than Victor!
I was devastated when I came into work one day, and he wasn’t there. He had suffered a major stroke. It happened right before I left for a weeks vacation. On our last night there, I had a dream about him.
In my dream, I was at work, and it was a Friday afternoon, when often the rabbi would play music at the nurses station for residents. My patient was there, and as I walked through, he stood up out of his wheelchair, took me into his arms, and danced with me, much like a father dances with his daughter at her wedding. He then let go, walked away, and faded into the distance. I woke up already crying. I sobbed like a baby for several minutes, because I knew in my heart that he was gone. Later that day, his obituary was posted. I’m certain he came to me in my dream to let me know that he was leaving, and that he was ok.
You never know how much your interactions with someone will make a difference. While not all of my sessions with my patients are extraordinary, I hope that most of the time, I convey care and compassion, sharing common human experiences and applying my skills to help my patients feel heard, valued, and better. It’s really not enough to just address someone’s physical needs in healthcare, especially when we spend as much time as we do with patients in the rehab world. The golden rule of nature is to leave things better than you found them. The golden rule of people skills is to treat others how you want to be treated. Combine the two, and that’s the power of connection.
Have you ever been the recipient of caregiving from a provider who took the time to connect with you? Or have you been on the caregiver side? I’d love to hear about your experiences. As always, I hope you all are safe and healthy.