Neuro/Safety

I am on a neurology placement at the moment

A patient i was allocated was an elderly gent who had a CVA following a 70% occlusion of his left ICA. Upon assessment his voluntary control of UL and LL was surprisingly good but there was some associated balance deficits mainly in standing but when it came time to assess his perceptual deficits it was evident he was suffering from expressive aphasia. During his subjective he often became frustrated as he could string sentences together but would be unable to verbalise key words unless i stated them then he would agree or disagree.

We finally got into the gym and from my previous chat with him i had gathered he was understanding me and answering my questions well. We were working on his dynamic sitting balance and other issues and he had performed quite well. When it came time to end the session there was 1 last t/f to perform from plinth to w/c. Once we were in standing i asked him to step towards his right towards the w/c once he had shifted his weight onto his left with close guarding and he proceeded to step in the complete opposite direction comprising his balance and safety. We eventually safely negotiated our way to the w/c. Because of the nature of the stroke i was talking to the Dr/OT and was querying receptive aphasia/ideamotor,ideational apraxia all of which they considered not present in this gentlemen.

This situation showed me that although we sometimes tend to take a person ability to perform certan tasks for granted it pays to underestimate their abilities slightly to ensure safety. I will now monitor my patients closely to ensure tasks are done correctly and safely.