5 answers
Jamar
Student
2
Questions
Updated
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How do you treat a patient in a healthcare facility who wants to do everything by themselves and resist your help? Especially if they're older and don't believe in your skill. I might get in trouble if I just have another clinician treat them if I'm assigned to. #Spring25
I'm studying to be an Occupational Therapy Assistant, and I need to be better at finding solutions to helping people who don't want help.
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5 answers
Hwal Lee
DMSc, PA-C
277
Answers
Albany, New York
Updated
Hwal’s Answer
Jamar,
Does the person in your example genuinely need (your) help? If so, how do you know that they do? The "treatment" of any sort within helping professions should be based on teamwork. In other words, both the helper and the other person need to contribute to, in this example, an activity called occupational therapy. Are you in a position to respect and accept the person's desire to be independent? I've found that some individuals' initial preference to 'go it alone' evolves over time as I develop rapport with them and gain their trust. Then again, often enough, simply being present for the person and remaining patient, caring, curious, and reassuring, while the they carry out an activity on their own, can itself be therapeutic for the person.
I hope this helps. Let me know if you have any specific questions I can help with.
Hwal
Does the person in your example genuinely need (your) help? If so, how do you know that they do? The "treatment" of any sort within helping professions should be based on teamwork. In other words, both the helper and the other person need to contribute to, in this example, an activity called occupational therapy. Are you in a position to respect and accept the person's desire to be independent? I've found that some individuals' initial preference to 'go it alone' evolves over time as I develop rapport with them and gain their trust. Then again, often enough, simply being present for the person and remaining patient, caring, curious, and reassuring, while the they carry out an activity on their own, can itself be therapeutic for the person.
I hope this helps. Let me know if you have any specific questions I can help with.
Hwal
Thank you for the advice, Hwal.
Jamar
Destini Hardy-Stover
Occupational Therapy
5
Answers
Raleigh, North Carolina
Updated
Destini’s Answer
Great question. I think you will have to try a variety of things and approaches with each difficult situation because what works for 1 may not work with another. 1 thing - try different times of the day. For example a patient may be "grumpy" with you but maybe they're just not a morning person and don't function well at 700 in the morning. Maybe their best time is after the soap operas have gone off and they've had lunch. Also, bring some equipment or ideas. For example "Ms. Brown I was thinking of ways that might help you with cooking. I know you want to get back to that. I would love to get up and go to the kitchen to show you some things - adapted cutting board, reacher, grippers, etc. And lastly gather suggestions from others who have been doing this a long time a d it doesn't just have to be OT. A PT, nurse may have good suggestions and tips for working with difficult patients. Sorry this is so long. Best of luck to you
Hello Ms. Hardy-Stover. It's all right if your answer is long. Thanks for the help. It's about understanding my client and building rapport.
Jamar
Amarja Desai
Occupational therapist / Assistive Technology Specialist
2
Answers
Gambrills, Maryland
Updated
Amarja’s Answer
Sometimes people need guidance more than help, so offer them that. Always give them praise to boost their confidence and sense of independence. Sometimes, stepping back and providing guidance instead of direct help can be the best way to support them.
Thank you!
Jamar
Kyla Remigio
CNA/ PCT/ PCA/ Nurse Extern
13
Answers
Converse, Texas
Updated
Kyla’s Answer
This kind of situation actually comes up more than you'd think, especially when you're younger or still in training, some patients may doubt your skills simply based on age or experience. One thing that's worked for me as a CNA is to calmly reassure the patient by letting them know that i've been trained and have the proper credentials to assist them safely. Just explaining that you went to school for this and that you're there to help, not to take away their independence can help ease their concerns.
Also, something I was taught is to dig a little deeper when a patient refuses care. A lot of times, the refusal isn't personal. It could be bad timing, maybe they're watching a favorite TV show, waiting for visitors, or just not in the right headspace that day. Taking a minute to ask why they're refusing can make a big difference (ensuring that the nurse has giving/the patient has taken their pain meds at least 30 minutes before you start their OT also makes a difference).
Of course, patients do have the right to refuse care, and depending on your facility, you'll usually need to report that to the nurse or supervisor as well as document the occurance. But when possible, try to let them do what they can independently first. That gives you a chance to evaluate their abilities while also building "rapport", that trust and connection is so important in OT. When they feel respected and understood, they're much more likely to accept your help.
Also, something I was taught is to dig a little deeper when a patient refuses care. A lot of times, the refusal isn't personal. It could be bad timing, maybe they're watching a favorite TV show, waiting for visitors, or just not in the right headspace that day. Taking a minute to ask why they're refusing can make a big difference (ensuring that the nurse has giving/the patient has taken their pain meds at least 30 minutes before you start their OT also makes a difference).
Of course, patients do have the right to refuse care, and depending on your facility, you'll usually need to report that to the nurse or supervisor as well as document the occurance. But when possible, try to let them do what they can independently first. That gives you a chance to evaluate their abilities while also building "rapport", that trust and connection is so important in OT. When they feel respected and understood, they're much more likely to accept your help.
Rosemary Banks
Property Management
9
Answers
Forestville, Maryland
Updated
Rosemary’s Answer
Good evening,
Jamar, you can do this. Always remember you are the professional, and you will not be intimidated. You have been trained for difficult patients. Many elderly are sad, depressed, and they feel hopeless. Be creative and willing to take it to another level. Build a rapport with them to gain their confidence in you. Find out what makes them happy and their hobbies. Maybe they like playing cards, checkers, or chess. If so, be willing to challenge them in a game or two. Play their favorite music to uplift and energize their soul. Fuel them with a lifeline, that will encourage them to trust you and want your help. Make them want to need your help, and they will become attached. So attached, they will be looking for you on your days off.
Jamar, you can do this. Always remember you are the professional, and you will not be intimidated. You have been trained for difficult patients. Many elderly are sad, depressed, and they feel hopeless. Be creative and willing to take it to another level. Build a rapport with them to gain their confidence in you. Find out what makes them happy and their hobbies. Maybe they like playing cards, checkers, or chess. If so, be willing to challenge them in a game or two. Play their favorite music to uplift and energize their soul. Fuel them with a lifeline, that will encourage them to trust you and want your help. Make them want to need your help, and they will become attached. So attached, they will be looking for you on your days off.
Thank you for your help Ms. Banks. I'll look back at this to grow in my education.
Jamar