Week 3

S: 83 year old male presented with acute dysarthria and right sided weakness following a fall one day ago. Patient (pt) is the primary carer for his wife who has dementia. Primarily Macedonian speaking and English as a second language. Previously independent with all duties and ambulating independently. Past medical history includes hypertension and carotid stenosis. Pt sustained left subdural haemorrhage and underwent a craniotomy and evacuation. T: Perform a full neuro assessment for the patient including tone, passive range, GCS, mobility and cranial nerves. A: I measured the pt’s range of motion, established an appropriate form of communication, measured tone and performed a mobility assessment to handover to the nursing staff. R: I was able to carry out a thorough neuro assessment. The pts range was within normal limits, cranial nerves were intact, the pt required 2 people to assist with bed mobility and maintaining sitting balance so the patient was not for ambulation. The patient was also set up with a stock wheelchair to be hoisted out of bed into daily as the patient was not for transfers. E: The patient tolerated well although it was hard to communicate with the pt initially as only short clear commands were understood and I was unable to explain the reasoning or educate the patient on the role and purpose for physio. This also altered the pt's GCS level due to confusion as a result of the language barrier. S: I asked my supervisor for feedback after the assessment and I was able to attain better forms of communication particularly with a head injury and also a pt that does not primarily speak English. I then used these for further treatment sessions throughout the week with good effect.