A rehabilitation center can have in patients or out patients. I worked at an outpatient one many years ago where I had mostly neurological dysfunctional patients. That means patients with spinal cord injuries, stroke, nerve damage after surgery, cancer patients with nerve damage from radiation, etc.
One day Genevieve and Mary were scheduled at the same hour. That was not meant to happen and since they both had severe difficulties getting to therapy in the first place I said to the office person, let's do it! They both needed full attention from me the whole hour with fall risk issues, blood pressure, fainting spells and even speech deficits. They both used assistive devices during ambulation.
Genevieve had had open brain surgery due to cancer, was frail, and had no movement in her right arm. Genevieve came from the upper class society. She had been a hostess to many important figures from her husband’s business.
Mary had had a stroke leaving her left arm useless. She was difficult to understand due to aphasia, but it was expressive aphasia so she understood all you said to her but when she talked to you her words would be a little mixed up. Mary had spent her life taking care of her many children and her large family.
They sat and looked at me from the large treatment table... Who was to be treated first? I felt the pressure, an aura of competitiveness ... Who was I going to choose? Who would have to wait? How was I going do this? I wanted to clone myself! I had no aid or assistant to help me. Both of these women were proud and private, there was no chance of introducing and coming together via words. I had to think quickly. So I did!
I called up the cafeteria and asked them to please send over 12 paper plates, 12 plastic glasses, 12 napkins, 12 plastic knives 24 plastic spoons and 12 packages of ketchup!
I than dragged our large lunch table to the middle of the treatment room, pulled out a white hospital sheet for table cloth; the center piece was a reflex hammer, a goniometer ( a tool to measure joint range), and a pinwheel to to measure sensation, all stuck into an old vase!
All the goods showed up. I laid it all on the large treatment table and asked the two to set a table together... Genevieve used her cane in the left hand and with her right set one by one knife followed by Mary who used her cane in her right and followed by setting one by one fork with her left arm. They had to go back and forth to the treatment table to pick up things, they had to do a mini squat, a forward lean (trunk strengthening) and walking standing ....
They had immediate fun, Genevieve with her drooping face on the right-difficulties with drooling and smiling...feeling ugly... she looked like the queen of the village! Mary who had simply come to just say “yea yea yea" to any question. Her left arm twisted into a contorted position across her chest.... feeling useless....she looked like the grandma who should be in every home!
Together they dressed the most beautiful table, plates in the middle and knife to the right, fork to the left, spoon next to knives, spoon above plate for dessert, glasses above knives and napkins on the plate.... And the ketchup packages were the name cards for each of the quest.
I monitored their safety for balance, their coordination during walking and carrying, their hearth rate and blood pressure and their need for rest. "Patient tolerating functional mobility of setting a table for max 3-4 min before needing seated rest." In the end, they learned to work around and through limitations by working as a team and simply focusing on the task at hand. Their limitations were forgotten in the pursuit of something fun and unique. This is a lesson I learned and have carried with me since.