I have done hundreds of physiotherapy home visits in kuala lumpur throughout my 7 years of working. It has been a fruitful journey as I get to explore many places, meet, and treat new people. I tend to get quite excited when I get enquiries for physiotherapy home visits because you never know what to expect. Every new patient gives me the opportunity to challenge my skills and expertise in assessment, analysis, diagnosis, and treatment.
Throughout my career, three home visit cases stand out the most and they are still memorable till today.
Case 1:
Mr A was bed ridden for a few months ( ? more than 6 months). I can’t remember his full history but he had a goal to travel to Bangkok to visit his sister. I can remember clearly that he couldn’t lift his left hip up because it will hurt. I tried lifting it upwards but it was painful as well. Furthermore, his left hip was rotated outwards in normal supine lying. I was concerned with his different hip position and advised his family to get an X-ray to rule out a hip dislocation. They spoke to their orthopaedic and he said I was over cautious so they didn’t proceed with my advice.
It was fair to me to be cautious because of my clinical findings. I have to be assured that the patient was safe enough to be sat or to be stood because it was not possible at the time of assessment. I also had to protect myself in case I was blamed for the possible missed hip dislocation.
Case 2:
This is a 90 plus old lady that had been bed ridden for five months. She first fractured her left hip, one month later she broke her back and she subsequently developed a lung condition.
The clinical findings of this old lady was her left hip was rotated outwards and she could barely lift it up. I could lift it upwards for a max of 30 degrees only. She could sit up but was leaning towards the right side. I told her daughter to do a hip x ray to rule out hip dislocation.
The daughter did not follow my X-ray advice but they did ask the helper to help the patient with her home exercise programme. From the whole situation and conversation, I could sense that the daughter wasn’t really interested in helping her mum recover. She just wanted to make sure there was nothing serious going on and that was it. I strongly felt that the old lady had a good potential to recover/ walk if she had physiotherapy.
Case 3:
Patient had a second stroke in April and was admitted but had no treatment at all till september so she has been bedridden since. The treatment she had was acupuncture once a week. The husband already postponed my physiotherapy visit once because she said his wife had cough and her knee was hurting so she can’t do the assessment and I had to explain to him that my job is to help such patients. Finally, I saw her. Her upper body was alright but her left hip was in an awkward position, it was flexed, abducted and rotated outwards. Her knee was painful to touch and it was not possible to straighten her left hip because it hurt so much.
I told her husband to send her for a hip X ray and he did. She didn’t have a hip dislocation but she had severe hip arthritis. Despite knowing the fact that physiotherapy will help with arthritis and stroke, the uncle said he would call me when aunty’s hip felt better. I was so frustrated after hearing that. I told him that it’s ok if he doesn’t want to engage me for treatment but please find another physiotherapist to carry out the treatment.
I honestly do not know what’s stopping him from giving his wife the treatment that she needs. I am quite sure that money wasn’t the issue here as they could afford private healthcare.
To sum up:
I still fail to understand some of my clients that refuse to have treatment for their loved ones when it is NEEDED. I only recommend physiotherapy on a need basis. It doesn’t matter if they don’t see me; the important thing is to seek treatment and to show care to the person they’re caring for. Neglect and not knowing is two different things! Is it really ok to you to leave your loved one bedridden in this time and age? I really can’t stop wondering! I try my best to educate the people I meet about the best care they can offer to their loved ones. The decision is still up to them even though I disagree with some of them.
Thank you for reading.
Lian Yun-Perng
Chartered Physiotherapist
Ace Physiotherapy
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