Physical Therapy Assistant At An Acute Rehabilitation Hospital

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Background
This case study is about a patient, T.C., who I treated while a physical therapy assistant at an acute rehabilitation hospital. T.C. had terminal spinal cancer and at the time of admission had a fair prognosis to maintain function and strength enough to be discharged to his daughter’s home with home health care and family support, and he wanted to eventually go back to his own apartment. He was using a wheelchair as he was partially paralyzed from the waist down, and was able to use a transfer board to transfer from his wheelchair to bed and back.
T.C.’s had two daughters and was a widower, he lived in a second floor apartment with a full flight of stairs. Once inside the apartment the layout was open enough for a
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As we started it became obvious that he had lost a lot of strength in a very short time. He was unable to do more then a few “scoots” on the transfer board. During this time I offered encouragement, but also gave him reassurance that he could rest another day if needed. After multiple attempts at the transfer T.C. broke down in tears, saying he was sorry he couldn’t do more, and he was apologizing to me for his lack of success that day. I kept reassuring him, and I also let him talk and express his grief. After getting him into the wheelchair and back to his room, I informed the physician of the change in physical status.
T.C. went out for testing immediately and unfortunately the test came back that the cancer had aggressively metastasized throughout his body. His pain level increase daily and he became increasingly dependent for all aspects of daily care. Prognosis was for weeks rather then months.
A family meeting was held with his daughters. T.C. was now adamant that he was going home to “die in my own bed.” His daughters were struggling to handle all the sudden changes in T.C.’s prognosis, one daughter was agreeing to everything he said, the other could see nothing but problems and obstacles. The meeting dissolved with all three of them too caught up in emotions to make any decisions. After the family left, the team stayed and talked; we decided

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