An Excerpt From An Ordinary Day of a Community OT

Friday morning, I was allocated to do an initial assessment for a patient who has been discharged back home the day before.

From reading the notes in our system, I was a bit anxious as the patient was assessed to be needing assistance of one with all transfers and can only mobilise within a micro-environment.

Fast facts:

- patient lives with husband in a flat

- husband is the main carer

- patient has long standing limited mobility due to history of nerve impingement

- known history of falls but normally mobilises independently with rollator frame

I was already expecting the worst so that I am prepared for all eventualities.

Upon arrival, I was warmly greeted by an elderly albeit relatively fit gentleman.

He apologised for only wearing a vest top cos he’s too hot as he had to turn up the heating because the patient gets cold easily. He offered a hot drink. I reassured him that it’s good that it’s warm inside cos it’s been really chilly and windy outside, and politely declined the drink while donning my PPE.

I introduced myself and explained the reason for the visit.

He led me to the bedroom where the patient is slumped in bed already looking pretty exhausted. He explained she had a fall last night in the bathroom while she was transferring from the commode which tipped forward as the breaks of the rear wheels were on but the front were off.

She fell forward and hit her chest on the edge of the bath and her face hit the side of the sink. He was able to lift her up and put her back into the commode, and wheel her into the bedroom where she step-transferred into the bed.

They called the ambulance. Paramedics came and cleared her - she didn’t need to be re-admitted to the hospital.

It was an eventful and exhausting night for the patient - hence why she is already looking depleted in bed.

I went to introduce myself to the patient and explained again the reason for visit (i.e. reason for referral was to review mobility and the need for microenvironment at home).

The husband said he couldn’t believe it when he received a call from the hospital PT whilst patient was still admitted saying that the patient mobilised 80m with a walking frame because pre-morbidly, the patient can only mobilise 10m on good days. Most days they use the wheeled commode as a means of transporting patient in between rooms. Patient has very limited mobility due to the nerve impingement that is currently still being investigated by the neurologist. He sarcastically laughed, and said she pushed herself to be able to walk with the PT because she knew that after that, they would send her home as she was desperate to go home.

I explained I can have a look at her mobility and go from there. I took her obs and they were stable. We tried to sit on the edge of the bed but she was just in too much pain and too exhausted to continue. So we just assisted her back to bed and made her comfortable.

I explained to the husband that I’ll have another therapist come see them again on Monday to try to review her again. I also explained that we can set up a POC to help him care for her even just for personal care in the morning. But they both declined. He looked at her and said that he has been caring for her for 16 years now and he’d still want to keep doing it for her for as long as he can.

I can see how tired they both were and it just breaks my heart to leave them. But I thanked them for giving the assessment a try even though she was in a lot of pain and truly tired. I also thanked them for their time.

They both thanked me back for visiting them. I blindly said I was only doing my job. But he said, “yes you were but it matters how you did it, my dear.” And I was just stunned with what he said; it kept repeating in my head the whole day.

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Sometimes we never know how we affect people. And that even with just the tiniest and seemingly ordinary acts, we can actually make a significant difference in somebody else’s day.

That’s why we should always aim to be kind to everyone that we meet - because we never know what battles each of us is fighting every single day.