Abstract 5
Abstract 5
Abstract 5
Factual Strand
therapy rotation and I was full of nerves. I reviewed the client’s medical history, took a
deep breath and went into the waiting room to find my client. There he was. A fragile 85-
year-old man with scabs on his face, greasy hair, and dirty fingernails. As he greeted me
with a smile he asked if he could take a moment to use the restroom. I kindly agreed and
He displayed abnormal gait, improper use of his walker, and required assistance to get in
and out of the restroom. Additionally, he took 15 minutes to use the bathroom and when
he finished his pants were soiled. Upon performing an occupational profile, I was
shocked to learn that he had not bathed for 8 weeks, he lived alone, he fell frequently, and
I quickly realized that while he did demonstrate minor essential tremors in both
hands, there was a much more concerning problem that I could not ignore. After
confiding with my clinical instructor she encouraged me to trust my gut and use my
clinical reasoning. I made an executive decision to change the plan and I performed an
impromptu ADL evaluation. I learned through both observation and the interview process
that he was in danger. He ended up sharing that his sole reason for coming was because
limited to 60 minutes, I opted to skip lunch and work with him longer until I felt
confident with his plan of care. With guidance and encouragement from my CI and other
therapists, I ended up contacting social work and forwarding both his PCP and
neurologist in on the evaluation. I also wrote the most detailed SOAP note I have ever
written. I will remember that moment forever because it tested my character and the type
of therapist I want to be. I could have easily seen him only for what his PCP requested-
advice on how to handle similar cases he told me I will never make it if I continue
practice with so much empathy because I will become mentally drained. I went home and
Retrospective Strand
perspective it was very clear that he was no longer functioning at his prior level of
function and was experiencing elderly self-neglect. Yet, his notes did not indicate concern
at any point from multiple healthcare providers. Knowing that his PCP had seen him only
a few weeks prior I could not understand how that was possible. I felt like the system
had failed him and ignored his cries for help. Simultaneously, I had a breakthrough
because it was the first time I felt like I was capable of making intuitive, client-centered
decisions. This feeling was solidified when my CI encouraged me to trust myself. After
spending months reflecting on the situation I realized that the advice that the other
therapist gave me was also sound, albeit slightly cynical. I need to establish boundaries
Substratum Strand
I recognized that I can be too harsh and critical of other healthcare disciplines. I need to
humble myself and remember that not every healthcare practice views a person
holistically, and that is not necessarily a bad thing. I also need to get rid of my
preconceived notions that doctors view patients as just another number. Each practitioner
has experienced different lived experiences, and these experiences influence their
practices. Additionally, theory greatly influences practice. The Biomedical model looks
different from the PEO model. Beauty is created when you can combine the two. Hence,
why it is so valuable to give every person a seat at the table and approach situations
without prejudice.
Connective Strand
Overall, this experience taught me that I need to have confidence in the practitioner that
I am becoming while remaining humble. While my intentions are pure I need to ensure
that I create a work-life balance. This means knowing how to separate my emotions from
my patients’ emotions. I have also learned that your gut feeling 9/10 times is right. I
should never feel ashamed for doing the right thing, even if that means working through
my lunch hour every once in a blue moon. I need to become comfortable with honoring
that. Lastly, I have learned that it is okay to rely on other members of your team for
guidance. I am not an expert in all things, and I never will be. I need to utilize my
A) Getting to know other members of the healthcare team and each of their duties. I
that I am able to keep my mental health a top priority and to avoid burnout. I also