16 June 2011

Wheelchair Wars

One of the most important lessons for every patient in rehab to learn is how to get back up off the floor.  Sure Rule Number Two of OT with Deb. is NO FALLING . . . sometimes, however, it's inevitable.  And while I prefer the fall is on their own time, I do consider it in my scope of practice to teach my patients how to get back up off the floor.

And considering the cultural context here, home life happens on the floor.  Nigeriens don't tend to have dining room tables, they eat on a mat on the floor.  They generally don't have couches, so they sit on mats on the floor.  Most social events take place sitting on mats.  So naturally, moving from her wheelchair to the floor and back is a much needed skill for H.

This was the content of our therapy session yesterday.  I don't want to go into many details, but it was a major, I mean MAJOR flop.  About a quarter of the way into the chair-to-floor transfer, H. gave up and refused to do anything more.  I'm not exactly sure of the Hausa words she used, but 'I CAN'T' was how it would translate.  

Only problem with that is, gravity helps on the way down . . . but she had given up, which meant it was up to me to put her back in her chair.  She's skinny (merci seigneur!), but dead weight is dead weight.

Needless to say she was angry with me by the end of our session.  I had made her try something she couldn't do.  So far in all of our sessions I've graded the activities in such a way that she is showered with success and progress.  This just made her look bad . . . and feel bad, I'm sure.

So this afternoon when I brought the wheelchair into her room she just laid there staring at me.  'Babu kasa.' ('No floor') I promised.  It wasn't good enough.  I was then verbally assaulted in Hausa by three hospitalized women and half-a-dozen of their family members. Again, not 100% on the exact translation, but pretty sure it was something along the lines of 'Hey, crazy woman . . . you're mean.  She's paralyzed, isn't that bad enough??  And here you come and you make her feel bad about it.  You're horrible.  No way she's going anywhere else with you.  Just leave her alone.  We hate you.  She doesn't want to do your stupid therapy.  She never wants to see you again.  The community has spoken . . . LEAVE.  NOW.'

The nice thing about being scolded in a language you don't speak, you can simple shrug your shoulders, smile sweetly and say 'Babu Hausa de yaouwa'.  Which usually brings on round two.

But if you're still standing after round two, I recommend moving the wheelchair into position, looking straight at the patient in question (who, mind you, has still not uttered a single word) and with that because-I'm-the-OT-that's-why voice ask 'Yo, babu iki?' (No work today?). 

I don't really know how, but it worked.  She agreed.

After promising a few more times that she wouldn't have to get on the floor, I took her to my office, where there was a second wheelchair waiting outside the door.  She stared at it . . . then at me.  I left her sitting there and I took a seat.  If she was going home with a chair, and she refused to learn how to get up off the floor, at least she was going to learn how to self-propel and steer.  Today, my hallway was completely desolate and unoccupied . . . perfect for wheelchair races.

It took a little while, but she finally got it.  I went down the hallway backward while she went forward, and vice-versa . . . we danced in circles, rounded corners, and even dodged furniture.  By the end, her smile was back.  

That is, until I made her push herself back to her room, which meant other people would see her . . . I think we're right back to Your-Therapy-Is-Stupid-and-I-Hate-You.  Guess I'm just going to have to get creative tomorrow too!

1 comment:

Kari said...

#1 - I love your (imagined?) translations.  But trust me - oh how I understand.  And I love the wheelchair races!  Your enthusiasm for life carries over into your work as an OT and your blog! Love it!