Sometimes patients don't realise what they can do

On my rural placement, a patient was admitted after having a CVA. On first impression, this patient seemed very unmotivated, and convinced my supervisor and I that she "couldn't do anything". She would continuously compare how she is now with her premorbid status, and was very fixed on the fact that she had movement on her affected side.

For the first few sessions, everytime my supervisor and I would attempt to stand her up and walk her, she would state that she can't, and would just sit straight down. After setting the goal of walking to the toilet, we were able to stand her up and walk her with 2 assist, however, the more steps she took, the more she would actually contribute, needing less assistance.

The next session, she still refused saying that she was unable, until I reminded her of her performance the day before. This seemed to have improved her confidence, and she was able to walk a greater distance with less assistance.

I FEEL THAT SOMETIMES PATIENTS THAT HAVE DISABLING CONDITIONS SUCH AS STROKES, WILL TEND TO COMPARE THERE CURRENT STATE WITH THERE PREMORBID STATE, AND WILL ASSUME THEY ARE UNABLE TO DO CERTAIN TASKS. I THINK THAT A GOOD WAY TO TREAT THESE PATIENTS IS TO SET REALISTIC SHORT TERM GOALS, AND USE THAT GOAL AS MOTIVATION FOR THE NEXT SESSIONS.