Placement reflection
Placement reflection
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Massage Treatment & Evaluation :
Most patient have different level of dementia except patient 2, the sessions begin outdoor and move indoor after an hour. The residents were satisfied, asking when we would visit again.
1) Female LBP itchiness
Treatment:
Patient have humpback, saying she have constant itchy back and would like a massage, in conversation I discover the words [numb] and [pain] were unfamiliar to the patient, and she described “itchy” with “needle pinching”, also the site was bilateral while only one side have rashes. Therefore, I decide to focus on massaging muscles compressing transverse process T5-8 where the dermatome directed to. Ended treatment with skin lotion and let rest indoor.
Evaluation:
The itchiness almost caught me off guard, but as the communication goes I discover the description refer to nerve related issue and change direction, reduced the symptoms. The patient says the “itchiness” reduced significantly after massage
2) Male R OA LBP
Treatment:
Male patient saying he feels weak on legs, the note indicates OA but knee extensor was able to make full ROM (strong enough to send a giant balloon straight to my face, Knee Flexion near 110), while mild pain were discovered at flexion. Moreover, no significant tenderness was discovered at knee during palpation, I massage the quadriceps and hamstrings and move on to LB as LBP palpation focused on L2 where myotome ID it might affects knee flexion.
Evaluation:
This patient is a spotlight as he went up and tried to jump and danced and almost bumped to another resident, since he feels his leg got more strength right after the session.
3) Female Neck and shoulder pain
Treatment:
Female patient have neck laterally flexed to left, tenderness and stiffness discovered at left scalene muscle group, applied massage to the area.
Evaluation:
Tenderness reduced on spot, the patient agreed to use hot pack anytime after treatment to keep the muscle relaxed.
4) Male shoulder stress
ROM and palpation present no significant issues
Treatment:
The patient shows mental stress significant with little muscle tenderness, he first refused to receive massage, but later requested to have one, he is not comfortable with the touch, I handed him to my peer who have a massager on him, however he continue feeling uncomfortable to use a device we let him sit and watch TV.
Evaluation:
This treatment was not too successful as the patient refused to be treated and there’s nothing we could do
5) Female stiff hand extensors, neck pain
Treatment:
Patient have weak hands with neck pain. I begin with accessing ROM of fingers, discover tightness at hand extensors, I massaged metatarsal/interphalangeal joints, and move proximal to arm to relax extensor muscles. She mentioned “weak” at moving hands, I also massaged the tender area at C6-T3 as I suspect the nerve were compressed.
Evaluation:
This patient’s reaction is similar to patient no.2, she feels encouraged and happy to get little strength back to her hands, which inspired patient 6 to receive treatment.
6) Female hand OA stiffness,
Fingers ROM affected, tight extensors
Treatment:
Patient have hand stiffness but “trying very hard” to move, she mentioned not feeling weak but “tight” therefore I repeated the hand and arm treatment from patient 5.
Evaluation:
The patient refused massage from peer earlier, however, she was inspired by the result of other residents, therefore opened up and receive treatment, she expressed some of her younger history and express thankfulness we send students to help them.
Overall reflection on the session:
Overall reflection on the session:
After discussing with my peers on their placement, I found my experience is one of the slightly difficult ones. Firstly most patients have dementia, and some had not very good experience with treatment prescribed. We were able to change their view not only by talking, but also listen to their needs and feelings, understand their language (especially under influence of dementia like the “itchiness” one), and prescribing the right massage for their issues. Also, under the request of some patients, I was able to humbly make a few SOPIAR reports verbally to my supervisor, explaining their latest condition and what treatment they are willing to receive in future; this would be vital to them, as the record of patient no. 2 did not include checking of muscle strength and PROM, his lower back did not receive much attention before we found it would affects his legs more than knee OA. ROM is a key factor in many decision making, I would bring a goniometer to placement next time.
The improvement would be in communication, as I found myself not too able to speak with some patients. Although they are under stress and dementia condition, some improvement would be to destress them from their issues and perhaps able to provide more input to treatments. Also, equipment preparation is important as one of the troubles on set is the lack of equipment from gloves to massagers, which we should be prepared next time.
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