Hi Ron - to be very directive: 
In a situation where you can walk on a straight flat surface with no turns
or obstacles -offer her your arm on the opposite side from the one for
optimal use of the cane. Let her take your arm, then affectionately lay your
other hand over hers and hold her solidly with your forearm against your
side. (Close human contact and trust to deal with fear while retaining
physical control of self) Follow her lead for starting and pace and have her
simply touch the cane down at the point of stepping forward with the foot
closest to you so she has practice managing the cane in her hand without
needing to depend on it. Have her play with the cane as a walking stick,
walking slowly but upright with a flourish. (I hope it is an elegant,
fashionable, well fitted one where the point of contact with the ground is
directly under her hand.) After several 'happy walks' you will begin to feel
her hand resting more lightly on your arm and ........ well you can take it
from there but don't be in a hurry. Most of all - have fun. (Think about
escorting a duchess in to dinner) She sounds like such a great person.
Seems like you've moved from expert to client-centred enabler with this.
What a case history this would make!
One more thing - don't ever again talk with her about mobility and safety
when she is sitting down at which point her sense of her physical abilities
reverts to what she used to be able to do. Actually try to stop talking
about it at all especially in negative terms of disastrous outcomes.
There are a lot more recommendations I've been thinking about. This is
enough for now.
Blessings, Joan



-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Ron Carson
Sent: Friday, September 07, 2007 10:34 AM
To: OTlist
Subject: [OTlist] Overcoming Fear During Mobility

Hello All:

Any  great  suggestions  for  helping someone overcome fear with using a
cane?  The  patient  really wants to be independent but she is scared of
falling.  She  is physically and mentally able to use the cane with only
occasional  cueing, but she is just fearful. But, she wants to learn to
safely  and effectively use her cane. Suggestions? I've told her that all
that  I know to do is give her the opportunity to be successful with her
cane  but  she  must  internalize  this success. I likened it to someone
learning to walk a tightrope. They are at first fearful but after proper
instruction  and  successful  engagement,  their  fear subsides. But, not
everyone  would  be able to control their fear in such a situation. I am
considering  that  this patient will not be able to find balance between
confidence and fear.

Thanks,

Ron

--
"... as a profession that offers unique services that are ideally suited
to  meet  the health, participation, and quality of life needs of people
of  all  ages,  occupational  therapy  is well-positioned to succeed and
flourish in the 21st century." [Fred Somers, AJOT, April, 2005, p. 127]

"The  part of convalescence that I found most profoundly humiliating and
depressing  was  [OT]...  I was reduced to playing with brightly colored
plastic  letters  ...  like  a three-year-old..." [AJOT, April, 2005, p.
231]


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