Hello David:

Nice  hearing  from  you. One of the reason we tried the cane is in fact
because  the walker is too cumbersome and complex in the house. The cane
is  much  simpler  for her. Interestingly, I've instructed that the care
giver  is  too  work  with  the  patient on safe use WITH the cane. I am
working  on  the  patient  not using any AD. It is not our goal that the
patient  walk  without  an  AD,  but I believe that non-AD training will
greatly   improve  her  safety  and  stability  with  the  AD.  She  has
demonstrated  correct sequencing and proper use of the cane so she knows
how to use it.

Honestly,  this is a very complex situation. She really wants to use the
cane,  she  has demonstrated that she is physically and cognitively able
to  use  the  cane  but  she  is  afraid.  I  believer  that her fear is
disproportion  to  her  abilities  and desires. I am not downplaying her
fear,  it's real, but the fear is preventing her success. She has fallen
and  she  is at risk to fall, but her fear increases her risk. Does that
make sense.

I  have  suggested  to  her  that  despite  her  stated  desire of being
independent with a cane, the reality appears that she may be best served
with  a  walker.  But  a  walker  is  not  a  panacea because she uses it
incorrectly (i.e. climbing over the wheels, etc)

----- Original Message -----
From: Lehman, David <[EMAIL PROTECTED]>
Sent: Friday, September 07, 2007
To:   [email protected] <[email protected]>
Subj: [OTlist] Overcoming Fear During Mobility

LD> I agree with you Ron...we only overcome our fears by attempting the task
LD> and succeeding.  As for balance control, the same holds true and also
LD> one must "fall" to learn how to regain balance control.....so, maybe use
LD> a "secure" environment (i.e. things to grab on or mats to fall on, and
LD> give challenges while she walks with cane (i.e. changing positions,
LD> shoving her, people walking in front of her, etc)...also, maybe she will
LD> do better without a cane - maybe the cane just adds more complexity to
LD> the task

LD> David A. Lehman, PhD, PT

LD> Associate Professor

LD> Tennessee State University

LD> Department of Physical Therapy

LD> 3500 John A. Merritt Blvd.

LD> Nashville, TN 37209

LD> 615-963-5946

LD> [EMAIL PROTECTED]

LD>  



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