Thanks Joan.

Interesting  and  'colorful' advice. I've stayed away from providing her
UE  support,  but maybe that's exactly what I need to do. She constantly
states that she needs something/someone to touch with her non-cane hand.
But  I've  told  her that if this is the case, then she is not ready for
the cane.

Ron

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

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



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

JR> Hello All:

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

JR> Thanks,

JR> Ron

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

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


JR> -- 
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