Hi Ron!

Another one of your support team cases - I'm delighted with 
a chance to be on board!

Ron Carson <[EMAIL PROTECTED]> wrote:
> Hello David:
>
> The  really  interesting  part  is  that  the patient has
> never lost her
> balance  to  the  point  that I've had to catch her. She
> has always been
> able  to  regain control with only minimal input.
> Actually, the can does
> provide  assistance,  in  fact I am trying to get her to
> decrease her WB
> through  the  cane.

WB is?


She  can walk remarkable well
> wihtout the cane, but
> that is not a long term goal.
>
> I  don't  believe  this  is  a  motor  learnnig  issue. I
> believe it's a
> fear-based  reaction.  Think  of  someone  learning to
> walk a tightrope.
> There  must be balance (no pun intended) between
> perceived abilities and
> fear.

*Smiling* No big fear in early tightrope training - the rope 
is barely above the ground. And this is where you learn to 
focus on the endpoint, so later you don't care much, how far 
away the ground is. (Sure there are other ways - but this 
worked for me:-)

Translated into helping your client, I believe it's 
important to get her very engaged into where she's going. 
Maybe over to that lovely bench in the shade? Or just to the 
table to pick up the remote in time for her favorite 
program. To the flower pots to nipple the dry leaves... 
Whatever that might occupy her mind and provide 
direction/motive. Then you facilitate more than teach, when 
you do as Joan suggested and offer her your arm. Hopefully 
she will soon find you´re slowing her down and let go of 
you?

An additional option I've used for cane walking is a hip 
belt - the kind also used for assisted transfers - had one 
or two handles on the back that was fast to grab when I saw 
my client about to loose his balance. Even when this did not 
stop him from falling, it sure made the fall slower and less 
dangerous. I also grabbed it when we met stairs, curbs, 
slippery places etc - or simply when he asked me to. OK - 
actually this guy used an elbow crutch - might be 
different...


Overestimating  ability  is  not good and being
> overly fearful is
> equally  not  good.  With  continuing  practice, ability
> and fear should
> reciprocate  from  each  other, shouldn't they. But what
> if the person's
> continued  training  does  not  yield  decreasing fear.
> Some people will
> never get over their fear, right?

Yes, I also believe that to be true sometimes. Ideally all 
activities "should" be possible to break up in achievable 
bits, so you can work on the edge of your comfort zone 
(NUZO - or nearest zone of development, to translate the 
danish expression). But sometimes the support, or equipment, 
or whatever...., to hit that zone is just not there. Like - 
anyone remembers when there were no little bikes, and we had 
to learn to ride the big bikes of our parents? Or how 
difficult it was to learn roller-skating with those skates 
that you strapped onto your shoes?

Then there are of course infinite other reasons why Some 
people will
never get over their fear. I find it interesting to look 
deeper into motivation - sometimes there is ambivalence to 
be found. But I think this doesn't apply to your client, so 
will stop my ramblings for now:-)

susanne, denmark


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