A Patient Resisting Wheelchair Use on an Ongoing Basis.
Caregivers are often involved when a senior comes home from a hospital or nursing facility. Resisting wheelchair use can cause a difficult time of transition for both the patient and the caregiver.
The stress of being under treatment and recovering from an illness or injury can be quite a burden. The stress of adjusting to caring for a person who has been sick and is now coming home to need care and extra attention there is an added stressor to the caregiver also.
Often, a patient is introduced to a wheelchair at this stressful time. If they haven’t used a wheelchair before, this introduction may come as a shock to the patient.
Have a bad attitude about wheelchairs
I have been with a patient who was recovering from a stroke and could stand only momentarily and heard her declare loudly, “I will never use a wheelchair!”. She was resisting wheelchair use but unfortunately, she had to use a wheelchair, since she could not walk, and could not be carried everywhere. She was forced by circumstances to gradually accept using a wheelchair. Spending a little time introducing a wheelchair to a patient is time well-spent.
While the caregiver regards a wheelchair as a necessary and useful tool for moving the patient, the patient often has a completely different and very negative perception of it. A caregiver may be puzzled by this attitude.
What’s the problem with a wheelchair? It’s just a piece of furniture. It helps me move you around. So, what? What’s behind this negative attitude toward your wheelchair?
What’s behind this negative attitude?
Resisting wheelchair use may represent something much more profound to the patient. Put yourself in the patient’s chair, and think about these perceptions:
- A wheelchair is a public announcement that I am a sick, elderly person, and I reject that perception of myself. I reject my illness and my aging.
- Using a wheelchair means I am dependent and incapable. I reject that perception of myself. I reject being disabled.
- Others will think I look ugly, sick, old, useless, different, etc. I don’t want to be regarded as any of those. I don’t want to be rejected by others, and avoided by them.
- I am mourning my loss of health and independence. I see the wheelchair as a symbol of that loss. I reject my losses.
- Using a wheelchair means that I have lost my independence and my dignity as a capable adult. A wheelchair is a barrier to my independence, and I reject that.
As a caregiver, I can understand the patient’s fears, worries, and anger when I see things from his point of view. We can sympathize and we can acknowledge the emotions behind this resistance to using a wheelchair, particularly when wheelchair-use will be a permanent change to one’s lifestyle.
So, how might a caregiver help a patient accept using a wheelchair?
Listen to the patient. What’s important to him or her: appearance, opinions of others, dealing with emotions around the loss of health or loss of independence? Try to determine the basic issues and move to address these.
A social worker at the facility, a pastor, a friend, or another wheelchair-user may be among the best people to counsel a patient and reassure them that they have a future that is worth living, and a wheelchair does not take that future away.
Get a positive assessment of the patient’s condition from the doctor, a physical therapist or an occupational therapist. In other words, don’t ask what the patient can’t do, ask what the patient CAN do presently, and identify some goals. Share this information with the patient, or ask the professional to have a talk with the patient about this. Getting a hopeful outlook on the future is contagious.
Educate the patient about using the wheelchair. The patient should be taught and be allowed to practice using the wheelchair to the best of their abilities. Ask the nurse or therapist to demonstrate and to let the patient learn. You may listen and learn too, but insist that the instruction is geared to focus on the patient using the wheelchair safely and effectively.
Encourage, but don’t force.
Keep the wheelchair nearby, and make time and efforts to make using the wheelchair something the patient can gradually learn to accept.
Yes, using a wheelchair, especially on a long-term, permanent basis, is a big change in life. It requires adjustments in many ways for both the patient and the caregiver. Be aware of the emotions that a wheelchair can provoke from a patient who has never used a wheelchair before. When resisting wheelchair use ease the transition by communicating, educating, and focusing on the positive in the situation. Caregivers and their attitudes can greatly influence a patient’s acceptance of wheelchair use.