During one of my treatment sessions this week, I had a patient who I have been seeing now for the third week of my prac. She is motivated, fun and friendly person. This week wasn’t the case.
During the session with her, another patient turned up in NOP clinic and began his prescribed exercises on the plinth next to us, so we ended up working on the same double plinth area. I have noticed a sudden change in my patient’s concentration level and quality of her performance. She looked very distracted and uncomfortable. Then she turned towards me and starts pulling all different faces, nonverbally letting me know that the patient next to us stinks and she cannot handle it. To make things more complicated she has an expressive aphasia and all she did was pulling her face in all different directions and squeezing her nose, as the smell coming from him according to her was unbearable. I would have to agree with my patient, as this man was smelly, although I do not agree with the attitude my patient had.
As funny as it may seem, it was quite uncomfortable for me, I had to stay professional and somehow redirect her attention, to prevent from the situation getting out of hands. I thing this poor man picked up on my patient’s body language and what she was trying to say to me. The good thing I suppose was that man didn’t get angry and got in to the fight with my patient. He was just focused on his exercises trying to ignore my patient.
To my luck after fifteen minutes of this uncomfortable situation, another plinth got available and I politely asked my patient to move there. My excuse was, I wanted to set up another exercises for her there, and that over there she would need to have more space for this particular exercise.
I am just wondering if that man was my patient, how I would have dealt with his bad hygiene? Any thoughts or a suggestion guys the best way you would approach someone with a bad hygiene?
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2 comments:
Hi Vaidas,
I agree, telling someone that his or her body odor causes an uncomfortable reaction in everyone else's olfactory system is very hard. I used to treat a patient whose feet were that smelly that you wouldn't want to get closer than three meters to him.
One way of trying to touch on the subject is offering the patient to have a shower before physio treatment (if the facility offers this service). You can explain to the patient that you understand that coming to physiotherapy is an exercise in itself and that he might want to freshen up before he is starting with any sort of exercise.
Some people are very aware of their body odor and just don't know how to handle it. Those people might actually be quite happy if you touch the subject and have some ideas about how to prevent a bad smell.
And others just don't smell that they smell...as it happened to be the case with one of my flat mates a couple years back. But if you realize it is affecting the climate in the outpatient gym the best way from my point of view is to talk to the patient and see if anything could be changed.
Good subject and I think this is one of the challenging ones we come across in our role as physiotherapists.
Edith
Hi Vaidas,
I can sympathize with where you are coming from as it is a rather uncomfortable situation you have described. I once had a patient who used to come into the NOP clinic I was working at, more than 30 minutes prior to the start of our sessions. He used to run stairs, hop on the trampoline, use the bike... all of which in track pants and a heavy t-shirt... in the middle of summer! By the time our session started and he removed his socks and shoes so that I could SIMM his feet and calfs, the smell coming from his very hot and sweaty feet was more than I could bear. I was lucky in that the first time this happened I had noticed he hadn't done a prolonged stretch for his calves on the wedge. So politely, I asked him if he could do a prolonged stretch on the wedge first with his shoes off and that after 10 minutes I would begin the session. He was happy to do that as he had + + tightness in his gastrocs/soleus, and I was happy as it gave his feet time to "air out". After that session, he got into the routine of spending the final ten minutes of his "warm up" just prior to our session on the wedge in bare feet.
Hope that helps!
Meg
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