Physiotherapists play a key role in the lives of disabled New Zealanders including those suffering from neurological conditions.
They help people to manage their physical limitations and re-learn, re-train and improve their ability to move their bodies.
But a physio is often one cog in a large team of professionals who are working to help an individual. To help celebrate World Physio Day, we spoke to JANE FAIRBAIRN about what a physio’s role is and how Occupational Therapists, carers, doctors and family members can make the most of their expertise.
Who does what?
Jane Fairbairn has worked as a physio in Wellington for almost 20 years, and specialises in working with the elderly and those with neurological conditions like Parkinson’s Disease.
She says the team of people working with a client can “potentially be huge” (especially under ACC), and communication is vital to figure out what the real issues are, what goals are realistic and who’s going to carry out what part of the treatment plan.
“I think we’re really lucky that most physios and OTs understand each other’s role so well that we can do that initial assessment and go ‘yeah there’s heaps of OT stuff here, not so much physio’ or vice versa. At that point you can make a plan to work towards the client’s goals, the client’s needs and what’s also realistic before taking them on that journey.
“There’s often lots of communication between the different professionals saying ‘actually we’ve got heaps of issues with this… I need you to do more on that, so I’ll pull back for a fortnight.’ It’s important to have lots of understanding between physios and OTs on how you can work together to get a greater outcome for your client.”
While there is a lot of cross-over between these two roles, physios can be regarded as movement specialists, while OTs help apply that movement to purposeful and meaningful activities. They also ensure the appropriate equipment is in place and the environment is safe for the task at hand.
Jane’s tips for fostering a great working relationship between these two professions include trusting each other’s skills and following your intuition.
“When you think you need to talk to someone, you probably do need to talk to them. A problem shared is a problem halved. If you’re worried about what’s happening for a particular client, chances are your colleague is too or they can shed some light on the matter.
“Recognise your fellow OT or physio’s strengths and use those. Tap into the support and clinical knowledge they have got to get a better outcome for the client.”
Jane acknowledges that liaising with GPs and specialists can often be more difficult due to their different demands and schedules. “They’re not always lucky enough to spend an hour or two in someone’s home to really see what’s going on. It’s about checking in and telling the GP what you’re seeing and why you’re worried and often it’s a trigger for them to go ‘oohh okay I didn’t know that’ and off they’ll go. It can be a great team when you pull everyone in and get them to help.”
Advice for carers
Physios have an important role to play in terms of educating and advising carers and family members who often spend more hours with the client than anyone else. Jane says it’s important they’re on board with whatever rehab programme the physio is trying to implement.
“It’s very easy to say ‘we need so-and-so to be walking’ but if they’re getting from A to B dragging their foot or sliding along the wall or overloading their walking frame, you’re not actually training good muscles, good posture, good movement. So if we can teach the carers the ‘why’ and the ‘how’ of what we’re doing, then they learn from that client, and nine times out of 10 they apply it to another client as well.”
Another piece of advice for carers and family members is to understand a client’s effort doesn’t always equate to their output, Jane says. “I always advise carers to ensure their feedback is about the effort and not only a quantitative assessment of what someone has done – whether they’ve done 10 steps or 200 steps, if they’ve spent 15 minutes concentrating and trying and working really hard, that’s what’s important.”
In terms of working with disabilities, a great physio is one who can actively listen to clients and read the situation at hand. If someone is reluctant to do their exercises, it could be because they’re afraid of looking vulnerable – not because they can’t physically do them.
“Truly listening to what someone is saying and then having that sensitivity to work out the how and why is crucial,” Jane says. “It’s a really private, personal thing to let someone in and share with me what they’re worried about and what’s hard.”
Physiotherapy is an extremely rewarding career and it’s a path Jane is thankful to have followed. Helping someone to regain their balance or improve their mobility allows people to re-engage in activities that give meaning and purpose to their lives.
“You meet the most wonderful people who have been dealt the toughest hand and you just learn so much about their grit that keeps them going. It’s a joy to help them because they deserve to be helped. I feel spoilt to have time with my clients and learn from them all because they’ve all got something to teach us.”