Working with the noncompliant patient
Being that Ms. Alma Faulkenberger is 85 years old, she has most likely had many interactions with healthcare staff that may have led to her this non-compliant, difficult way of thinking. “A participatory relationship between patient and physician appears to be the most important factor promoting medication adherence” and that “the more actively the patient is involved, the higher the level of adherence and the greater the chance that the patient engages in healthy diet and exercise behaviors” (Kleinsinger, 2010). Research has shown that open communication, quick responses and creating a trustworthy relationship will help the patient remain compliant with their plan of care.
I would start my interaction by introducing myself, apologizing and asking her how to pronounce her name. Then to develop a plan for Ms. Alma to be compliant with the procedure and post-treatment, it is important to assess her needs, and include her in the planning. Opening the floor with open ended questions and allowing her to voice her opinions and needs/wants is a method that enables her to feel included in the plan of care. I would use this time to discover any barriers in learning such as difficulty hearing, unable to read, living situations and needs at home. I would ask how she learns best, reading, written or demonstration. After assessing her and asking her questions, I would then use what I discovered to implement education. I would ask her to teach back what she has learned. It would be best if this teaching were done with a family member to help with coherence to the plan.
Kleinsinger F. (2010). Working with the noncompliant patient. The Permanente journal, 14(1), 5
To help Alma be compliant with the invasive pelvic procedure and post-treatment medication, the health care professional must develop a plan. The first step is providing therapeutic communication. Explaining the logic behind the plan, understanding the patient perceptions of the treatment and procedure, and talking about any problems with the post-treatment plan is important to have an effective plan (Falvo, 2011). Asking her about her family and other significant people can help aid in the education efforts as well. Being specific and providing printed handouts can help with the higher level of education needed for an extensive procedure and treatment. Being a positive influence on patient adherence is a great skill of health providers to have. Building a relationship should also be part of the health professionals plan to assist in Alma being successful in procedure and post-op treatment.
Then, another step in the plan should be to meet the patients individual needs, if that patient wants to go biking again, we can work with her to ensure she can do that in 6 weeks after post-op for example and maybe collaborate with PT/OT to get here there. Same with finding out a medication regimen that works best for her every day life, if she has a book club at 10am every Wednesday, but you ask her to take it at 10am she may skip doses. The plan should be holistic and use communication and creating a relationship with the patient for it to be successful. Meeting the individuals needs with their strengths and being aware of weaknesses is also important. In patient education, the health professional should talk calmly, clearly, and slowly. Providing follow up questions and really taking the time to listen to Alma is very important. Using all of this into the plan of care, Alma’s pelvic procedure and post-treatment medication should be successful.
Falvo, D. R. (2011). Effective Patient Education: A Guide to Increased Adherence. Retrieved from https://viewer.gcu.edu/RQBKXW