Aphasia frustration

On my inpatient neuro prac I have been dealing with a 65 year old person who has had a L TACI and this has left her with expressive aphasia. anosognosia, gowland 2/7 in R arm and leg. She has been very pleasant to work with and has a good sense of humour and the only real words she says is "NO" and "DONT" which obviously are important for physios wishing to gain consent to treat. Anyway she has recently become agitated and due to her anosognosia has tried to stand and get out of bed which has led to some falls and she now is strapped into her w/c. This has increased her frustration and being unable to verbalise anything but NO and DONT she became very aggressive during a Rx session and would not allow us to transfer her back to her w/c.

This was an interesting situation as she wanted to get back into her w/c chair but would not let us assist and she was a falls risk if she attempted it herself. Fortunately we had some excellent guidance from the supervisor who had to take over and allow the patient to do their own transfer and our job was then to catch her as she fell and help her in her own way back to the w/c. This transfer would have been a fail any day in an OSPE and Ann Furness would have ripped some heads off but it was the only way to get her back without assaulting her. She now shows more respect to us as we did not force her to do it our way but her way and is now more cooperative with us. She still does her own transfer which is unsafe but for now we are just there to catch her.