How Rehab Therapists Help A Nursing Home Resident Regain Confidence

Home Resident Mr Azman bin Sawal with the Therapy Team (From left) Janet Oh, Aye Myat Su and Jason Ang

With patience, understanding and determination, the rehab therapy team at St. Andrew’s Nursing Home (Taman Jurong) helped and encouraged one resident to stay active and meaningfully engaged.

When 54-year-old Mr Azman Bin Sawal first arrived at the St Andrew’s Nursing Home (SANH) in Taman Jurong in April 2019, he had multiple chronic medical conditions, the result of two strokes, in 2013 and 2017.

This led to limited movements on the left side of Mr Azman’s body, and he also has oral dysphagia. He now relies on a nasogastric tube for feeding.

Moreover, Mr Azman’s left leg was amputated below the knee in 2017 due to complications from diabetes. He was understandably frustrated and experienced bouts of helplessness.

Introducing Therapy for Recovery

To help Mr Azman regain some mobility, therapy was in order. After an assessment, the Physical, Occupational and Speech therapists decided on an individualised therapy programme for the former interior designer. Their aim - to maximise Mr Azman’s ability to perform his daily activities. This includes encouraging him to consume food orally, improve personal hygiene, and strength training for his limbs to transfer from his bed to a chair.

In the beginning, Mr Azman was scheduled to have therapy at least once a week for about 30 minutes to an hour. However, the frequency and length of the sessions were mostly dependent on Mr Azman’s mood.

“When Mr Azman first started therapy, due to his physical state and care needs, he was often not in the mood and felt helpless at times,” shared Physical Therapy Manager Margaret Chua. It did not help that Mr Azman would occasionally experience pain in his hemiplegic side – weakness on one side of the body.

He preferred staying in bed, rather than engaging in therapy or socialising with other residents. Faced with this challenge, Margaret and team had to find ways to motivate Mr Azman to do therapy.

Finding the Breakthrough

The therapy team found a way in to win Mr Azman over: At a general group art activity session organised for residents, Mr Azman revealed his passion for Chinese painting.

“We felt we could motivate him to engage in therapy through his interest in Chinese painting. This will also get him out of bed, engage with residents, and work on his sitting posture,” explained Margaret.

Mr Azman’s wife, Mdm Mohaini Binti Abdul Majid, brought over his old paints, brushes, and name stamp, but the paints had already hardened and dried up. The Home got him new paints while a volunteer befriender gifted him a thick roll rice paper. In no time, Mr Azman was up and painting up a storm.

Therapy Assistant Jason Ang would assist Mr Azman during his weekly painting session, getting ready his paint, brushes and paper. Often, Mr Azman would experience cramps in his left hand, which Jason would patiently massage to ease the stiffness.

Building Trust and a Relationship

Slowly, the therapy team bonded with Mr Azman through his interest in art, followed by food and news. “On days when he was not keen on therapy, we would still engage him by just chatting with him and get to know him better,” said physical therapist Aye Myat Su.

It was through one of these sharing sessions that the therapy team discovered Mr Azman’s love for cooking. Mr Azman used to run an Italian food stall with his wife for two years. The team finds this as another opportunity to boost his self-esteem and at the same time, encourage him to chew his food.

They set up a cooking session for Mr Azman. The cooking station was catered for his right-hand use. After he displayed his cooking skills, the speech therapist persuaded him to try his own cooking and worked with him on swallowing the food.

By communicating with Mr Azman, the team found that he was able to trust them slowly, and were heartened to see improvements in Mr Azman’s willingness to participate in therapy.

Today, the once reluctant Mr Azman is happy to chat with anyone who is interested to learn more about his paintings. While he was once reluctant to speak due to excessive salivation, he now engages in lively conversation with his therapists. He appreciates the time and effort the team devotes to him and has even dedicated his cherry blossom painting to them.

Acknowledging his increasing interest in painting, the therapy team plans to give Mr Azman more opportunities to showcase his works by hanging them up in the ward and gym area.

Margaret is keen to find new ways to engage residents like Mr Azman. "We are heartened to see the changes in Mr Azman's mood and are motivated to explore other creative avenues to improve his overall wellness and quality of life."