The Universalities of Compassionate Care


Our lives can change in an instant, but with a community of people near and far, that change may be filled with love, hope, and compassion. One day, Adele was walking down the street in the Municipality of Villa Nueva, Guatemala when someone ran by and knocked her to the ground. She braced herself with both hands, but the force caused her right wrist to bend backward towards her elbow. Realizing the trauma to her right wrist, Adele sought medical treatment at a nearby hospital. After surgery and being in a cast for 2.5 months, she had lost mobility, function, and strength in her right arm and experienced nerve and skin damage. She read in the local paper about the presence of the Jairo Rodríguez Municipal Physiotherapy Clinic in Mercado Concepción, Villa Nueva and ventured out to learn more in the belief that she could get better.

Adele arrived at the physiotherapy clinic in February 2018 to the welcoming presence of Paty, a local Guatemalan physical therapist (PT). Paty listened to Adele’s story: the pain, struggles, and hopes. Adele could not straighten her arm and had lost strength and endurance from her shoulder to her fingertips. Her fingers were like wood, and she could not pick anything up. She went from being self-sufficient to relying on others to bathe, eat, and dress. This change in lifestyle was wearing on her physically and emotionally. She desired to regain full functionality and questioned all that had happened.

Over the next three months, Adele and Paty worked to progress and increase the functionality in Adele’s right arm. They worked on strengthening her shoulder and elbow and increasing movement in her elbow, wrist, and fingers. She experienced severe and continuous pain caused by the nerve and skin damage, which was being treated additionally by her doctor. After three months, she was progressing and able to straighten and bend her arm at the elbow and to shower, brush her hair, and eat. She was now at 90% function in her shoulder, 85% in her elbow, and 30% in her wrist and fingers that had minimal functionality in late February.

There was positive progression, but Adele still had a ways to go. She continued to struggle emotionally, which is common. When people experience the loss or change of everyday function, it can be difficult to accept and understand the impacts and limitations of the injury or disease. People also look for reasons and explanations for what happened and is happening from the injury itself, the treatment, and acceptance of a new normal. Therefore, treatment involves much more than assessing the direct, apparent physical need. It engages the universalities of compassionate care: presence, listening, eye contact, touch, and a smile.

Presence begins with the physical access to quality care found in the Jairo Rodríguez Municipal Physiotherapy Clinic. The availability of access brings to the local community hope and gratitude. They are grateful for the people near and far who are helping to maximize their lives with quality compassionate care. Each new sustainable clinic provides people like Adele hope and energy to overcome and pursue something greater in life.

Next, the presence of people listening and caring with touch, eye contact, and a smile transforms the lives of all engaged. Amelia, the APTA Senior New Media Specialist, sat down with Adele to capture her story. She listened to the pains, struggles, hopes, and gratitude for what had been, what was, and what could be. Amelia reflected on the impact the Clinic Development Program (CDP) participants had on the lives of those encountered by just listening and being present. She was humbled and energized by the opportunity to interact and capture the story of so many lives impacted by the increased access to quality rehabilitation care in Guatemala through these new clinics.

In listening to these stories, we also have the opportunity to expand our impact by connecting one with another. Amelia seeing Efosa, a core leader in the development and operationalizing of the clinic, introduced Adele and Efosa to one another. The connection provided another solid presence of care for the community and the people.

Efosa sat down with Adele and Amelia and listened to her story. He did not physically treat her but provided a caring presence as she explained her experiences with words, actions, and touch. Efosa then reassured Adele that the clinic was an excellent place to be as they provide quality, attentive care and collaborate with Move Together for additional support and resources. It is a bidirectional impact. As Efosa shares, we receive a gift “when people like this special lady, let us in on the journey of their life – a journey that is internal and external alike.” We not only touched her life, but she touched our lives, and we hope her story continues to impact the lives of many more.

Adele continued to receive support and care as she was treated by Gabi, a Brazilian PT working on her Ph.D. at the University of Massachusetts Amherst, and a local Guatemalan PT student. Again, the treating team sat down with Adele to listen and gain a comprehensive understanding of where she was. They asked critical questions to understand: how she was feeling, what was her role before the injury, and what was her role and function now. This allowed them to develop a plan of treatment and a method of communicating, what is and where things may go in terms of her needs and desires.

The pain and acceptance of the limitations present with the injury were limiting Adele’s progress. Therefore, Gabi and team developed a treatment plan that included desensitization techniques, accessory mobilizations, and adaptive home techniques. Desensitization techniques use different textures to create a stimulus to the affected area thus tricking the brain into perceiving the stimulus differently than a painful motion. Gabi engaged the local PTs in learning and awareness of different accessory mobilizations for increased movement and joint function in clinic treatment. Lastly, they explored adaptive techniques to assist in the performance of everyday tasks at home in a different way than before. Adele left very encouraged and hopeful for future treatment and continued progress.

A community of people came together as brothers and sisters, colleagues and teammates focused on the person in front of them: treating, teaching, listening and loving. The collaborative team approach of listening, connecting, and assessing Adele’s needs and concerns led to a comprehensive plan of treatment, multiple layers of engagement and reassurance for her, and increased knowledge amongst all involved on how to better treat Adele and future patients.

All of this came to be because of the presence of a sustainable PT clinic, the local PT community, and the extended Move Together family. Everyone is transforming lives through presence, touch, listening, eye contact, and a smile.

Thanks to all who have impacted another life with your engagement and support of Move Together and our affiliated pro bono programs around the corner and around the world.

We’d love to hear from you the impact of Adele’s story on your life. Please comment below and share with friends and family across social media and beyond.

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