Is the person cleared to work with you? Do you have any recommendations from their healthcare providers? If you are ready to go, start small and adjust to what you observe and the client tells you. Let the clients reaction to every progression guide you.
I would start with ROM movements without added weight. Arm/Upper body movements can be done sitting down (as necessary). Sitting down and standing up is very useful. A variety of leg motions can be done with hand support on the walker, a chair, ect. (make sure it is stable). Be sure to cue the client very clearly. Try not to talk too much while they are doing the exercises.
Be cautious, everyone is different and will react according to how they function and respond.
Update on this client. I now have him up and walking with a walker up to about 40 feet! He is using a 2lb med ball and light bands for training in all planes. As well as working on weight shifts, gait work and balance. We have made HUGE progress and he is very happy and feels very motivated and did NOT want to go to the PT’s who he felt they were not very nice to him.
As for calling him extremely frail, that is what he was when we started, however he is quickly building back up into a self functioning and confident senior that he once was before he became so ill. I would never refer to him in that manner to his face, however to explain his situation to a group of professionals, this is what his situation was, I felt this was the best description.
I have been in constant contact with all of the professionals such as his Doctor, nurses and anyone else who needed to discuss his case with me at all times. They have all felt I was the right person to work with him as I have gained his trust.
You know, it kind of irritates me when ego gets in the way and people judge you without knowing the complete situation. I honestly asked a question and felt like I was being berated immediately. I have been in this industry since 1998 and know the rules and follow them to the letter! My clients mean everything to me. I would never do anything to harm them, in fact I might be a little too conservative.
There was a lovely lady who wrote a response that has not been posted yet and I would like to thank her for her kind words. I have done all of the things that you suggested and yes, he is doing great!
I did get your note Ida and it meant the world to me! Thank you! Encouraging does so much more than discouraging. Something to always remember when working with clients as I’m positive you know, my friend.
Take care and let’s keep doing what we are so passionate about doing, helping other’s with an open heart.
For clients who don’t have much strength I would recommend my own program of Chair Dancing® fitness. It is an all seated program that gets everyone moving no matter how much strength they have. Once your client gets a bit more strength they can add some hand weights if needed. It is fabulous that he has been able to walk that far, congratulations for all your hard work! good on you for keeping all his doctors and nurses in the loop, you are doing a great job!