The dreaded questions!

I was on my geriatric placement at the Moss st centre, which is apart of Fremantle Hospital. The Moss st centre provides patients with an allied health team (consisting of physio, OT, clinical nurse, GP and on occasions - a speech pathologist) and is considered to be the Parkinsons centre south of the river, therefore, approximately every 2nd patient that you see as a physio student is a Parkinsons patient.

Many of these parkinson patients usually come back for their annual check - up as we apply objective tests, such as TUG, 6 min walk test and berg balance, and compare them to how they have gone compared to their results from the previous session, approx 12 months before.

One of my first patients that I treated on my clinic was a very active 67 year old male who only had just been recently diagnosed with parkinson's approximately 4 weeks beforehand. I was halfway through completing the berg balance tests with the patient when he looked across the room and started to watch another parkinsons patient go through the same testing process. This parkinsons patient had been diagnosed for about 6 years and was really starting to struggle with the harder aspects of the berg balance tests such as single leg stance. It was then my patient turned around asked those two dreaded questions, "how long do I have until i start becoming like thaat guy? and how long do I have left to live?" - the awkward questions that you hoped no patient of yours would ever ask.

My facility supervisor was watching the treatment session up until this point and came and sat on a chair next door to me as i began to explain. After explaining to the patient about the usual things such as everyone is different, there are always other factors, course of the disease is unknown - you could tell that the patient was getting frustrated as his two qestions were not getting directly answered.

My facility supervisor helped out with a similar explaination - but it didn't seem to help. After the end of the session, the patient walked out of the centre and you could tell that he was frustrated, not knowing what the disease will do to him, both physically and mentally.

It's one of those hard situations, the only thing you can do is explain the pathology and how it progresses as there isn't a one word answer to the question of how long do i have to live? You can't just say - ok approx 6 years - as there is far too many factors that need to considered and it goes onto the old cliché that "everybody is different".

My supervisor explained to me that I did quite well despite the situation but you start to wonder what else you could have done and how else to explain it. She went on explaining to me that she says those particular questions are the hardest questions to answer as there usually is no answer to patient that will make them feel happy. Have any of you guys ever come across any of these "dreaded" questions? Would be interesting to see how you go about it.