gerontology

I am currently at a gerontology outpatient and my patients normally have balance, fall history and short term memory problem. Recently a lady came to the clinic with her husband. The patient has same problem as other patient such as balance. She also has heart problem that reduce her endurance. It was not first visiting for her to the clinic. She came in Jan and Feb in this year and refused further treatment and management for her balance because previous physio introduce using 4 wheel walker to her but she thought she didn’t have any problem with her balance and walking.
It is clear that she has poor balance and poor endurance of her cardiovascular system from the result of Berg scale and from her medical history. Her mobility capacity is very low such as walking distance and she has potentially 90% risk of fall resulted from Berg scale. Currently she has used a walking stick that improves her dynamic walking balance. However, her balance is still not steady enough. That’s why a previous physio introduced her using 4 wheel walker that allows her much safer than her stick and her to sit on the small seat of the walker when she feels short of breath. She declined at the time and didn’t come to next session.

I am very sure she needs to start using more stable and supportive walking aid that reduces her risk of falls. On the other hand, I caution that she refuse and is not coming to a treatment session again. That’s why I didn’t mention anything about her walking aid in first session with me. I am planning to introduce a 4 wheel walker again after 2 or 3 treatment sessions.
If you have any good ideas please shear with me.