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Discussion

Conversion disorders you have a patient with conversion disorder and she believes she need

If you have an elderly patient that has conversion disorder and she believes she needs a wheelchair, do you allow her to have it when she's transferred on the floor?

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    I don't know about adults, in Peds the one time I've had a kid with a conversion disorder, the MD told me I had to make him walk and no pain meds not even Tylenol. That's what I did.

    He even put it as a communication order :D

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    • Experts

    True conversion disorder is fairly rare, in my experience, and I have seen it misdiagnosed at times for example when a neurological condition such as Multiple Sclerosis was not yet being picked up on diagnostics such as MRI. Unless as in the case of the above post where the provider orders no assistive device I would be hesitant to refuse a patient a wheelchair even if only to reduce psychological stress/anxiety during their hospitalization.

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    Let her use the wheelchair. If she has a true conversion disorder in which she can't walk, she really needs the wheelchair. Her brain is avoiding a stressor and she really can't walk. She's not pretending!

    If she's just attention-seeking, you're giving her more attention by refusing to let her use the chair than by just letting her use it.

    Consider the rationale for refusing. What's the expected outcome? Is it likely? Will it make things better or worse?

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    • Experts
    Let her use the wheelchair. If she has a true conversion disorder in which she can't walk, she really needs the wheelchair. Her brain is avoiding a stressor and she really can't walk. She's not pretending!

    If she's just attention-seeking, you're giving her more attention by refusing to let her use the chair than by just letting her use it.

    Consider the rationale for refusing. What's the expected outcome? Is it likely? Will it make things better or worse?

    This ^^ -- Plus, if you don't let her use the wheelchair, you're likely to end up dealing with the consequences of a fall.

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