Saturday, October 31, 2015

5 Simple Ways to Motivate Your Patients

What motivates you?

Motivating yourself to continue moving forward during tough times can be a challenge.  Believe me, I know! But motivating a patient requires a little more finesse.  I realized that this week as I was talking to a patient and his wife.

Until he had a stroke in September, Mr. H was working full time as a business consultant. He's 81 years old, and maybe you know his type? He's focused, driven, and no nonsense. He looked me right in the eye and asked me, "How long is this going to take?"

My first thought was to tell him, "Forty minutes." Then I realized he didn't want to know how long the treatment session would be, he was looking for something more. My next thought was, "You have 12 scheduled visits." No, that's not it. "There are 60 days in each home health certification period." I sensed that was not the answer he was looking for.

As my mind scrambled to formulate an answer, his wife chimed in, "He's really down in the dumps. He thinks he's not making any progress and can't understand why he's not getting better any faster."

Well, bring out the pom poms...we've got some motivating to do!

The question is, what motivates an 81 year old man?

Stickers, Goldfish and M&Ms might keep kids happily coming to speech therapy week after week, but Mr. H, like most adult patients, needs something more. Here is a short a list of my favorite ways to motivate adult patients.

5 Simple Ways to Motivate Your Patients

Show them:  
  • Quickly calculate percentages of accuracy at the completion of a task and/or show the percentages of accuracy you have recorded at the end of a session
  • Share daily notes or weekly progress reports- compare the numbers recorded from day to day or over the course of a week
  • Review percentages of change upon reassessment and again upon discharge- it's a quick and easy way to assure the patient they are making positive progress

Record them:

  • Snap picture to capture an image of:
    • oral weakness
    • facial droop
    • poor posture
  • Use audio recordings to capture:
    • vocal quality
    • volume
    • intelligibility 
    • fluency  
  • Use video to record performance while speaking or eating

  • A smart phone or iPad is all that you need to:
    • increase awareness
    • improve self monitoring
    • judge progress as treatment continues
  • Be sure to ask permission before making any sort of recording; most people will agree if they know the images/ recordings will only be used in their treatment sessions
  • Save the recording for future comparisons- patients are often amazed when they see or hear themselves before and after 

Encourage them:
  • During practice or upon completing a task, when they get it right, phrases like good, that's right and nice job, are appropriate from time to time
  • When they come close but don't get it perfect, you can give simple encouragement by using phrases like better, good try and you're getting closer 
  • At the end of a session, at the end of the week, or whenever you see fit, a short discussion about progress toward goals or functional improvements is appropriate to keep patients trying their hardest during therapy...See, you are getting better.

Teach them:
  • Patients and family members like to be informed, so provide information regarding short and long term goals- it's good to know what you are working toward and it's even better to know that you are making positive progress
  • Provide education to keep motivation high during treatment sessions:
    • the purpose, meaning or rationale of a task
    • the functional importance of a skill 
    • the relevance of a therapeutic activity or exercise
  • Discuss disease process(es): 
    • a general understanding of their disease or disorder keeps them realistic about what to expect during the healing process
    • tell about the typical progression toward recovery- it's going to take some time
    • share information about promising new research and recent studies- Neuroplasticity!  
  • Teach them the basics of therapeutic progression- look at it as a means for measuring progress
    • levels of assist: min, mod, max, etc. 
    • types of cues and/or prompts: verbal, tactile, visual, semantic, phonetic, etc.
    • levels of acuity:  normal, within functional limits, mild, moderate, severe, etc.
  • Therapists have a knack for observing progress so discuss the many different ways to measure improvement:  faster, slower, louder, smoother, safer, more often, less often, etc. 

Talk to them:

  • Without getting too wacky, discuss the importance of positive self talk- encourage a change in mindset:
    • I'm working on it
    • I'm getting better
    • I can do this
  • Tell them success stories about other patients you have worked with

A short pep talk and a new perspective on measuring progress worked wonders for Mr. H and his wife. They now better understand the process of brain reorganization and the complexities of recovery following a stroke. Both are moving forward with anticipation of progress.

Proper motivation can be the key to getting the most out of your patients. While each patient will have their own unique needs, if you focus on keeping your patients motivated you will help them reach their highest potential.

Instruction does much, but encouragement does everything. 
Johann Wolfgang Von Goethe