The Family Motivation
There are many motivating techniques as PT/PTAs we can utilize with our patients to encourage participation and compliance with their plan of care. I like to think my ability to discuss a wide range of topics (Halibut fishing? NFL stats? Crochet patterns?) can angle me into getting an extra ther-ex set of mini squats. Despite my varied repartee with patients, I've found nothing as truly motivating as having family present during a session.
Having worked with the young 18-30-year-old to the end-of-life geriatric patient, I can tell you from my experience, when a spouse, parent or child is observing or in many cases participating during the treatment, the patient (in most cases) exerts more energy and simply tries harder than if it were a regular one-on-one session. This does not exclude patients with cognitive impairments. I've seen patients with advanced dementia, who are typically agitated and nonverbal become (physically and emotionally) calm and even carry on conversations with their family members. This results in a vastly more productive therapy session than the average with that person.
With a few beautiful exceptions, most patients don't have family members present during their daily treatments because it just isn't realistic. Most patients have therapy 5-7 days a week and their close family members work or often don't have transportation to the facility (this is a major obstacle for spouses who don't drive anymore). When the opportunity arises and a family member happens to visit during the patient's scheduled therapy hour, I highly encourage that person attending. Often family and friends feel like they're "intruding" or "disrupting" their loved one's therapy session. I'll take that opportunity to educate the family on the importance of their presence and encouragement.
Unfortunately, there are instances where family members are so incredibly uncomfortable witnessing their loved ones weak and ill -- they can't leave the patient's room fast enough as I enter to begin therapy. But when the opportunity arises, those family and friends can be incorporated into a therapeutic session. I never pass up the chance to suggest they observe or, even better, encourage them to participate in the therapy session. The cathartic love that family brings into therapy can be the most successful tool for a person's recovery.