Rose-Colored Rehab Glasses
I like to see our patients succeed in therapy and I encourage them with continued success so they achieve what they set out to do. But there are some patients who do not have the endurance, strength or ability to achieve what we have set before them, or what they have set out to achieve. I talk with the PT about changing goals to suit the patient's current ability and then I hope to see a difference in progression even at a diminished level and throughout our sessions I still encourage the patient. Sometimes I am too optimistic and would like to see the patients do more.
Two people come to mind. One a CVA who initially refused all therapy services before he decided he wanted to go home. It is never too late to go home; however, this patient lacks fundamental skills of core stability. If he had participated with our program sooner he would have better trunk stability and require less assist with scooting and transfers. Now that he decides he wants to go he requires a lot of time, energy and encouragement to participate. I don't mind this but if he does not practice the skills he has learned, it will be more difficult for him to achieve his goal. I think the reality of harder work is setting in and he is becoming discouraged with the progress.
The second patient came to us and again initially refused services. When he finally agreed, participation was at the minimum amount possible to say he did it. Then he tells everyone we are not doing enough for him and he is in pain every time we try something different.
Throughout therapy I continue to put on the coach face with semi-tough discipline and encouragement to get the best out of every session. Some days it works better than others. Or maybe my glasses are fogged and I am not seeing what the patients really desire.