How to Know if an Elder's Physical Rehabilitation Program is Good

When seniors need rehabilitation therapy it is often the result of a significant medical incident that drains the senior of strength, energy, and the ability to perform self care tasks. Due to the nature of needing rehabilitation therapy, many caregivers are overwhelmed with the stress of it all and challenged by communication between the health care providers and the family.
As a health care professional I know the jargon, lingo, and pace of elderly health care can be a challenge to understand and manage well. There is often an acronym for everything. What rolls off the tongue of a patient's doctor, nurse or therapist ends up sounding like Charlie Brown's Mother to many. This challenge in communication and unfamiliarity with what should occur can make it difficult, if not impossible, for a family to know what is appropriate and if the treatment interventions are effective. Here are a few questions to answer in determining if your elderly loved one's rehabilitation therapy program is as effective as it could be.

Difficulty: Challenging

Instructions

Things You'll Need:

• Pen/Pencil
• Paper
• Time to consider current rehabilitation challenges

1. Ask Yourself: Is your loved one making progress in the therapy program? This is by far the most difficult rehabilitation therapy challenge to manage. The challenge for rehabilitation therapists is to meet a patient at their current level of performance and build their skills and abilities from there. Patients recover at different rates and respond to treatment interventions with varied outcomes and time frames. If your aging loved one is not progressing the therapists and treatment team should evaluate if the therapy program is too difficult, if the program needs different activities, or if activities need to be presented in an alternative way. For example, patients with head injuries and hearing difficulties may be affected by the noise level in an environment. For a senior with a head injury or stroke, a noisy environment can be a distraction and limit his ability to focus on the task at hand and perform well. On the other hand, a patient with hearing difficulty, may have not problem ignoring the noise of an environment but at the same time may be unable to understand and process all verbal instructions of the therapist. This may give the impression of being unable to perform well when perhaps the hearing impaired patient simply needs a quiet environment and physical cues (gestures) in addition to verbal instruction.
   
   TIP: If your loved one's abilities are not increasing with the therapy program talk with your therapists consistently to discuss alternative ways to tailor the program for maximum success. Keep in mind that if Medicare is paying for your loved ones care in a rehabilitation center, the general expectation is consistent and measurable progress on a weekly basis.

2. Ask yourself: Does your aging loved one appear to struggle with the therapeutic activities? The initial goal of rehabilitation therapy is to establish a baseline level of performance - that is to identify what your aging loved one is able to do now (after an illness). The therapy program is designed to return your loved one's abilities to the level of performance that existed before the illness. If the therapy program is challenging - always moving forward to a higher level of complication or difficulty -you will notice that your loved one is adequately challenged until he or she reaches her previous level of performance. When your parent or loved one is at his or her previous level of ability, your therapy program has achieved its goal.
   
   TIP: If you find the activities your loved one participates in are easy for him or her to complete, talk with your therapist and ask her to suggest some activities that may be more difficult and challenging for your loved. For example, if marching in place is very easy for your loved one while sitting, ask the physical therapist if she can work more on marching in place while standing or ask her to provide more challenging exercises in sitting if standing is not appropriate.

3. Ask yourself: Does your aging loved one feel engaged in the therapy program? If your loved one complains of not being interested in the types of activities performed during therapy it may be an indication that the therapy program does not include enough activities of value for your loved one or perhaps your therapist has not explained the therapeutic value of the activity. We all prefer to perform tasks that we enjoy. Patients in therapy would rather participate in therapeutic activities that have meaning and value than activities that have no significance to their personal concept of self and preferred interests. If you dad was a pipe fitter before he retired, your occupational therapist may want to work on hand control by including tasks that involve assembly and the use of tools. Your dad may find it more interesting and participate more fully.
   
   TIP: Clearly communicate your parent's interests and preferences to the therapists during the evaluation and on an ongoing and supportive basis. If you position yourself as a resource of support to help your therapists build a relationship with your parent, your input will be welcomed and often sought.

Tips & Warnings

• When talking with your rehabilitation therapists, reinforce your presence as a support and information resource.
• If challenges arise, remember the wisdom of honey versus vinegar.
• Most therapists are professionals in title and disposition, first speak with your therapist to collaborate rather than complaining to management.
• If you don't get results after all your diplomacy, talk with management and consider moving elsewhere as appropriate.
• Get impartial advocacy and professional advice if necessary.