Frequently in skilled Nursing rehabilitation we need to wear many hats to achieve the goals set out for our residents. We need to be the compassionate ear, the fixer, the teacher, and the cheerleader.
Every resident we work with needs some combination of all thoses roles we need to play. The more we can listen to them and do our best to fix problems, the more of a relationship we develop and helps to build trust. This trust is imperative to push beyond the comfort levels to achieve physical gains. They need to have trust in us that we will do everything in our power to keep them safe when they attempt to stand or walk.
The Compassionate ear
We need to show true caring and compassion with everyone we interact with. We need to actively listen to the residents to help them to make the great leap of trying something rather scary.
No one chooses to get into rehabilitation. It is the unfortunate accident or illness that leads them to the hospital and eventually to us to make a full recovery. There are many aspects of trauma associated with the event. In order to get by the trauma we need to be active listeners and assure them that they are not alone, the harder they work the better they will be, and it’s natural to be aggravated and sad. They need reassurance thet the emotions they feel are completely natural.
Unfortunately even though this is prevalent with most of our residents upon admission, but this can be compound even more with the holiday season. It is even more traumatic to realize Christmas will not be the same this year.
The Fixer
You would be surprised how much this role can make a tremendous difference in outlook and outcome of your residents. Because we work in all aspects of the nursing home it is easier for us to know who and when to talk to to get things “fixed”. A little bit of effort can go a long way for something as simple as making sure a good hot lunch happens, or the TV remote has new batteries, or the paper towel dispenser is refilled. Simple fixes that we can do, or at least know who to talk to to make sure it happens can make a huge difference in the relationship we are trying to establish. If we can take a moment to grab something from the kitchen, then you know we are going to help get you to where you want to be functionally. It just makes it easier when we ask them to try for one more lap walking or to add another pound of weight to the exercises.
The teacher
This aspect is the actual nitty gritty of therapy intervention. We are teachers guiding them to return to their prior level of function. We are teaching the right exercises for the right muscle groups. We are cueing with our words, hands, or demonstration the proper performance of exercises to maximize ROM and muscle recruitment while decreasing the risk of injury from poor performance
We are teaching the proper techniques of how to roll in the bed, to transfer from the bed to the wheelchair, to get bathed and dressed. This is the whole essence of what we do and work towards the goals established on evaluation of what needs to be done to accomplish the ultimate goal of return to home. Without establishing a good relationship there is less buy in to the established plan of care and a delay in goal achievement.
The cheerleader
Every small gain must be celebrated and encouraged. We need to be giving the applauds, the high fives, the pats on the back. All the positive reinforcement you can muster needs to be utilized. Rehabilitation is hard work. This is true for relatively healthy and young individuals. It is even harder for geriatrics which have many multiple co-morbidities and limited energy levels.
We need to fill up their bucket of positive thoughts with every bit of praise and encouragement we can muster. This will be the fuel needed to push their limits.
A well rounded approach
The more successful we are at our approach the better our outcomes will be. Positivity breeds more positivity and will help you guide them to their goals as well as give you as a therapist a wonderful feeling of accomplishment and pride. So don’t be bashfull and “put out your couch” and be the therapists you know you can be.
