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| Rebecca Dutton Home After a Stroke |
Writing a book about my stroke experience taught me the power of story telling. Readers need to understand why they should care about what I do. So I didn't start by describing how to put on a bra with one hand. First I wrote about clothes that don't fit because my breasts are closer to my waist than I ever thought possible. Then I wrote about how I would feel about saying "I'd love to come to dinner if you hook my bra when I get there." I live alone in my own home so donning a bra enhances my social life. Describing how a problem affects my life reveals the anchor that makes therapy personal. An anchor is anything people want so much that they are willing to work hard to get it and keep it.
Therapists write ADL goals because this is how they get insurance companies to pay for our care. They also think about deficits because how they treat one deficit like muscle weakness is different from treating another deficit like visual neglect. Having a stroke helped me understand why clients have a different point of view. For me dressing skills and grip strength are methods not goals. Rehab gains have to make things I want to do easier.
A statement that links a functional goal to a personal anchor can make everyone happy. One example is "independently don a bra one-handed + so I'm not embarrassed when I eat dinner with friends." Clients and caregivers need a crystal clear understanding of how goals that therapists write for insurance companies makes their lives better. Gains in therapy don't feel personal if therapists don't encourage clients to share their concerns. Clients and caregivers should tell OTs what they really want and stop worrying that their concerns may sound trivial. After being kept inside for four months, an OT can motivate me by linking any therapeutic activity to sitting on my patio to watch the sunset. Living life to the fullest means turning "I should" into "I want to."
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