Research suggests that patients’ satisfaction with brain rehabilitation can be enhanced and their recovery can be enhanced by their involvement in setting meaningful and customized goals. However, how can you ensure that the objectives are practical—that is, that they directly connect to activities that patients need and desire to engage in outside of the clinic? This blog post provides examples to support its points and demonstrates how to connect those dots.
A key component of patient-centered rehabilitation following a stroke or traumatic brain injury is setting recovery goals. Prior to beginning treatment, patients and their medical providers collaborate to determine the goals they hope to accomplish throughout their recovery.
In the past, rehab goal-setting was based on a purely medical model. Decision-making was unilaterally driven by clinicians. Goals were frequently missed with this strategy, though, as it caused patients and
clinicians to have misaligned expectations.
To overcome these shortcomings of clinician-only goal-setting, it has shifted toward a patient-centered model. By doing this, the rehab plan can be guaranteed to meet clinical standards while also considering the patient’s needs and expectations.
Realistic goal-setting can help patients participate as much as possible in their rehabilitation. By establishing goals, patients take control of their treatment and make sure it is tailored to their needs and circumstances. As they guide treatment team planning and patient progress communication, goals also give the rehabilitation process structure.
To be sure, patient-centered goal-setting can be challenging, as patients may have difficulty understanding their own level of impairment and opportunity for recovery, which often contributes to idealistic goals. This can be mitigated by using a SMART goal approach – setting goals that are Specific, Measurable, Achievable, Relevant, and Time-bound.
In addition, if a clinician believes a patient goal cannot be safely achieved during the time frame of rehabilitation, they can work with the patient to redirect the goal, or to dissect it into more manageable, smaller parts.
Measuring patient satisfaction with performance on goals correlates with goal achievement
Studies have found that measuring patients’ satisfaction in their performance of specific brain rehabilitation goals—both before beginning therapy and after therapy—is a good method of assessing patients’ perception of their own progress.
Patient satisfaction with their abilities is a measurement that can help determine the value of healthcare since it has been shown to strongly correlate with goal achievement.
How to establish practical goals for brain rehabilitation
Involving the patient (as well as their caregivers) in the process of setting appropriate and functional therapy goals is crucial from the outset of therapy. In cases where patients struggle to formulate recovery goals, the following queries may serve as helpful nudges:
What is it that you want to return to but haven’t been able to since your injury?
What would you like to be easier but are finding harder since your injury?
When you’re ready to stop seeing me, how will you know?
Patients may reply with very general, long-term, or impairment-based brain rehabilitation goals, like “get back to work,” “improve my balance,” or “be more social.” The trick is to make these into more manageable, shorter-term parts that are connected to daily tasks.
“I will” statements are an essential part of SMART goals. They’re more empowering. For instance, a patient’s objective might be “I will speak to my daughter on the phone for 10 minutes,” rather than “speak better.” Sub-goals for that specific objective might be, “I will learn word-finding strategies,” and “I will say “Hello, how are you?” correctly four out of five times.
Eight functional therapy objectives with helpful tasks
The table that follows provides: (1) general goals for cognitive, speech, or language brain rehabilitation; (2) strategies for converting these goals into practical objectives; and (3) therapy tasks that may increase the likelihood of achieving the goal.
Naturally, each patient has a unique set of injuries and interests, so each patient’s goals should be specific and appropriate. Furthermore, this list is not intended to be all-inclusive; rather, it serves as an illustration of some of the objectives our patients have been known to pursue. We hope it encourages more fruitful discussions about goal-setting with your clients!