Compliance – Alliance
Adhering to your home program
Being a practitioner of the healing arts is a great job. It is immensely satisfying to precipitate a client’s recovery or improvement and then nurture them along the way to full function. But…it is probably safe to say that one of the most frustrating aspects of being in the field of injury and pain rehab is client compliance with home programs and prescribed exercises.
Before I launch headlong into a mini-rant, I must preface it with a little story about someone I know quite well.
A few years ago I was suffering from a chronic eye infection that I nursed myself with home remedies until it became clear that it was not going to shift without professional help.
I went along to a highly respected ophthalmologist, paid vast amounts of money for his expertise and 2 separate prescriptions (one bottle of eye drops and a scrip for a very specific antibiotic) and then proceeded to do it my way. Which is to say I used only the drops.
Initially my eyes improved using only the drops. Wonderful. The tablets were known to cause photosensitivity and it was summer so no time for sun-avoidance! But within a few weeks, my eyes started to go red, sore and swollen again. I took my gritty, bloodshot eyes back to the ophthalmologist who admitted that he was surprised that his prescribed remedy didn’t work.
Doc: “Did you use the drops I gave you and finish them?” he said rubbing his chin with puzzled medical gravitas.
Doc: “Strange. This type of infection usually responds well to the tandem protocol of the drops and the tablets.”
Me: “Oh. I didn’t bother with the tablets. I wanted to go to the beach.”
The doctor peered at me intently. Scary.
And then he asked me to leave.
I was horrified to be thrown out of a doctor’s surgery. After apologising and promising to be a good girl, I convinced him to keep me on and he issued another prescription for the drops and told me to take both medications as directed.
I did. My eyes cleared up and the painful infection never came back.
Now I never have (nor will I ever) throw anyone out of my studio, but that anecdote illustrates the frustration of pulling everything possible out of the professional toolbox to help your patients or clients only to have them fail to help themselves.
I am as guilty of being lazy (and human) as anyone and it usually takes blinding pain or the price of a Lamborghini to induce me to assiduously follow health care advice – in other words, desperation – but I am getting better as the cavalier luxury of youth slithers ever farther away.
Oh, for the magic bullet or elixir that you could take once and be done with it.
Unfortunately, the time required to correct a postural issue or an injury is generally commensurate with its chronicity – that is to say how many months or years the faulty pattern or injury has had time to embed itself into your body
And the moral of this story?
If you’re the patient, comply with your healthcare provider or therapists advice. After all, you’ve likely paid handsomely for it and they have trained and studied long and hard to bring it to you. Make the most of the time and money you’ve spent. If, after complying with your prescribed program, you do not see the desired or expected progress, discuss it with your practitioner but please, DO YOUR HOMEWORK, so that if nothing else your practitioner will be able to adjust your program or refer you to someone who may be better able to help. If you don’t do your home program, you’ll never know if it works.
If you’re the practitioner, ask your patients/clients questions they must answer, e.g. “Will you do your home program at least three times a week?” instead of, “Don’t forget to do your homework.”
Studies show that asking people to state their intention out loud helps encourage compliance. Enter into a written agreement or ‘contract’ with your client. Make it clear that you are in their recovery TOGETHER. “Fix me” is not part of the therapist/client lexicon.
If all else fails, try scare tactics – cue sinister laugh – for example, “What colour would you like your mobility scooter?” For some, fear of the negative is more incentivising. It worked on my father. He now religiously walks 1.5 miles everyday, rain or shine.
The threat of an incontinent future also works a treat. Try it on your women clients. Incontinence pads are NOT sexy.
All kidding aside, set aside the time in your busy schedule of juggling plates to invest in you. You’ll be a better mother, father, provider, employer, employee, and lover, –whatever – if you and your body are happy companions.
Please get in touch if you have any tips or helpful hints on this blog topic!
Until the next time…