I wanted to put pen to paper, well fingers to key board and reflect on a situation that seems to happen all too often too those living with a neurological condition. This is not a post about pointing fingers or disrespect to anyone but a post to highlight the strong impact we (health professionals) have on an individuals beliefs and consequently quality of life.
I unfortunately come across time and time again individuals who have been told there is;
“no chance of recovery”
“Its a degenerative condition and not much you can do”
“You will never walk again”
“What you have after 2 years of recovery is all you will get back”
Do we really understand the impact of what we say and more importantly what is heard and what is remembered by an individual with a neurological condition. This is where the 80/20 rule seems so imperative – we only retain 20 % of any conversation – forgetting the other 80% within the following few hours or days. How do we know as health professionals what part of our conversations and education make the 20%…….well we don’t, however I am pretty certain the parts that equate to NO HOPE is often what is remembered. And when on earth did it become our role to diminish and destroy someones HOPE, someones BELIEF, someones GOAL.
Neuro rehab has dramatically changed and advanced over the recent years with the research proof of neuroplascticity giving EVERYONE the opportunity and POTENTIAL to change and improve their situation. I am not saying everyone is going to make a full recovery and I firmly know the difficulty of driving neuroplastic changes, but the slightest improvements can dramatically improve someones quality of life. This is not only physical but also significantly psychological, to find someone who believes and encourages and empowers the opportunity for change to be created unleashes a positive drive in an individual that can help them restore some of their lost self identity.
The initial example I want to discuss is about a lady I assessed and treated today at a regional / rural neurological physiotherapy satellite clinic I was running. After being diagnosed with MS in 1994 and by 2000 she had declined to the point that she was provided a wheelchair and “told she would not walk again”. What she was exactly told I and we will never know but what she hear and what she has believed for the last 17 years is that she will never walk and can only use her wheelchair. I saw her for a 1 hour assessment and a 1 hour follow up session over 2 days, after seeing in the initial assessment that she could stand with minimal support, I start thinking why on earth is this lady not walking. Halfway through her second session we walked across the room with minimal assistance of her hands on my shoulders and me bringing the wheelchair behind her (as quite rightly she was rather concerned about the idea of walking across a room since she had not walked for 17 years). However she did it with ease and will hopefully be walking around her house with her frame again in a few weeks.
What changed….simple…..her belief that she could rather than she could not.
Was this a miracle…….NO…….Do I have a magic wand…..NO…..Do I believe in change…..YES…..Do I install positivity and confidence in my clients……Well I definitely try!!!
Have I managed to give this individual enough confidence and motivation to want to walk again and be out of her wheelchair……that I don’t know and at the end of the day it is her complete choice. However at least she now knows she CAN walk!
This is just one of many many cases I see on a regular basis, people being told or only remembering that health professionals have said they will not recovery and they will only decline. A classic is spinal cord injury clients, often told they will NEVER walk again. When actually the research now shows us the spinal cord is plastic and their is a potential of improvement, I am not saying this improvement is walking again and I am always very careful with my words regarding NEVER guaranteeing anything as change is very hard to achieve. However by aiming for change and aiming for sky high goals you never know what you may improve on the way. For example I work on lower limb activation with all my complete and incomplete spinal cord injury clients, how many have I got walking again….not many…..how many have I significantly influenced through believing in them and achieving even some basic improvements but life changing in transfers or wheelchair skills….ALL of them.
I could go on a write a lot more on this topic but I will wrap it up here to hopefully highlight to health professionals the stark importance of positive empowerment in your clients. And for those living with a neurological condition BELIEVE IN YOURSELF!