Christine Licata, PT, DPT, SCS, CSCS
As clinicians and health care providers we are in a unique position to enter into peoples lives when they are in need of help and support and are in a position of vulnerability. Although many patients have supportive families, friends, spouses and children, there are also patients that do not have this support system and in these situations we become their only connection to compassion.
When a physical therapist becomes a semi-permanent fixture in ones life for months at a time and for 2-3 times per week, relationships form and bonds are made. For us as health care professionals this comes with the territory, however, for many people this relationship often transforms into more of a dependency than medical care. Whether it is how we listen to their stories about their weekends, family drama, relationships, life experiences and personal tales of triumph or the fact that they can count on us to always lend an open ear, patients often begin to wonder how they will respond to discharge from physical therapy…and often times this begins to frighten them.
Here are some simple tips to ease the blow of discharging your patient:
- It is important to set expectations regarding the length of care, goals of care, and emphasize the ultimate goal of transition to independence with a home exercise program (HEP) in the very beginning to make the end to the patient-therapist relationship less traumatic for the patient.
- Consistently updating home exercise programs is something that often is forgotten and this often leads to the patient feeling overwhelmed at the end of their therapy sessions when they receive a comprehensive home exercise program with many activities listed. Remember to update the HEPs often so that when discharge does occur, the patient finds all of the activities familiar and is confident with completion of these activities independently.
- When appropriate, contacting the physician to inform them of the impending discharge allows for all parties involved to be on the same page. That way when the patient asks “so what if my doctor wants me to continue with PT” (when they are fearful of discharge) you can simply answer them “I already spoke with your doctor and informed them of your discharge and they are in agreement with the plan of care”
- Encourage the patient to make a follow up visit with the MD if they desire to update the MD on their progress in physical therapy and their discharge with an HEP. This way the patient feels that all loose ends have been taken care of and they can get some closure with the situation, especially if the injury was a traumatic one and it can allow them to move on with their life.
- Suggest that the patient set time aside 2-3 times a week on a consistent basis similar to when they were scheduled for physical therapy to perform their HEP. This allows for compliance with their HEP and also fills the void of time that they would have been with you in physical therapy.
- Emphasize to the patient that graduation from therapy is an accomplishment not a punishment and that they should be proud of themselves for achieving this. Often time’s patients feel a sense of rejection and that we don’t want to see them anymore and this as we all know is simply not true.
Hope this helps!