Long-Term Care Survey Alert

Rekindling can ignite motivation.

Depression and hopelessness can derail a resident's rehab program--but not if the interdisciplinary team stays hot on the care plan trail in addressing these psychosocial issues.

Some residents can "physically participate in therapy but lack the emotional wherewithal to do so," says Inne Taylor, RN, the MDS coordinator at Sunshine Terrace Rehabilitation Center in Logan, UT. "That's why the rehab team includes the families in the plan of care to help motivate the resident and address his or her psychosocial issues," she says.

Real-world clinical example: The rehab team tackled a case recently where a resident had worked hard to recover from a stroke five years ago and had been living at home. "But suddenly the woman became ill with osteomyelitis and lost function of one limb for unexplained reasons," says Taylor. As a result, the woman was losing her hope for recovery and her goal of going home to live independently.

The care plan thus included a goal to help promote whatever hope the patient might have of going home. The team worked with the patient's family to make them part of that effort, as well, says Taylor. "Part of the effort involved helping the resident realize that people can function and have a quality life even if they do have limited use of a limb or limited functional capacity in some way," says Taylor.

Combat misunderstandings: In some cases, residents become sad and feel hopeless because they don't understand the therapy goals, in the experience of dietitian Cheryl Connors. For example, a resident may tell Connors that she isn't eating because she's depressed about being in the nursing home for the rest of her life. Yet the care plan goal actually may be for the person to go home, says Connor. In such a case, the team re-explains the goals of therapy or treatment to the resident. "And we explain to the person that she can't achieve those goals if she doesn't eat."