Motivation

A patient admitted to my ward with active gout and he was await for a placement to hostel. Knowing that he would end up in a hostel, the patient tended to rely nursing staff to do ADL's for him and reluctant to initiate any althought that he was capable. At physio section, the patient was polite enough to be compliant but I feel that the patient is just doing the exercises for me because he was mouning all the time and really reluctant to do the exercises. I discussed this issue with the clinical tutor and we decided that I would need to change my communication skills and emphasize the importance of independence and link exercise to functional goals.
My way of approach was like this:
I acknoledged to patient that he would go to a hostel where there staff for basic help. But the level of assistance he would get in the hostel would be much lower than in the ward. And even if he would get the same level of assistance in the hostel, however, I suggested that it would be simply nice to do things by yourself like going to toilet, getting your self a cuppa, walking to dinning room and socializing with new friends in hostel. Then I re-introduced each of the old exercises to the patient with spacific functional goals eg practiced waling is for walking to dinning room or visiting friends in other room in the hostel. I felt that patient's motivation was boost significantly and he was really trying hard to do the exercise with me FOR HIMSELF. How great was that!