New year resolutions remind me of SMART goals because if made by the patient they are
ambitious and can be unrealistic. But wait, I’m guilty of that too!
We are a vital part of the goal setting process to help make patients make goals using motivational interviewing and SMART goals (created by Peter Drucker “Management by Objectives”).
(Image from Motivational Interviewing in Healthcare, second edition, by Stephen Rollnick, PhD, William R. Miller, PhD, Christopher C. Butler, MD.)
This goal setting process is therapeutic for any kind of adult neuro patient and it gives them autonomy. You can incorporate it into swallowing, such as when I had a geriatric patient of Jamaican origin that only asked for one thing, and this was her goal:
“I will have my porridge every morning without choking by doing my swallowing exercises, coming to therapy and following swallow precautions so that I can feel like myself and have energy for the day in 12 weeks.”
This patient had severe dysphagia when she was on my caseload and we worked together for many months without success but, after talking to her son and the patient, it’s came to light that she was already eating porridge daily. The goal was altered to to focus on the safety and comfort. We cooked porridge in the clinic to meet the consistency requirements, as an example. Even though the intake was minimal, her dysphagia did improve over time. She felt empowered, and goal focused – which was really her goal (and ours) all along.
If you want to take this info “to-go” I have included a good SMART goal creator/GPDR below that I found. Please feel free to contact me with any questions or thoughts!
