How to Improve Patient Independence Through Education and Disease Management

By Lindsay Milgrim, OTR/L
Occupational Therapist
NJ West 1

We are the “eyes and ears for the doctor.” That’s a phrase many rehabilitation professionals impart on their patients and families at the start of care. Clinicians are in a unique position as healthcare professionals since we see our patients routinely, two to four times per week until patients achieve their set goals. This amount of time allows us to build rapport, educate on disease management, and ensure carryover with training.

Throughout treatment, we communicate with a patient’s care team, such as nursing and doctors, to ensure proper regulation of chronic diseases or to report new issues that may arise. At times our job can be intimate, but we are another line of defense for our patients, and utilizing our clinical skills and empathy allows us to best advocate for them. But once our care ends, how can we help our patients learn to advocate for themselves?

Is Patient Education Within a Clinician’s Scope of Practice?

First, are clinicians trained in health education? Is this within our scope of practice? Per the OT Practice Framework, “the outcomes of advocacy and self-advocacy support health, well-being, and occupational participation at the individual or systems level.”

As occupational therapists, we utilize occupations and evidence-based research to promote population health from the individual to the community level. Occupational therapists, physical therapists, and speech-language pathologists are all trained in using patient-centered approaches to set attainable goals that address a variety of disease processes. Advocating on behalf of our clients, through attaining resources, DME, or optimal referrals is one piece of the therapy puzzle.

Assessing patients’ cognitive, physical, and environmental barriers and needs allows us as clinicians to create an appropriate plan for patients to achieve their long-term goals. Chronic disease management can be overwhelming to an individual, but with the help and guidance from a therapist, patients can learn to not only manage their condition but also thrive.

Self-Regulation Improves Carryover

Many patients improve with treatment when they understand their limitations and how to embed their education into their daily routines. Our goals usually center around our patients becoming independent, or as close as possible, in their tasks of choice. Patient independence in chronic disease management and self-advocacy is a skill that will improve patients’ lives for years to come. When learning to live with a chronic disease, understanding the illness, treatments, and precautions are key to living a fulfilling life.

According to a 2016 study, occupational therapy was the sole spending category within hospital systems that showed a statistically significant reduction in hospital readmission rates for three health conditions: heart failure, pneumonia, and acute myocardial infarction.

The study identified that improving a patient’s independence through education, recommended equipment to improve safety during ADLs (activities of daily living), and safety assessments all contribute toward improving their disease management and allow patients or families to better manage conditions and advocate for themselves. This further allows patients to remain at home longer and safer.

It is evident that knowledge is power and education requires a multitude of skills and approaches to ensure understanding and carryover.

4 Ways Clinicians Can Improve Patient Disease Management and Self-Regulation

Let’s be proactive, not reactive! People can improve their ability to manage their disease and advocate for themselves by receiving meaningful education and training.

1. Communicate With Patients and Caregivers

Collaborating with your patient and their caregiver is crucial to establishing a successful plan of care. Provide clear education and resources to patients and caregivers. Use “layman’s terms,” instead of medical terminology when communicating.

I like to provide handouts and visual aids to ensure carryover and allow patients to review materials and education outside of sessions. Common handouts I use are customized home exercise programs and disease-specific education. I always ask patients to repeat or demonstrate education back to ensure they fully understand.

2. Set the Right Goals For Your Patients

Create a meaningful, realistic, objective, and attainable goals. I create goals for independence in education or a home exercise program. For example, for a patient with poorly regulated hypertension, an appropriate goal could be for independence and daily compliance in the use of self-monitored blood pressure to be completed three times per day. For a patient with Chronic Obstructive Pulmonary Disease, a goal could be geared toward independence in implementing energy conservation techniques during meal preparation — a routine that is important to the patient.

Remember, clinicians are not just providing education, but ensuring patients understand it, can implement it, and are able to carry it over during their daily routines.

3. Focus on Patient-Centered Treatment

Managing our health is in everyone’s best interest- that’s a given. Ensuring goals and treatment are meaningful is necessary for a patient-centered approach. Assess your patient’s environment, cognition, and physical performance to create a plan that will allow the patient to complete their preferred tasks in a safe, independent manner.

What is important to them? What are their fears? How much social support do they have? Placing the patient at the center of their treatment plan will motivate them to be active participants in their care as well as help identify their potential barriers to success. A thorough understanding of each patient’s varying circumstances will prove optimal outcomes and better disease management. This is not a “one size fits all” treatment plan!

4. Make the Right Modifications and Adaptations

Understanding your patient’s chronic condition and applying education to daily life are two separate principles. Through occupational therapy, we can educate and empower patients to implement education into their routine to create new, healthy habits.

Do they need any assistive devices or adaptive equipment? Can they problem-solve through a complex task to complete it safely? Are modifications warranted to improve their independence? Implementing proactive approaches allows for better outcomes through reducing risk and improving safety.

Through education, meaningful goals, and patient-centered care, we can improve individuals’ chronic disease management and independence. Clinicians are in unique positions to assess, treat, and educate individuals to ensure independence in disease management, but also to help them carry over within their daily lives and routines. Let’s flip the switch from “sick” care that is so prevalent to preventative health care!