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Patients can be fickle when it comes to making them do something they don’t want to do. Taking medicines, following a diet, getting exercise, are just a few. There is no limit to the things that they will say “No” to.
One of the best examples of refusing a treatment is physical therapy. Let’s say you have just been released from the hospital. You are weak and having trouble walking. In comes the physical therapist to make you strong again. You don’t even have to go anywhere. The therapist comes to you! How convenient.
But then you see the amount of work you have to put into getting strong again. The exercises are tedious. You may become short of breath from being out of shape. You are definitely tired afterwards and need a nap. Not only that, the therapist wants you to do even more exercises when they are not there. It’s a sad reminder of your failing abilities. It’s enough to make you say “Enough!”
But should you do that? Many patients do. They give up too soon. They don’t believe they can reach a level of functioning they had years ago. The process is overwhelming because they are not in good shape. They want to avoid the work, the shortness of breath, and the fatigue that goes with it. What’s the point?
The point is this: It can help keep you out of the hospital again. A recent study published in the Journal of the American Medical Directors Association found a drop in re-hospitalization rates after patients were given extra physical therapy treatments. Positive results occurred in patients who had higher levels of functioning. The patients did not have to go back to the hospital as frequently compared to those who had fewer therapy visits or those who were sicker.
There is a huge push by the Centers for Medicare and Medicaid to avoid re-hospitalizations. This is not simply to save money but to help control a problem seen in healthcare over and over. For every hospitalization, the patient becomes weaker and in a less stable condition than the time before. It takes more work, more effort to get back to baseline. In the long run it is much better to avoid a hospitalization. The hospitalization may fix the prevailing ailment but leaves the patient with more weakness. Weakness leads to less mobility which leads to falls, fractures, and another hospitalization. Weakness also leads to less ability to care for yourself which makes you more reliant on others. The cycle becomes a spiral headed in the wrong direction.
The next time you are tempted to say “No” to a physical therapist remember this. It is in your best interest to make the effort and do what the therapist says. Think of it as a new goal to reach or a challenge that will not beat you. Once you see the benefits of what therapy can do, you will become a believer, an advocate, and, most of all, have a renewed sense of self. You can say “I did it and I feel great”. And, avoid another hospitalization.