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Stroke Recovery: the importance of setting goals

Stroke Recovery: the importance of setting goals

Goal setting, as defined by Wikipedia states: “Goal setting involves the development of an action plan designed to motivate and guide a person or group toward a goal. Goals are more deliberate than desires and momentary intentions. Therefore, setting goals means that a person has committed thought, emotion, and behavior towards attaining a goal.”

As a Physical Therapist, I set goals for patients every day, starting with their initial evaluation. Working mostly with patients who have had strokes, this becomes an integral part of the rehab process. Including the patient and the family in the process of setting goals is especially important. Finding out what they did before suffering the stroke, related to home, family, job, and school help to set goals that are meaningful to the patient and their family.

Setting goals starts from day one after a person suffers a stroke. Goals should be specific, measurable, attainable, relevant, and time-bound. Patient goals after suffering a stroke usually tell me they want to walk again; drive again; be able to go back to work; golf, play tennis, or fish. Listening to your patient and acknowledging their goals is important. Helping them to set smaller more attainable goals early on will help them see their progress along the way.

An early goal in acute care may be something as simple as being able to sit up in a chair for an hour. Once they get to an inpatient rehab facility, patient goals are aligned more toward self-care, activities of daily living (ADLs), mobility, and being able to get home. Working as a team, the physical therapist, occupational therapist, speech therapist, physician, nurse, and social worker all help the patient get to the goal of returning home. Goals at this stage may include being able to get up from a chair, walk with a walker, get dressed, get showered, or perform ADLs with adaptive equipment.

Once the patient returns home and continues their recovery in outpatient therapy, they have a better idea of their abilities. They know what they can and can’t do as well as they used to before the stroke. Goals may include higher-level functional tasks that can make them more independent in their home and community. These goals may evolve as the patient makes progress. Initially, the goal might be to walk a mile without using a cane or walker. As they get closer to that goal, it may evolve into running a mile, if their progress permits.

Often, patients mention activities they can no longer do, such as fishing, golfing, playing tennis, attending grandchildren’s sporting events, and going to church and sitting in the pew, all of which can lead to new goals along the way. Evaluating why the patient can’t do the task helps to set goals and plan treatment toward attaining these goals. Physical therapists may have a person swing a golf club or a tennis racquet to work on balance during that activity. Performing exercises and drills geared toward the task can help them build the necessary components to get back to their desired activity.

Listening to your patient and encouraging your patient to produce goals helps them to understand there is a potential to return to a premorbid lifestyle, even if that includes the use of adaptive equipment or a compensatory means to do the activity. As therapists, we work to guide them, encourage them, motivate them, and provide them with the necessary tools to achieve their goals. We hope that patients can get back to the life they love living.

About the Author: Stacey Williams, PT, DPT, C/NDT, specializes in the treatment of patients with neurological disorders/diseases, with a focus on Spinal Cord Injury and Stroke/brain injury. She is the Therapy Team Manager at the Luger Scranton Rehab Center and also serves as an Assistant adjunct professor at the University of Scranton in the Physical Therapy department.

Stroke Recovery at Allied Services

Our inpatient and outpatient stroke rehab programs address physical, cognitive, behavioral, and socialization needs as well as identify and manage risk factors to help prevent future strokes. To learn more: