On February 2nd of each year hundreds of people assemble at Gobbler's Knob in Punxsutawney, Pennsylvania, to watch men in tuxedos and top-hats snatch Punxsutawney Phil (a groundhog) from his natural deep hibernation mode of dormant existence. Phil is held high for the crowd to see and then placed on a fake tree stump so that highly trained observers can judge whether he casts a shadow. When a shadow is not cast, it is announced that there will be an early spring. If you missed this momentous event for 2016, which was the 130th anniversary, you can go to http://www.groundhog.org to view a live stream of the entire proclamation. I have had a groundhog living for several years in a mound of soil that I use for landscaping. I know because it (I do not know if it is female or male) smiles a devious little smile at me as I try to scare it away from eating my perennials. I have spent a good amount of money on aluminum pie plates (groundhogs supposedly do not like the shimmering objects), whirly-gigs, environmental concoctions, and a trap to catch it alive for relocation. I actually have a picture of it snickering at me from behind my granite stairs as I was on my knees planting newly purchased plants that would eventually be its lunch. The Groundhog Day continues each year even though the data reveal that the result of Punxsutawney's prognostication is only correct 39% of the time (http://www.stormfax.com/ghogday.htm). That data caused me to put aside thought of holding my own event, though wearing a purple top-hat would be fun.

Earlier this year I was watching a documentary about hibernation and I began to think of some of its benefits. I thought that hibernation would be a good diet plan as well as a way to avoid all the sad and scary news that newscasters think we need to hear, and the political jibber-jabber that is almost unavoidable for the rest of 2016. However, I could not find any sponsors to pay my bills, so... my thoughts will have to remain unfulfilled. Although people do not enter the near-comatose condition of hibernation, many do become less active in the winter. I did not cross-country ski last year because of it being bone-chillingly cold and icy, and this year there has been hardly any snow (these are facts, not excuses). During the day I tell my patients/clients to be more active. At the end of my day I come home with the intent of exercising, and then make the mistake each night of sitting in my most comfortable chair and have a few sips of wine. Then my brain synapses generate the thought that I can exercise the next morning (yeah... right!).

When I worked in the outpatient setting, I used to tell most patients/clients that they should walk each day and gradually increase the distance they walked. Now that I do homecare physical therapy, I can see that I was telling many individuals to do something that was very difficult for them to do. I now observe that there is very little space to walk in most of the homes I visit, and that there are no sidewalks where many of the people live. Because there is usually more snow and ice here each winter, I would tell people to walk more when they go to a grocery store or to a large department store. Well ... now I know that many do not have a way to get to any store, and even if they can get to a site with aisles to walk in, there are no benches to allow for rest when they get tired. I was guilty of telling them to do something that was not possible. I have made a short story long in this editorial toward my goal of emphasizing that we must carefully consider what we ask patents/clients to do. Many of my older patients do not drive and so must rely on other people to drive them. This often means that they do only the absolutely essential tasks of grocery shopping and medical appointments. I have learned that I cannot only tell patients what activities they should try to complete, I must provide them with information about how they might be able to do what I want them to do, or assign tasks that they will be able to perform. I now carry with me information for community resources for transportation. I have made the phone calls for possible volunteers to assist with activities. I have recently visited with our town development person to discuss the possibility of having a pathway paved near the community center with benches every few yards so that people can rest when they need to. The director of the community center is exploring ways to get the housebound to the community lunch each week so that socialization can occur. I have suggested the possibility of an event called "Start today with a little K" (vs the 5K races that occur almost every weekend for the more able-bodied). I also stipulated that the pathway should accommodate 2 rolling walkers side by side, as well as the widest of wheelchairs.

From my experiences with inpatients, outpatients, and homecare patients, I have learned that I need to ask patients/clients what is possible for them to do instead of assigning tasks that they may not be able to do. If a patient/client cannot perform the activities that physical therapists prescribe, there is a good chance that both will be disappointed and unsuccessful. And, someone is paying for that lack of success. It is my belief that if we really listen to patients/clients, and prescribe evidenced-based interventions that have been found through research to have a greater than 39% chance at being effective, then our successes will overshadow our failures.

Nancy Donovan, PT, PhD

Editor-in-Chief