This past week, my home was the venue for Geriatric Rehabilitation Education and Training (GREAT) institute's certification. For those of you who do not speak "GREAT", I will explain. Candidates from all over the country converge for a week of collegial exchange and testing. The candidates must take 160 hours worth of continuing education from GREAT within a 7-year period. Then the candidates complete a self-study of more than 20 hours of complex questioning. If the candidates demonstrate their expertise, they can sit for the week-long certification. This week-long process encompasses 40 hours of review and 20 hours of testing. I am referring to this process because one of the main areas where expertise must be demonstrated is that of motivation.
For many years, GREAT recognized the importance of motivation as it relates to the older adult. The wealth of knowledge any practitioner may have is of limited value if the client will not participate. Therefore, recognizing this as a core area for certification in geriatric rehabilitation as well as for the topic for not just 1 but 2 issues of Topics in Geriatric Rehabilitation is well thought out and reasonable.
During the certification process, there was a half day of oral examinations. The candidate who received the oral question on motivation took a very different path. I believe the path he took in his answer can add a skewed but highly enlightening look at motivation. I think his answer will provide groundwork for the wonderfully researched articles that flow in these issues.
His answer enumerated 7 points:
Number 1-First, know the patient. This entails recognizing his/her mental status in terms of dementia or depression and current socializing patterns.
Number 2-Know the history. He suggested having the patient or family fill out a memory book.
Number 3-When giving rehabilitation, always explain why the patient will be doing something.
Number 4-Avoid prejudice. Really take the time to look into the patient's eyes.
Number 5-Have a fun attitude.
Number 6-Communicate. Take the time to learn something in all languages our clients speak.
Number 7-Turn the situation around. He gave an example of a patient who took the clipboard from the therapist and instead of the therapist getting upset she walked up and said, "Thanks for finding my clipboard. I have been looking for it"-thus turning what could have been an unpleasant situation into a pleasant one.
These 7 items are simple but powerful and can be a stepping stone for the even more powerful information presented in these issues. We all know the importance of exercise and rehabilitation. We also know how important it is to motivate our patients to participate. This issue guest edited by Ann Williams includes wonderfully moving, well-researched articles that provide compelling information crucial to the practice of geriatric rehabilitation. I thank Ann and all her authors for doing such an outstanding job on such an important topic.
To the readers: enjoy, absorb, and motivate!!
Carole B. Lewis, MSG, MPA, PhD, PT, GCS
Editor