There are a many things I love about living in an older home. A 170-year-old home to be exact.
Uneven, squeaky floors that move ever so slightly beneath your feet. Creepy, damp cellar spaces. Skeleton keys to lock exterior porch doors. And your own friendly household ghost.
I see my ghost, for the most part, as a friendly helper. She turns off lights, she shuts gates, and she turns on music boxes in the middle of the day to provide me some cheer.
Mischief, however is also in the repertoire of “Ghosty,” as 4-year old Emmy has affectionately named her. She has been noted to open every bathroom shower door midday, and stomp through the front “parlor” in the evenings, just to stir up my nerves near bedtime.
I assume this is because, much to her dismay, this space that had finely carved wood furniture and was meticulously kept, and was used for dancing and gathering of friends in her time, is now my family’s dumping ground. At any moment, it is full of backpacks, shoes, jackets and a stack of need-to-return school library books.
Therapists experience the same impact when facing the ghosts of predecessors in their own therapy departments. And when considering the spirits of old habits needing to be shifted by significant changes facing our post-acute care industry.
I will never forget how a prior speech language pathologist impacted my first role in a SNF, and the resulting questions I received during my first month on the job. (“What do you mean you can do more than modify diets?” “Why is Renee always singing with patients?” And, “Really, you can provide treatment to impact cognitive function?”
Like my experiences, some ghosts from our past leave a friendly mark, while others are just down right troublesome.
The positive impacts we see are tied to our therapy roots: therapeutic progression of tasks, evidenced-based care, manual therapy techniques, patient and caregiver education, and remembering why we all became clinicians in the first place.
The not so good? All you therapists out there reading know them all too well.
Non-prescriptive exercise programs; non-therapeutic seated exercise; repeated use of gym equipment over functional based tasks — therapy arch, you hear me!; and ineffective “watch me” training models absent of return demonstration.
Perhaps, I now ponder, Ghosty is not stomping at all. Maybe she is stumbling through her poorly trained waltz. Did her dancing partner not use the best approaches when training her how to complete the fluid movements associated with the waltz’s rise and fall?
Let the training begin.
On the first step forward, the weight is taken on the heel, then on to the ball of the foot.
Nice work, Ghosty, you are catching on!
Next, a gradual rise to the toes should be started at the end of the first beat, and continued to the second and third beat of each bar of music.
Looking great, Ghosty!
Finally, lower to the normal position at the end of the third beat by lowering to the heel of the foot which is carrying the weight.
Perfect, Ghosty, now you’ve got it down!
In the coming year, don’t let the ghosts from your past set you off on the wrong therapy footing.
Time to set a new course, while owning our past, and establishing a new path as the industry moves forward.
Renee Kinder, MS, CCC-SLP, RAC-CT, is Director of Clinical Education for Encore Rehabilitation and is the Silver Award winner in the 2018 American Society of Business Publishing Editors competition for the Upper Midwest Region in the Service/How To Blogs category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty, and is an advisor to the American Medical Association’s Relative Value Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC).