In the realm of physical, occupational and speech therapy, the concept of freedom takes center stage as therapists strive to empower individuals on their path to recovery.

Mr. Eisenstadt desires to spend time daily outside in the fenced-in patio, unsupervised, whenever he desires. He wants to be able to go for short walks as well as sit in the sun.

Mrs. Murtha states that she prefers to eat foods of regular texture rather than the recommended puree texture. She would rather risk choking than “have to eat pureed foods the rest of my life.”

Mrs. Sing wants to ambulate independently to the bathroom without staff supervision/assistance.

Therapists, you know we have all seen cases where there is a difference between what is deemed “safest” and “best practice” versus what allows freedom of decision-making on behalf of those we serve. 

As rehab professionals, these situations are challenging, but also push us to better understand our patients, meet them where they are and provide the highest level of person-centered care.

Even better news, you are not alone in developing materials for navigating the process of ensuring everyone has the right to freedom when it comes to their decision-making.  These examples above are all situations provided in the Rothschild Foundations Approach to Person-Centered Care Planning.

The Rothschild Foundation approach to person-centered care planning not only revolutionizes treatment plans but also emphasizes the importance of independence in choice. 

Let’s explore further how this approach liberates patients and therapists alike, promoting personalized care and fostering a sense of autonomy and self-determination.

The Rothschild Person-Centered Care Planning process involves:

I – Identifying and clarifying the resident’s choice

II – Discussing the choice and options with the resident

III – Determining how to honor the choice (and which choices are not possible to honor)

IV – Communicating the choice through the care plan

V – Monitoring and making revisions to the plan

VI – Quality Assurance and Performance Improvement

The core of the approach lies in empowering patients to make decisions regarding their treatment plans. By incorporating their perspectives, goals and preferences, therapists give patients the freedom to choose what path aligns best with their aspirations. This active involvement fosters a sense of empowerment, as patients become active participants in their therapy, shaping their own recovery journey.

Most importantly, during the outlined process of person-centered care planning, the approach nurtures patient autonomy. 

This begins with the therapy evaluation and goal setting. When patients have control over their own goals, we foster a sense of freedom. 

By involving patients in goal setting, therapists empower the identification and prioritization of what matters most to them, not us. It also provides a sense of purpose and motivation, encouraging progress towards meaningful functional outcomes enabling those we care for to reclaim their freedom in activities they once enjoyed.

How do you make this shift? 

It often begins with an approach and the environment set in your rehab team culture. Therapists should create a supportive environment where patients are encouraged to express their desires, make choices and take ownership of their health, beginning with evaluation at the start of care and continuing throughout treatment. 

Think: less talking and more listening. 

This cultivation of autonomy enhances patients’ sense of self-control, enabling them to actively participate in their treatment decisions and regain control over their functional abilities, lives and desired discharge environments. 

Finally, when we structure care this way, our patients learn the art of self-advocacy. 

We can’t hold on to them forever, which can be difficult at times. But by actively participating in their own care planning, patients develop the skills and confidence to voice their needs, preferences and concerns in our setting and those beyond our care.

Hey, who knows, a newfound freedom of self-advocacy may even extend beyond therapy sessions, empowering your patients to navigate healthcare systems, access necessary resources and take control of their overall well-being.

If we can make this level of impact, we can truly shift the course for our patients. 

As many of us close this week of time with friends, family and loved ones, let us also consider what we can do to promote freedom for our patients, in goal setting, attending to mental and emotional well-being, and inspiring self-advocacy. 

Renee Kinder, MS, CCC-SLP, RAC-CT, is Executive Vice President of Clinical Services for Broad River Rehab. Additionally, she serves as a member of American Speech Language Hearing Association’s (ASHA) Healthcare and Economics Committee, is a member of the University of Kentucky College of Medicine community faculty and is an advisor to the American Medical Association’s Current Procedural Terminology CPT® Editorial Panel. She can be reached at [email protected] 

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

Have a column idea? See our submission guidelines here.