I recently had a client who one morning became extremely upset that her breakfast order was incorrect, to the point where she threw the hospital phone in her room against a wall.
After working with this individual for a few days prior, I knew that this behavior was out of the ordinary. As I implemented strategies to calm her down and empathize with her emotions, I discovered the root cause of her outburst—feeling out of control. She shared that she believed what she decided for breakfast was the only thing she felt in control of during her hospital stay.
Unfortunately, my client’s story and feelings are not unique. It is very common to feel out of control while staying in the hospital. Just the environment alone can be extremely overwhelming, let alone grappling with the psychological difficulties of a new injury or diagnosis.
Although, there are elements of your hospital stay that are simply out of your control, such as when food will be delivered or when the doctor will come to visit you, there are tools you can implement to be a confident, informed patient who feels empowered by the care one is receiving.
This article provides steps to increase your personal autonomy and tools that caregivers and clinicians can use to further promote their loved ones’ and clients’ sense of autonomy while in the hospital.
See video if you want to hear a more in-depth discussion of these tips: https://youtu.be/_GCf_CcxL94
The Empowered Patient
Increase Your Health Knowledge and Understanding
Lack of understanding can create a feeling of uncertainty. If you are unaware of your plan of care or what the clinician is discussing with you, it is more common to feel out of control with your health and life.
As the old saying goes, information is power, and a key way to gain a sense of empowerment with your hospital stay is to improve your health literacy.
According to the Patient Protection and Affordable Care Act of 2010 health literacy is defined as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions” (CDC, 2020).
First of all, it is important to disclose that I am not saying go out and buy every health book you can find to ensure you are informed if you ever go to the hospital. However, I want to reinforce that it is essential to gain the information necessary while in the hospital about your health to make knowledgeable decisions.
You may not have control over your prognosis or diagnosis, but you do have control over the decisions you make for your health.
Tools to use while communicating with health professionals in order to ensure learning and understanding include:
- Ask Questions and Request Clarification
- Use the Teach Back Method
- This is a common tactic I use with my clients to ensure education comprehension. With this method you summarize/repeat back what the health care professional explained to you. I love this tactic not only because it demonstrates understanding, but also by repeating the information you are promoting information retention.
- For example after your therapist explains how she wants you to stand up from bed. You could say, “okay the way I am understanding what you said is you want me to push up from the bed instead of holding onto the walker when I stand up so I do not fall backwards.”
- Ask “Why”
- Request information on why a healthcare professional is providing you that certain type of care. I honestly love when my clients ask me why I am having them do a certain activity because it provides me an opportunity to share how I designed their therapy to meet their specific needs. By understanding the “why” you are receiving a certain type of treatment, you can feel more in control of your health and recovery.
Assert Yourself in the Decision Making
I have perceived many of my patients become overwhelmed by the number of clinicians they interact with on a daily basis, which causes them to take on a passive role in their plan of care.
Remember that you are the playmaker of your health and the healthcare professionals are your support team.
When you perceive there is something that needs to be addressed in your plan of care, it is important to vocalize it to the medical staff. By asserting your opinions and knowledge into the discussion you become an active member in the decision making process.
Practice Self-Care
It can be challenging to continue to engage in your normal self-care routine while in the hospital. However, implementing self-care becomes that much more vital when experiencing a disruption with your daily routine. Finding ways to manage the stress, anxiety, and pain that accompany being in the hospital will help to alleviate feeling out of control.
Being in the hospital due to a physical ailment does not just impact an individual physically, but also spiritually and emotionally as well.
A few weeks ago, I had a patient who became very emotional when she found out a priest could not come visit her in the hospital due to the COVID-19 visitation policy. After I offered to help her look up the local parish to call a priest, my client stated that she just needed a rosary to pray with while she was in her room.
I realized in that moment my patient was vocalizing that she needed to attend to her self-care and spiritual health. I was able to acquire a rosary at my hospital and after being provided time to pray, my patient became calmer, hopeful, and more motivated in her rehabilitation recovery.
Although certain self-care practices may be difficult in the hospital, such as yoga or running, there are many activities you can implement easily while confined to the hospital.
Examples include journaling, praying, crocheting/knitting, mediation, coloring, requesting to speak to a chaplain, implementing breathing techniques, reading a spiritual/religious book, calling a loved one, or sitting in the hospital garden.
The Empowered Caregiver
Becoming an empowered caregiver is essential especially when your loved one has cognitive or physical limitations that impact his or her ability to advocate for oneself. COVID-19 has added additional challenges for caregivers to be able to be physically present to assist their loved ones in their medical care.
The following are strategies you can use as a caregiver to advocate for your loved one while he or she is in the hospital:
- Request for the doctor and other medical professionals to update you frequently regarding your loved one’s health status and recovery.
- Although with COVID-19 this is restricted right now, when the visitor limitations have been lifted request to be present at important sessions, appointments, and procedures.
- Provide insight to the medical team regarding important information about your loved one to promote patient comfort and participation, for example if there is a certain breakfast item he or she prefers or strategies you utilize at home to promote emotional regulation if your loved one becomes agitated or restless.
- Join a caregiver support group either virtually or locally. Caregivers have a wealth of knowledge and can be an incredible resource on how to further advocate for your loved one.
The Empowerment Clinician:
Promoting autonomy and a sense of self-efficacy are foundational components of therapeutic practice. The following are strategies one can implement as a clinician to promote your client’s voice not just in the hospital, but also across all medical settings:
- Establish a strong therapeutic clinician-client relationship that emphasizes collaboration and joint decision making
- Advocate for your clients when speaking with other medical staff
- An example of this can include educating the medical personnel that the patient is hard of hearing so it important to speak on a certain side of his or her body.
- Understand your clients’ individual preferences and provide them with options to gain a sense of empowerment through making decisions
- Promote your clients to write down their questions so they can remember to discuss their concerns with the doctor
- Encourage your clients through positive feedback in order to improve their self-esteem
- Incorporate activities that are meaningful to your clients that allow them to feel successful
- Empathize with your clients’ emotions and try to identify the cause of their anxiety and fears
- Explain how you have designed their plan of care to address their individualized goals
- Discuss self-care strategies with your clients and incorporate them during your session
As a clinician, having a patient throw her phone across the room initially made me worried that we were going to have a difficult time reaching her goals. However, the use of empathy, listening skills, and patient-empowerment techniques enabled this patient to discharge home healthier, more independent, and more confident about her ability to care for herself.
In conclusion, one may not be able to control the environment or what is physiologically occurring in the body, but by adopting an empowered mindset one can manage the challenging emotions that accompany being in the hospital. Find strength and comfort in knowing you are in control of your decisions and capable of determining the best course of action for your health in collaboration with trained professionals.
Reference: Centers for Disease Control and Prevention. (2020). What is health literacy? Centers for Disease Control and Prevention. https://www.cdc.gov/healthliteracy/learn/index.html