Writing goals with Alice

Following her review Alice was asked if her priorities were the same.

Alice told you – ‘I am happy with cooking because I know I can make a meal. I know I will be slower and will need some help from my husband but with the adaptive equipment I feel I can quite happily manage the cooking. My husband has already bought the one handed tin opener I think he bought it for himself, he likes his gadgets. The others I’d like to keep as the same but one thing I really would like to be able to do and I’m not sure how easy it would be, is to go out with my husband in the car. It would be great to be able to go for a drive, especially as it’s our daughter’s birthday in a few weeks and I’d really like to go and buy her a present’.

Alice’s priorities and current status
Alice’s priorities Alice’s current abilities/status
1. To walk around the house When walking Alice needs help to get up from a chair to standing and needs help of two therapists to walk as she finds keeping her balance and moving her left leg difficult. She feels that if she had a higher chair to get up from and a walking aid she would be able to walk by herself.
2. To be able to dress myself Alice is able to put on her t-shirt and jumper getting help with her bra only. She needs total help with her lower clothes from one person.
3. To be able to go to the toilet by myself (including getting to and on/off the toilet; adjusting clothes) Alice transfers onto and off the toilet with the help of one person. She can stand with a rail but is anxious about letting go fearing she will fall. She requires help from one person to pull up and adjust her clothes.
4. To be able to go out with my husband for a drive Alice would like to be able to go out for a drive with her husband. She recognises she will need a wheelchair to go out but is concerned about accessing one and how to use it.

Q. From the information given above which are the appropriately written patient centred goals? Answer yes or no to each of the parts below.

Q. From the information given above which are the appropriately written patient centred goals?

Priority Goals Yes No Feedback
1 Alice will get up from a higher chair walk across the gym with a stick and supervision from one person safely and consistently this is a simple, easily understood goal which is clearly measurable and relates directly to her current status.
Alice will transfer her weight forward when sitting to standing, stand independently and once standing gain her static balance. During gait she will keep her dynamic standing balance; swing her left leg through and will maintain her knee extension on left leg stance. She will walk 10 steps with close supervision and verbal prompts only. this goal is measurable but is very detailed and is not written in patient friendly language and uses professional and medical terms that patients would struggle to understand. This means that the goal would mean very little to the patient and it would be hard for them then to assess if they have achieved it or not.
2 Alice will be independent with her upper garments using the correct hemi technique. She will put on her lower garments; stand and gain static standing balance and begin pulling up her garments requiring moderate assistance from one person only. this goal is not written in patient friendly language and uses professional and medical terms that patients would struggle to understand. This means that the goal would mean very little to the patient and it would be hard for them then to assess if they have achieved it or not.
Alice will dress her top half; put her pants, trousers, socks and shoes on in sitting. She will get assistance of one person to pull up her lower clothes in standing to the level of her hips. Alice will complete the final pull up of her clothes over her hips with supervision only. this is a clear and simple goal that is detailed enough to ensure that Alice knows exactly what is required of her.
3 Alice will transfer onto and off the toilet with supervision safely and consistently. Alice will confidently and consistently release the rail and assist with pulling her trousers up over her hips. this is a clear simple measurable goal that relates directly to her current status. It is written in patient friendly language.
Alice will be able to go to the toilet independently. whilst this is a simple, measurable patient centred goal that relates directly to the priority looking at her current status it is too advanced a goal for Alice to achieve in two weeks. Not all goals are achievable but it is important to break down goals into sensible and manageable components for the patient.
4 A wheelchair will be identified and provided for Alice to use; she will get in and out of the car with the help of her husband safely and consistently and will have gone out for a drive. this relates directly to the current status. It is a nice simple, clear and measurable goal written in patient friendly language.
Mr. Rowan will attend therapy and learn how to do a step round transfer onto/off the bed with his wife. Then he will practice car transfers and be shown how to fold a wheelchair. Nursing staff will practice toilet transfers with Mr. Rowan so he can take his wife to the toilet. this is the method that the team will implement to try and ensure and optimise the outcome of the goal but it is not the goal. The goal is to go out in the car. This could be seen as the professional therapeutic goal.

 

Page last reviewed: 01 May 2020