"Ideal Daily Game Plan", Long and Short Term Goals; Tools from MY OT Toolbox for YOU

As an occupational therapist, I focus consultation and 'treatment' around function, and just as I want Lumigrate to be streamlined for people, as time and energy are limited for so many people, I have taken that approach as an OT as well. 

The other side of that coin is that today many people don't have the insurance or the money for copays or fees for what occupational therapists 'do', so I'm frequently essentially distilling a lot of occupational therapy training and other education to people related to their specific case.  What seems to be needed for many people I will then put on Lumigrate, knowing that as time goes on we then develop a bunch of useful information to help many people. 

I find it interesting that in a conversation this weekend with another provider who coaches patients with fibromyalgia verbalized the problem of 'forgetfulness' with her clients related to their carrying out the things they are discussing and agree upon as things to do for turning around the health issues.  I was preparing this to post here for a client/patient/case/team I'm working with currently to use as a resource -- someone with a totally different 'medical malady', as a friend of mine likes to call things. 

There likely are many who can benefit from this "Daily Game Plan".  This is something I developed in the past five to ten years and used with overall success with patients who have had anything going on with their body/mind/spirit which was making them forgetful or in disarray related to taking care of their daily needs and habits for the best interest of their health and well-being.  That can be strokes, fibromyalgia, attention deficit disorder, Parkinsons disease, and various conditions related to dementia or simply being overwhelmed with a family medical crisis or being in menopause!  

This is something each person/team can develop and change, then fine tune and photocopy the original of so that every day the person has a new checksheet to go by.   Every person's mind works a bit differently, and some people are going to be more inclined to use a tool like this, but it's a good place to start with every person having difficulty working all the things into their day they are wanting to do.  It goes hand in hand with goal setting or intention setting.  Please refer to the forum on Life Coaching for more resources/information related to goal setting.  One suggestion is a piece from New Years 2010/11 timeframe by Gwen Pettit, one of Lumigrate's contributing Life Coaches (and also Western Colorado therapist with many years experience as a Physical Therapist).  She provided something wonderful about goal setting which I'm going to copy and add below here so you have them both in one "Stream"/topic). 

Here's how:  

1. Take out a blank piece of paper or get on your computer if that's how you 'are' -- use whatever software YOU know and think will work for this task. 
2. Write  or type "Ideal Daily Game Plan for (then write the person's name)"
3. Then make several columns so it essentially looks like this example:  

Things to do from start to end of day                Completed                      Notes

      4. Then along the left side, list the things that person's ideal day would have, from start to finish. 

           Example (and how it might look later):

Drink glass of water set up at bedside                X

Do brain integration exercise                             X

Go to the bathroom                                          X

Take morning medications                                X                        Need to call related to ordering more

Eat breakfast                                                   X                        Had oatmeal and a glass of juice.

Brush teeth

Do morning stretching

... (another task)

... (another task)

Go for mid-day walk

...

...

Set up glass of water by bed for tomorrow

Do mindfulness meditation related to day's highlights (and record tomorrow reflections on the previous day)*

*This last one you don't have a checkmark for as you don't want the person to get back 'awake' to check it off, but you have them record their thoughts the next day and then file the page wherever they are filed for future reference.  In that case, you'd add a line item potentially for 'complete yesterday's game plan and file it'

I hope you see the application to how this can be helpful to people -- yourself or a loved one you are helping, or if I'm updating this in summer 2011 related to a court appointed medical guardian who is on a budget related to health care for the client and 'deputizing' her as a 'peer occupational therapist', and then my charges are reduced to doing the supervision and training to the staff involved in the person's day to day and weekly/overall management.

I've used this with many different patients and an example of how it can be helpful is in making nutritional changes and changing habits.  An example from my past years working with a patient who was working on brain/body re-integration exercises and modifying lifestyle due to a stroke wanted to start drinking pomegranite juice, as he believed it was a good juice to add to what he was doing for nutrition.  He was accustomed to taking a break in the afternoons and having a soda pop, so we listed it as pomegranite or cola, and then he could chose at that time of which route to take -- the old habit or the new. 

For a couple of weeks he tried to have the pomegranite in the afternoon but he ultimately changed the flowsheet to have the juice in the morning and have a cola every afternoon.  It's up to each patient/person each moment what they chose to do, it's our 'job' as the therapist or supportive team member to offer solutions to fill the gaps in what keeps people from doing their best.  And then we have to let them 'own' the reality which they create. 

Habits are difficult to change and the more cognitive dysfunction a person has the more difficult that can be, but this IS a tool which, if a person can read and write checkmarks and a few words and has the desire to work with this type of strategy, has proven to be very helpful for those who are having difficulty with time management and memory, among other things.

If a person does not 'take to' this, then the next step is to assess 'why' -- is it they don't remember it, see it, or WANT TO.  And if they don't want to, then you can see if there are some motivators to get them to do so. It's a process of ongoing problem solving and trying things and I suggest you not get discouraged if something doesn't work -- as long as some of the things work and you are making progress then that's what matters most.  

I hope you find this a useful tool to trial, and I look forward to working with this in the future if people wish to consult with me privately.  ~~ Mardy