F. Keller1, A. Schoeb2, V. Schoeb1 (1Lausanne ; 2Zug)
Physiotherapy is an important part of rehabilitation, especially in Geriatrics. While physiotherapists assess the patients' functional capacities, social aspects are sometimes neglected. Yet, environmental resources and patient participation are important for enhanced rehabilitation outcomes, as emphasized in the "enablement concept". It enables patients to identify their capabilities, to reinforce and use them to live as independently as possible. This study aims to analyse caregivers' involvement in ambulatory physiotherapy and its impact on patients' rehabilitation potential.
Inspired by a participatory research approach (Citizen Science), this contribution presents a collaborative case study between relatives and the researcher (FK). Exercise instructions were collected from the treating therapist and compared to those suggested by the daughter (VS). The researcher and relatives (VS;AS) evaluated the rehabilitation process of the wife/the mother using qualitative document analysis to highlight the differences.
The analysis reveals the neglect of the caregiver's potential involvement during rehabilitation. Due to the daughter's understanding as a physiotherapist and knowledge of her mother's social environment, a more appropriate exercise program was established tailored to the patient's current activity level. The husband provided structured support to the patient in performing the exercise program resulting in a rapid regaining of mobility. The themes described the supporting nature of caregivers to strengthen patients' abilities: (1) considering and promoting current activity levels; (2) improving exercise adherence; (3) and providing assistance with daily life.
Integrating caregivers into the treatment process helps optimize patients' resources and utilize their potentials. The inclusion of social embedding allows for a more comprehensive evaluation of the patient's social situation and thus more tailored interventions. The support of caregivers enables additional activities and creates more time resources during consultations. However, physiotherapists need to enhance their communication skills and adopt inclusive and shared decision-making with caregivers in order to overcome patient-therapist hierarchy.
Engaging caregivers within an enablement concept is highly recommended as it allows for a holistic assessment of the patient, thereby leading to improved treatment quality in pyhsiotherapy.