Motivating and coaching clients, and addressing their concerns

It is important to consider that many people may not want to do exercises for various reasons and to find solutions to them. Some of these reasons may include:

1.     Fear that rehabilitation will

• Cause pain
• Cause breathlessness
• Worsen an already existing health condition
• Not work

2.     Past traumatic or unwanted experiences with rehabilitation

3.   Embarrassment. People may want to appear healthy and fit already and not want to be seen doing rehabilitation

4.     Lack of knowledge on the benefits of rehabilitation, indications and how to do it

5.     Lack of time to do rehabilitation

Empower a person to do home exercises by providing the following:

• Educate and advice – educate and advice the person on the causes, management and how to prevent exacerbation or recurrences of the condition. This can be enhanced by providing written information such as brochures and flyers on the condition or links to websites with information.
• Motivate and coach – motivate the person to continue with home exercise programmes. Build the person’s confidence by giving encouraging words, letting the person practice and gently correcting the person. Provide coaching on ways to adjust self-care activities in order to live as independently as possible in the community (link to self-care module). Discuss with the person how best to create a rehabilitation plan that fits into their daily schedule and enables them to achieve the desired goal.
• Provide support – Be willing to answer any questions the person might have regarding the rehabilitation process. If possible, link the person to a support group or persons with similar conditions who are successfully self-managing and can serve as role-models.

Caregivers who are involved in and support a person’s rehabilitation can easily find the work demanding and depressing sometimes. Providing them with the measures for self-management can also help them to provide better care and prevent caregiver burnout.

Monitoring exertion levels

It is also important to determine the intensity of the exercise and this is usually done via the BORG scale.

The modified Borg rate of perceived exertion scale allows participants to estimate how hard they think they are working (intensity).

Modified Borg rate of perceived exertion scale

Exercises are usually set at a rate where the person will perceive the intensity as ‘moderate’.

If the person reports an exercise intensity as ‘hard’ or ‘easy’ following prescription, then the prescription should be reviewed