As occupational therapists, we've all been there. The patient’s progress seems to have slowed, their hemiparesis lingers stubbornly despite all their hard neuro re-ed work, and measurable goals feel harder to find.
It’s that limbo where the patient is discharged from the hospital but hasn’t fully returned to living life.
They’re no longer in crisis, but they’re still stuck—not yet thriving.
What now?!
Grieving their Losses
Let us not be afraid to sit with our patients, to talk about and grieve the losses they’ve experienced. They’ve lost jobs, roles, independence, and even parts of their identity. Yet, there’s no ritual to mark these losses—no retirement party for their career, no funeral for their rather dead arm.
Let’s talk about what’s been lost and give them the space to grieve. Because on the other side of that grief lies the opportunity for acceptance—and with acceptance comes possibility.
What now?!
Rediscovering Meaning
One of my favorite parts of being a neuro OT is witnessing a patient’s spirit come back to life. It’s when they start wearing jeans again or putting on makeup…when they start believing there’s a life for them to live.
What do they want more of in their lives now?
This is one of the meatiest conversations we can have with patients. And it’s likely not a one and done.
And don’t fool yourself if you think this isn’t skilled.
It takes so much skill to facilitate a person to move towards meaningful living. And it starts with planting seed thoughts. At first they quietly whisper…”Well,
“I’d love to spend more time with my grandkids.”
“I want to bake Grandmother’s dish for the holidays.”
“I’d like to play euchre with my friends again.”
Turning Goals into Action
As therapists, it’s our job to turn these desires into doable goals while demonstrating our skilled interventions. Here are some goal ideas:
Goal 1: Patient will identify 3 leisure, productive, or community re-entry occupations to participate in over the next 6 months to improve health and well-being with no more than moderate cues.
Goal 2: Patient will identify at least two barriers and solutions for engaging in one leisure or community activity to enhance executive functioning.
Goal 3: Patient will initiate at least 1 new leisure activity this month with [strategy/support/resource] and [assist level].
These goals show our skill in blending emotional support with functional progress. They reflect the deeply human, holistic nature of neuro OT.
Why This Matters
This is why we do what we do: to help people rediscover themselves after profound loss. It’s about more than functional gains; it’s about facilitating a return to meaningful living.
If you’re feeling stuck on how to approach these moments in your practice, you’re not alone. At New to Neuro, we provide resources, mentorship, and a supportive community to help you navigate these complexities in neuro rehab.
Join New to Neuro's OT Collective today to access greater support in navigating how to bring more purpose and possibility into your patients' lives.
✌🏽🧠 Peace + Plasticity,
Jessica + the New to Neuro team
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