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Self help

11) Setting goals

You may have had some experience of goal setting if the person you care for was treated on a stroke unit or by community rehabilitation team once they came home.

Goal setting can be very formal when in hospital but at home it can be used to think about what is important for the person and for you the carer.

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Here are some tips to help you with goal setting.

  • Identify the problem. It could be personal, (walking to local shop) a family task (planning a day out ) or a long term plan ( driving again ). Write down what you want to achieve.
  • Start small. Even if the problem is a long term aim it can usually be broken into smaller tasks. For example the goal maybe to wash and dress without help. Break this down into smaller goals such as washing hands and face at the sink. Use a chair if the person has poor balance. Put all items required for the task within reach. Move on as the person achieves each part of the task. Wash upper body and affected arm and so on.
  • Specify the goal. Sometimes by being specific about how many times the person will do the task every day or for how long can give you a measurable goal. “I will do my leg exercises three times a day for ten minutes each time”. This also allows you to make the task a little harder in stages by increasing time or frequency.
  • Be realistic. If the person sets too high a goal they are more likely to be disillusioned if they fail. It is better to set small steps which eventually lead to improvement.
  • Adjust the goal if they are not achieving it. Look at why the person is struggling and try to break down the task further or change the method of how the task is done. You can ask for help from your health care team.
  • Be flexible. We all have good and bad days. If it is a bad day, rest and try when they are feeling more able to attempt the task.
  • Review and revise As the person progresses think about the next goal or the next stage in achieving this goal.
  • Increase independence in a task For example in the kitchen, this task can be as simple as buttering bread or as complex as following a recipe to make a two course meal. All the stages in between can add to the person being more independent with practise.
  • Relearn a skill or adapt Start with the basics and increase skill level as confidence increases and the physical effort becomes easier.
  • Set a reasonable time scale It is easy to put off a difficult task. Having a timescale to follow it gives a focus to complete it and satisfaction when you do.

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Here are some tips to help you with goal setting.

  • Identify the problem. It could be personal, (walking to local shop) a family task (planning a day out ) or a long term plan ( driving again ). Write down what you want to achieve.
  • Start small. Even if the problem is a long term aim it can usually be broken into smaller tasks. For example the goal maybe to wash and dress without help. Break this down into smaller goals such as washing hands and face at the sink. Use a chair if the person has poor balance. Put all items required for the task within reach. Move on as the person achieves each part of the task. Wash upper body and affected arm and so on.
  • Specify the goal. Sometimes by being specific about how many times the person will do the task every day or for how long can give  you a measurable goal. “I will do my leg exercises three times a day for ten minutes each time”. This also allows you to make the task a little harder in stages by increasing time or frequency.
  • Be realistic. If the person sets too high a goal they are more likely to be disillusioned if they fail. It is better to set small steps which eventually lead to improvement.
  • Adjust the goal if they are not achieving it. Look at why the person is struggling and try to break down the task further or change the method of how the task is done. You can ask for help from your health care team.
  • Be flexible. We all have good and bad days. If it is a bad day, rest and try when they are feeling more able to attempt the task.
  • Review and revise As the person progresses think about the next goal or the next stage in achieving this goal.
  • Increase independence in a task  For example in the kitchen, this task can be as simple as buttering bread or as complex as following a recipe to make a two course meal. All the stages in between can add to the person being more independent with practise.
  • Relearn a skill or adapt  Start with the basics and increase skill level as confidence increases and the physical effort becomes easier.
  • Set a reasonable time scale  It is easy to put off a difficult task. Having a timescale to follow it gives a focus to complete it and satisfaction when you do.

If the person you care for wants to find out about practical things to do to help them self manage after their stroke then the Self help 4 stroke website contains all kinds of really useful tips and practical tasks to set goals and enjoy life after stroke. It has a section on Goal Setting and Emotional Support. It is simple to use and is full of information they can download or print to try at home.


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