Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Interfering with Recovery

Two things ecourage a patient to become more active:

a. It is imperative that all injured workers be as active as their physical condition permits. Most do a great deal less than that of which they are capable. Many can walk, garden, clean the house, and engage in numerous other activities within their objective limitations. They fall into a pattern, however, of doing little more than watching TV, gaining weight, looking forward to their next pill and/or drinking. They become sedentary, obese, irritable and acclimated to living a life of restriction and self-imposed disability. The need for them to be active is unquestionable.

b. However, if you are able to mobilize them, then other forces may use this healthy behavior in an unhealthy fashion and punish the patient for having mobilized.

This can be readily resolved.

1. a written treatment plan that describes the activities that that are being encouragws. A copy should be sent to each treating doctor that assures that the doctor is aware of the plan, that the plan falls within objective limitations, and that the plan is endorsed by the doctor as part of rehabilitation.

2. A copy of this plan in the insurer/employer_s file on the patient and direct dialogue with the claims adjuster (or manager) that this is the plan upon which all have agreed (patient, doctors, etc) and that if the patient is observed in these and related activities, it is no different than physical therapies. The activities are part of the recovery process.

Without a consensus among all involved, however, the problem, is a consistent concern.

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