care planning for idiots

My husband has had a painful knee for ages. After months of moaning, limping and ignoring my advice, he finally went to see his GP who gave exactly the same advice as I had. However, he then began to dutifully take his paracetamol 4 times a day. Because the doctor said so. A few months passed, several more visits to his GP, followed by an MSK consultation and, last week, a physio appointment.

He returned from his physio assessment clutching an exercise regime, a red elastic band and a fluorescent post-it note with “Don’t forget, see GP” written on it. His first point of call, as usual, was the remote control, quickly followed by the telephone to make an urgent appointment to see his GP. Being slightly concerned, I enquired as to why he needed to see his GP urgently, to be told that the physio had pointed out that he had a rash on his legs.

“That will be your eczema then” I said, before pointing out that he had had eczema patches intermittently for years and had ignored any advice or remedies that I had provided during this time. Nevertheless, off he went to see his GP, and returned with the expected tube of steroid cream. This now sits in the bedroom alongside the identical tube provided by yours truly.
The very next morning, the alarm went off, I legged it across the bedroom, pressed snooze and, as I was climbing back into bed, caught sight of myself in an ill-placed full length mirror. “Oh bugger” I thought to myself as I pulled the duvet over the offending wobbly bits “I’m still fat”.
Not wanting to waste time pondering this, I shut my eyes to get another five minutes before I had to repeat this ritual. Next thing, I heard a groan and prising open an eye, saw himself’s head and shoulders appear into sight from the floor at his side of the bed, followed by a red elastic band landing on the bed. Breathing a sigh of relief that he isn’t on the bedroom floor because I accidentally kicked him there in the middle of the night, I then watched him pick up his steroid cream (the new one, of course) and start to apply it to the offending dry, scaly patches on his legs.

I was slightly incensed about this. I had spent months, if not years, offering explanations, advice and treatment to clear up some relatively mild eczematous patches and one word from a physio and off he was seeing his doctor, not only that, he then follows the self-same advice to the letter.

“What have they got that I haven’t” I wondered aloud, childishly pointing out that I had given him exactly the same cream as his doctor, only to be informed that “obviously, he is a professional; he knows what he is doing and anyone would be silly not to follow the treatment he has prescribed to sort the problem out. Especially when you had to get your legs out in a fortnight and be evaluated on the effectiveness of the treatment”.
Strange language from my husband indeed, I thought, especially the ‘evaluated’ word. Clearly, he had taken great notice of these words of professional wisdom.

I fumed about this all the way to work, still pondering why he will follow someone else’s advice, but not mine. My conclusion was that I am just the missus. One that can’t (won’t) change a light bulb, and can’t (won’t) lift heavy things. He obviously doesn’t recognise me as someone with any medical knowledge or ability. And why should he? He has never seen me at work and I tend not to talk about the details of my work, unless they are really juicy. After all, there are far more interesting things to discuss than patients and their common ailments. However, he does sometimes comment on how nice the house smells and the occasional tasty meal, and he asks my advice on how to work the Hoover or sew a button on, but given he spends much of his time at home watching me do these things, he obviously see’s my housekeeping ability as my true vocation. Once I had rationalised his behaviour, I still felt a bit annoyed, but I could understand his logic.

This morning, as usual, I jumped back under the duvet muttering profanities at the image in the mirror. Hubby isn’t usually around to hear this every morning, but his cream-rubbing ritual means he has witnessed this for several days now. “what’s wrong with, you grumpy sod?” he lovingly asked. So I stuck my leg from out of the duvet, grabbed hold of my thigh and gave it a shake which, I incidentally noticed, made my upper arm and stomach wobble too. So I told him that I am sick of waking up, looking in the mirror and seeing the same depressing reflection every day.

“Mm” he pondered, “given how much low fat crap and vegetables you make us eat, and how much your bloody gym membership costs, I’d be a bit pissed off too I suppose. But obviously your plan isn’t helping you towards your goal. Maybe you need to re- evaluate it”

“Pardon?” I snapped, but he was off, bouncing down the stairs, tripping over a cat, and out of earshot. I turned the alarm off – well and truly awake by now, and got back into bed without looking in the mirror. Reflecting on our strange conversation (strange in that we don’t usually have any conversation whatsoever in a morning), I get inklings of a distant memory...... bloody hell...., Goals, evaluation, problems, treatment,............ care plan language!

“That’s it”, I thought. Realisation dawning. How could I expect to change my body when I had never really sat down and thought about what I wanted to achieve? OK, ‘lose some weight’ is kind of a goal, but not very specific. After all, I could lose half a pound and have achieved my goal, but I would still be swearing at the mirror every morning. I was a member of a gym, but quite often just went to sit in the aromatherapy steam room and then have a coffee and a cake with my mate. Steamed broccoli plays a huge part in my culinary repertoire, but was the creamy, cheesy sauce poured over the top helping?

“That’s it” I realised, “I need a care plan”. Identify the problem, have a SMART goal, develop a plan of action, and evaluate my progress regularly.

Easy!

Just one thing before I get started, can anyone remember what S.M.A.R.T stands for??