How a Home Health Nurse Can Help Patients with a Change of Habit

• As people age, implementing a change of habit — even to benefit their health — can be a challenge. 
• Home health nurses can play an integral role in helping patients create plans to reach their goals. 
• Consider motivational interviewing and habit stacking in your approach. 

Your patient is diagnosed with a new illness that requires new medications, changes to exercise, and diet. They admit they want to improve their lives but can’t seem to continue with positive habits for more than a few days. 

You explain that the choices they make each day lead to their health outcomes. They nod their head and understand. However, they still struggle with staying consistent with lifestyle choices to feel their best. 

As a person ages, it can be especially hard to change existing habits or adopt new ones. Many people are set in their ways and wired for what they are accustomed to. We are human after all! 

As a nurse working in the home setting, you play an integral role in helping them devise a plan to reach their goals. You’ll need to meet them where they are in their journey. Help them create a plan and customize the approach to make improving their habits achievable. 

Change of Habit Begins with Motivational Interviewing 

Motivational interviewing is a conversation with someone to help make the person’s motivation and commitment to change stronger.

It’s important to engage the patient and help them understand the importance of making improvements to their lifestyle. Patients don’t want to feel dismissed and left out of these important conversations. Include caregivers and family members for additional support.

RELATED COURSE: Case Management and Advocacy in Home Health

The O.A.R.S. mnemonic is an easy way to remember the four ways to communicate when it comes to motivational interviewing: 

• Start with open-ended questions so that you can focus on the patient and begin to understand their knowledge, habits, way of thinking, and beliefs. 
• State affirmations that recognize their strengths so you can help build their confidence. 
• Practice reflective listening to express concern and help them feel heard and understood. This always feels good to the patient. 
• Finally, summarize what you heard from the patient to be sure you are clear and can help them move forward. 

Steps to Take for a Change of Habit

1. Start small: Help your patients by starting with small steps to reach their health goals. For example, if they need to increase their activity level, see how much they are currently moving. If they do about 3,000 steps per day or walk a total of 1 mile, set a goal of increasing that number to 4,000 steps or 1.25 miles a day. Small increments! 
2. Habit stacking: Each of us already has habits or choices we make each day. Whether it’s brushing our teeth or feeding the dog, we do these activities without thinking much about it. The best place to incorporate a new habit is attached to that activity. For example, if a patient needs to add a morning medication — have them take it when it’s time to brush their teeth or feed the dog. Keep it simple. 
3. Keep a record: Put a calendar on the refrigerator and write down the days they need to add more exercise, see the doctor, or start/stop a new medication. Or put a notebook on their side table or counter with directions for them to follow. 
4. Set up a timeline: As you help them keep a record and set small goals, devise a timeline for them to follow and work toward. They’ll be proud of their successes and be more apt to keep going. 
5. Share the decisions: Include the patient (and caregivers or family members if needed) in how the habits will be set up. Decide together what system will work. Don’t let them feel left out! 
6. Be specific: Now is not the time to be vague with a plan. Help your patient understand the specific goal. Walk one extra block a day, eat one fruit for breakfast and as a snack, or elevate their legs for a specific amount of time each day. They’ll be relieved that you are helping them set up this plan. 
7. Identify triggers: Choosing less healthy habits is usually triggered by something. For example, someone who smokes may be accustomed to choosing to do this at specific times of the day or during stressful events. Help them replace these habits by learning what triggers them and how to decrease stress. 

Make the Change of Habit Easy

Changing habits can be hard for many people. We are creatures of habit and aren’t always amenable to new, healthy habits.

It’s natural for patients to fall back to their old ways. This does not mean they are doomed to fail.  

Habit stacking is especially useful to get patients to stick to new habits. Since this technique builds off the existing neural networks in their brains, it’s effective for building new habits.  

The Bottom Line

New habits take time and can be hard to achieve. Many individuals need encouragement and a plan that works. Help devise a plan and set your patients up for success in making better lifestyle choices they can be proud of. 

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