004 TFCC: Dear Diary…

9 Oct

Today, we’re diving into a tool that can make a significant difference for anyone with cognitive barriers: Health Journals.

We all know how difficult it can be to keep track of appointments, medications, symptoms, and advice from doctors and therapists. For individuals with cognitive deficits, this challenge is often magnified, especially when they’re managing multiple professionals, including:

Specialist appointments, like neurologists
GP appointments
Tracking symptoms and responses to new treatments
Navigating funding support
- Understanding new funding schemes
- Grasping available supports
- Engaging in independent medical examinations
Allied health involvement
- Discussing current concerns and tracking occupational performance
- Monitoring application statuses
- Rehabilitation programs and homework
- Reviewing progress
Support workers
- Schedules
- Tasks to be completed

This is where a health journal can be a game changer. It serves as a central place to record all health-related information in a way that suits your client.

What is a Health Journal?

A health journal is a simple yet powerful tool that provides a summary of a person’s health journey. It can help track:

Personal details, particularly around funding schemes
Contact information for health professionals and services
Medications
Symptoms and patterns that need to be reviewed by specialists or GPs
Rehabilitation programs and recommendations
Application statuses for equipment, such as wheelchairs or funding support
Appointments and follow-up actions

The beauty of a health journal is its flexibility—it can be digital, like a Google Doc or Google Drive folder, or physical, like a notebook. The key is that everything is in one place, reducing the cognitive load of remembering details and improving communication between all involved.

Benefits of a Health Journal

A health journal can provide several advantages for individuals dealing with cognitive challenges:

Organisation & Documentation: A health journal helps clients organise and document all their health information in one accessible place, making it easier to track important details such as medication schedules, doctor’s advice, and symptoms.
Symptom Tracking for Medication Reviews: Clients can monitor and record symptoms or reactions to medications, ensuring that they have accurate information for their doctors during reviews.
Improved Communication Tool: It becomes a practical tool for sharing information with therapists, GPs, and other professionals. This is especially useful for multidisciplinary teams, as it ensures everyone is up to date with the client’s treatment progress.
Reduces Cognitive Load: For individuals with cognitive impairments, a health journal alleviates the pressure of having to remember complex health information. It allows the client to offload the burden of recall, making their healthcare journey more manageable.
Supports Accurate Communication: With all health details recorded, it ensures accurate communication between the client and their healthcare professionals, reducing the likelihood of information being missed or forgotten during consultations.
Empowers Clients: A health journal encourages clients to take an active role in managing their health. By having all the necessary information at hand, clients can engage more confidently with their healthcare team and make informed decisions about their treatment.
Compensatory Strategy for Cognitive Challenges: For clients with cognitive difficulties, a health journal serves as a compensatory strategy, helping them stay organised and process information more effectively, which can lead to improved outcomes.

Who Would Benefit from a Health Journal?

A health journal can be particularly helpful for:

Individuals Experiencing Cognitive Overload: When health management feels overwhelming, offloading information into a journal reduces mental strain and simplifies the process.
People with Processing Difficulties: Writing things down can aid understanding and retention of information, supporting clients who struggle with processing complex details in real-time.
Clients with Memory Difficulties: For those with memory challenges, a journal provides a reliable way to record and review important health details, avoiding reliance on memory alone.
Clients with Large Multidisciplinary Teams: Health journals can significantly improve communication and coordination between multiple healthcare providers, particularly when tracking therapy goals, tasks, and progress.

Why Use a Health Journal?

Incorporating a health journal into your client’s care routine can offer several important advantages:

Improved Recall: A health journal allows clients to track vital information, such as symptoms, medication schedules, and follow-up actions, easing the burden of trying to remember everything.
Enhanced Communication: By keeping all health details in one place, the journal serves as a key communication tool between healthcare providers, ensuring that everyone involved in the client’s care is well-informed and on the same page.
Empowerment: With a health journal, clients are encouraged to take an active role in managing their health. It empowers them to make informed decisions about their care, knowing they have a comprehensive record of their health journey.
Consistency & Routine: A journal reduces the cognitive load of remembering health details, which is especially important for clients with memory or processing difficulties. It allows for consistency in their healthcare routine, reducing the risk of forgotten appointments or missed medications.
Organisational Tool: Health journals streamline the complexity of managing multiple care providers, therapies, and treatments. For both the client and their healthcare team, it makes life a little easier by ensuring that all information is easily accessible.

How to Set Up a Health Journal:

Helping your clients set up a health journal can significantly streamline their health management, especially if they have multiple providers. Here’s how you can guide them through the process:

Choose the Right Format:
- Digital Options: If your client is tech-savvy, a Google Doc or Google Drive folder, or an app like PrepareMe could be ideal.
My preference is a Google Doc alongside a Google Drive. It’s easy to update, can be shared with their care team, and is accessible from anywhere. It’s also great for storing related files, such as doctor’s notes or prescriptions. You can add Photos and Videos for relevant information.
A note on digital tools: there are so many options out there for organising. With those with Cognitive deficit the goal is to be clear and implement one method and adhere to it. Trialling different tools will likely cause confusion and risk of abandonment. Make sure you are aware of what you are doing: Educating someone with minimal errors will help the teaching of the task. Consistency is key with implementing a health journal.
- Hardcopy: For clients who prefer pen and paper, a notebook or planner works just as well. Writing things down can reinforce memory and keep information accessible.
Set Up Key Sections: Make the journal easy to navigate by organising it into clear sections:
- Personal & Funding Info: Track personal information, such as claim numbers, and plan goals for funding schemes (like the NDIS) or status updates on compensation claims, as well as notes on how to access this further information. I also add information around any consideration such as ‘I need people to send me text message summaries after a phone call’.
- Contact Information: List the names and contact details of healthcare providers, specialists, and support workers, so it’s easy to reach out when needed. Noting what each support does. For clients who ask re-occuring questions it’s great to mock up a decision flow chart to assist with who these questions should go to.
- Medications: Dedicate a section to recording medications, dosages, and any changes. This will make it easier to communicate with doctors, especially if side effects arise or medication adjustments are needed.
- Symptoms & Rehabilitation Programs: Help your client log symptoms or responses to any treatments and medication. This is where it’s also great to monitor goals and homework related to a persons rehabilitation goals. This enables them to be more accountable and adhere to homework plans. It can also help with professionals helping professionals, for example A Physiotherapist who provides a home program may have some environmental assistance from a Home based community OT to set up the home and routine for success of adherence.
- Appointments & Follow-Ups: As per most people’s journals the opportunity to record upcoming appointments, outcomes, and any follow-up actions. This is great for allied health professionals who need to keep the client updated on the status of Assistive technology or Home Modification applications. The quick reference guide empowers the client to know what’s happening in their plan.
- Support Worker Tasks: If applicable, use this section to keep track of support workers’ schedules and the tasks they assist with.
Personalise It: Encourage your client to customise the journal in a way that suits them. Colour-coding sections, using bullet points, or adding diagrams can all help make the journal more user-friendly and meaningful.
Keep It Updated: Consistency is key. Set up reminders on your client’s phone or calendar to update their journal regularly, especially after appointments. I have set expectations with the Care Team to spend 5 minutes at the end of their session to support the client to engage in the Health Journal review. This will help ensure that the journal is current, which in turn supports better communication across their healthcare team.

Why Health Journals Matter:

For individuals with cognitive deficits, managing appointments, medications, symptoms, and therapy can feel overwhelming. A health journal helps reduce that mental load by providing a clear system for tracking and managing health information. It also facilitates communication between the client and their team of professionals, ensuring that everyone is on the same page. With everything organised and in one place, clients can feel more empowered and less stressed about their health journey.

I’ve had clients go from feeling overwhelmed and flustered in appointments to empowered and informed with the implementation of a Health Journal.