The Plateau Paradox
... and why it
can end therapy
Insurance usually provides coverage as long as
the patient is showing improvement. However, if
improvement stops, even for a few months, coverage usually
ends and never resumes. That's where therapy usually
ends. Patients need lots of practice to master
the new skills they learn in speech therapy. But patients
can't do that practice on their own. They need help. But
insurance doesn't pay for that help. Here's why...
Rehabilitation from a brain injury can take
many months or years. Improvement comes in
spurts. Everyone eventually hits a plateau where
recovery seems to come to a standstill. This does not necessarily mean recovery has ended. It might
mean the survivor needs lots of drill practice to break
through the plateau. Here's where it gets
Insurance coverage is intended only for skilled
medical professional service, i.e., a therapist or
doctor. However, what's needed to overcome the plateau
is lots of drill practice, which does not require a medical
professional. So, guess what?
Insurance does not cover the therapy needed to
overcome the plateau.
And caregivers often cannot get the patient
over the plateau alone. Caregivers are
expected to provide therapy practice to get the patient though
the plateau. Unfortunately, most caregivers are just plain busy working, caring for their
families and the survivor. And, while you don't need to
be a trained professional to provide drill practice, you do
need to have some training or teaching experience.
Therapy practice isn't simply about "testing" or
"correcting" the patient. It's about providing
appropriate (and minimal) cues and hints. It's also
about being patient for hours at a time. That alone is a
challenge for anyone.
So, where does this
leave the patient ?