I almost threw in the towel after reading this and didn’t write this post. The interventions in the article aren’t earth shatteringly awesome or all that interesting. But then I realized that that “average” therapy intervention is exactly what this article was getting at. Let me explain.
For this article, they took 2 folks with Huntington Disease, used a new, function based classification system called the Treatment-Based Classifications (TBCs) to guide their clinical decision making as to what types of interventions these people got and then gave them the boring treatments. What WAS interesting about this article is that in the usual, medical Huntington Disease classification scale– The United Huntington’s Disease Rating Scale Total Motor Score (UHDRS-TMS), both of the people involved here fell in the “late stage” Huntington Disease category. The authors of this article were able to demonstrate that we as clinicians can be biased against providing treatments for “late stage” terminal disease folk, even though they 1) aren’t necessarily that functionally declined (TBCs level 3/7) and 2) still have the capability to make meaningful improvements not only in their own lives, but also on our own therapy outcome measures.
Bias can be a powerful thing. So this article serves as a reminder to take the labels our patients come to us with with a grain of salt. Look instead at how they present and at the human face that just wants improved quality of life.