Telling people, “You have to learn and do this” most often is just not going to work. Whether it’s a patient, a colleague or staff member, you can’t teach anybody anything until you motivate them to want to learn. So how do you motivate people? It may be one of the hardest things health care providers ever have to accomplish.

What’s important to them?

If there’s no personal incentive to do so, why would anyone do something that you know might keep them well or even keep them alive? Look at the people you’ve cared for who fight to survive and the people who just give up or become a member of the “noncompliant patient group.” You’d think that staying alive and healthy is enough of an incentive but it can be so overwhelming to some people, they believe they’ll fail anyway. What’s the point?

In order to learn or do something, there has to be some internal stimuli that says, “This is important to me. It will make a difference in my life and I will do it for me or the people I care for.” Sometimes the incentive is because they’re afraid not to do it. That’s why we teach people about complications and ramifications of not taking their medications or not following treatment regimes.

So what buttons do you push?

What’s important to her? What would he go to war for? What’s not important? Should I get his family or significant other involved? In order to find the right buttons, we need to talk to the person, but more importantly, listen to their answers. Ask them what they want from you and really listen. You’ll hear what’s important to them, and then the critical point arises. Give them what they want, the way they want it.

 I like to ask patients several questions in my first visit. “How do you feel about having diabetes?” is always the opening. Then I want to know what they expect me to do for them and very importantly, what they already think they know about diabetes.

Anything you have to teach a patient must become relevant at that moment or teaching is useless. Sometimes the hardest thing I have to do is correct misinformation they’ve gotten from other health care providers. My specialty is diabetes but this is applicable for any patient care situation. Whether it’s an acute or chronic illness, every person has to learn something about their health care needs. Just look at all the things a new mother has to learn about caring for that tiny baby.

What do they care about?

Health care providers are well intentioned people who work very hard and in difficult situations with time constraints. We may be in a hurry, but we need to make the time when the questions and answers will change the patients lifestyles for the rest of their lives.

I define patient education as giving the person all the information they need to make decisions about what they will or will not do. Give them what they need to make those decisions. Adults need to take some responsibility for their own lives. They need to:

• become part of the health care team
• ask questions
• insist on understanding the answers
• be informed

7 common barriers

So if we know how and what to do, why doesn’t it work all the time and just get done? Because there are barriers. You can find the motivation, but remember that barriers will not take care of themselves.

What kinds of things constitute barriers and what can you do about them? Here are some suggestions:

1 Avoid using complex materials and teaching unimportant things
Keep it simple and don’t waste patients’ time with things that aren’t relevant for them or important in their lives. If they don’t have to do it, don’t teach it.

2 Don’t waste their time
Respect their time. Teach when it is convenient for them, not for you. A person who just worked an eight hour day may not learn anything in an evening class. 

3 Eliminate unreasonable rules
Give them choices in what they can learn. It doesn’t have to be all or nothing. Remember changing one behavior can motivate people to change others when they see successful outcomes. For example, nothing makes you continue to lose weight like losing weight at the beginning. If I can get a person to change from regular soda to diet soda, that’s a major accomplishment.

4 Recognize language barriers and respect language issues
Make sure materials are available in clear concise English or in the proper language for the patient. Spanish in Mexico uses different words and has different meanings than Puerto Rican Spanish. Where do your patients come from?

5 Overcome cultural barriers
These can be enormous challenges when you teach in a multicultural environment. Do some research and ask your patients to share what values their culture find most important. Most Latino people will want their entire family present when they are taught anything. You can change the meal planning lives of an entire family.

6 Is cost an issue?
Do your patients have to choose between medications and the food you want them to eat? Are you prepared to help them find the resources they need to fund the health processes you want them to follow?

7 Are they health literate?
Health literacy is defined as the ability to obtain, process, and understand health information and use that information to make appropriate decisions about one’s health and medical care. I read a study lately by Dr. Barry D. Weiss that said that one third of the American population, 90 million people, had limited health literacy.

What pushed your buttons?

To find out how to motivate the people you care for or work with, think about what turns you on. Are you so different from those people? Did something get you excited about a subject and turn you on to learning more about it? Was it a group or a person? Was it a subject or an instructor? Did it make your life easier or better? Did it make you richer or better looking? Did it keep you healthier or actually save your life? Maybe it just helped you pass a course so you could graduate.

Make goals reasonable and achievable

If you want to motivate people you need to ask them what turns them on or off because once you know what turns them on, it then becomes the teachable moment. That is so exciting. You can achieve amazing things when a mind opens up and says, “teach me, help me.” However, the goals need to be reasonable and achievable.

Here’s an example. One of the most interesting things happens when you talk to a group of people about losing weight. Ask how many of them have been on a diet and then ask them all the reasons the diet didn’t work. Usually you’ll find out that the goals were too high or the expectations were unreasonable. Always happens. When someone told them they had to lose 50-100 pounds, they were overwhelmed and knew they couldn’t succeed.

I ask them how they’d feel if they could lose ½ a pound a week by walking one mile, three times a week. They all look disappointed and disgusted. I then remind them that that adds up to 26 pounds in one year. Then I ask them how they’d feel about losing 26 pounds this year. They all get excited and turned on. How would you feel about losing 26 pounds this year? Think about it. Are you motivated now?

That’s how you motivate people. Turn them on, remove the barriers, and get them going!