Rehabilitation Process Overview

The Rehabilitation Process

• Rehabilitation involves several basic tasks, including working in partnership with the disabled person and family, providing accurate information and advice about the disability, listening to needs and perceptions, working with colleagues in an interdisciplinary manner, liaising with key caregivers and advocates, and assisting with establishing realistic goals.

Key Topics for Discussion

• The study will cover identifying the client, the rehabilitation contract, the rehabilitation process, documentation, and discharge planning.

Identifying the Client

• No specific details provided.

Rehabilitation Contract

• Effective rehabilitation relies on an implicit contract, sharing a mutual understanding of the client’s aims and achievable goals within a defined timeframe.
• A formal agreement is useful when understanding is limited or expectations are unrealistic.

The Rehabilitation Process

• The process consists of data collection, data analysis to identify problems, therapeutic decisions based on comprehensive understanding, and asset generation.
• Data collection involves recognizing patient problems, identifying available resources, and gathering subjective and objective data. Subjective data comes from the patient's perspective (symptoms, feelings, concerns) and is gathered via interviews; objective data is observable/measurable data (signs) obtained through observation, physical examination, and lab tests.
• The data gathered is organized and analyzed to identify the complex network of the person's system and prioritize patient impairments, limitations, and restrictions.

Data Sources

• Sources of data include the medical record, interviews, assessment procedures, screenings, and definitive analysis.

Factors Influencing Examination

• The examination's specificity and depth depend on factors like patient health condition (severity, complexity), stage of recovery (acute, subacute, chronic), phase of rehabilitation (early, middle, late), and cognitive/behavioral factors (level of arousal, communication, participation ability).

Data Analysis and Problem Identification

• The most crucial step is interpreting disability in terms of the individual's complex system.
• Data from the initial assessment is organized and analyzed.
• The therapist prioritizes and identifies patient impairments, activity limitations, and participation restrictions and develops a problem list using the WHO framework, taking the person's system into account.

Therapeutic Decisions

• Therapeutic decisions must consider pathology, problem identification, patient needs, and available services.
• Impairment and disability should be analyzed to determine causal relationships.
• Asset lists are essential to the process.

Example Impairments, Limitations, and Restrictions

• Specific examples of direct and indirect impairments, activity limitations, and participation restrictions, like hemiparesis, shoulder subluxation, decreased ROM and communication are given.
• This demonstrates an example of impairment, activity limitation, participation restriction, and contextual factors.

Contextual, Physical, Social, and Attitudinal Factors

• Factors such as the individual’s living situation (one-level house, limited steps) social and attitudinal contexts are relevant and mentioned (spouse as main caregiver, motivational level, family involvement etc).

Rehabilitation Aim and Goals

• The aim should be the overall expected outcome, achievable in the long term.
• Specific goals are precise to allow monitoring of progress. They should be SMART (Specific, Measurable, Achievable, Relevant, Time-bound).

Components of Goal Statements

• Goal statements should clearly include the individual, behavior/activity, condition, and time elements.

Examples of Expected Outcomes

• Short-term and long-term goals for rehabilitation are provided, covering areas like ambulation, wheelchair propulsion, activities of daily living, independent behaviors, mobility.

Creating a Rehabilitation Plan/Plan of Care (POC)

• The plan of care details anticipated patient management.
• The therapist evaluates and integrates information (patient history, systems review, tests, etc.) considering patient overall health, social support, living environment, and discharge destinations.

Complexity of the Decision-Making Process

• Parameters that increase the complexity of the rehabilitation process and the criticality of optimizing quality of life were presented (QOL), is stressed as important.

Essential Components of the POC

• Anticipated goals and expected outcomes. The predicted level of optimal improvement. Specific interventions (type, duration, frequency). Discharge criteria.

Interventions

• Interventions focus on return to previous function, maintenance of function, slowing progression of functional loss, habilitation of function, or striving for excellence in performance, depending on patient goals.

Clinical Learning Environment

• The concept of a learning environment encompassing the internal and external considerations of the client and clinician.
• A conceptual triad is described: the concept of human movement, the CNS as a control center, and the interaction between the client/therapist in open and closed learning environments.

Monitoring Progress/Re-Evaluation

• Standard documentation is critical for rehabilitation monitoring, progress recording, and auditing. A comprehensive list of problems, impairments, disabilities, goals, actions, and outcomes should be maintained.
• Constant effort by the team to not be constrained by existing routines is crucial. All members should use notes as a central resource for progress recording in a concise and standardized format. All members of the rehabilitation team should document.

This quiz explores the key components of the rehabilitation process, including client identification, rehabilitation contracts, and discharge planning. Understand the importance of interdisciplinary collaboration and realistic goal-setting. Test your knowledge on the foundational tasks involved in effective rehabilitation.