UNIT=VII
REHABILITATION
Prepared By
Samjhana Neupane
Msc. Nursing 2nd year
TERMINOLOGIES
IMPAIRMENT :
• Any loss or abnormality of psychological, physiological, or
anatomical structure or function.
• Impairment includes clinical features or manifestations of the disease
or condition. Examples: weakness, confusion etc. In this definition
function is the function of a body part, not the whole-person function.
DISABILITY :
• Any restriction or lack resulting from impairment of ability to perform
an activity in the manner or within the range considered normal for a
human being.
HANDICAP:
• A disadvantage for a given individual resulting from an impairment or a
disability that limits or prevents the fulfillment of a role that is normal
(depending on the age, gender, social and cultural factors) for that
individual.
INTRODUCTION :
• It is commonly known as Rehab, is a scientifically developed
procedure for ensuring the recovery from any kind of
disability and injury.
• It is a slow but steady process.
• Here patient have to follow special instructions to ensure that
the malfunction does not hit back again.
MEANING OF REHABILITATION :
• It is restoration of ability to function.
• It is to support the patient with an injury or disability
illness to achieve maximum function and
independence
DEFINITION OF REHABILITATION
• “The combines and coordinated use of medical, social, educational
and vocational measures for training the individual to the highest level
of functional ability”. WHO
• Rehabilitation is a treatment designed to facilitate the process of
recovery from injury, illness, or disease to as normal a condition as
possible.
OBJECTIVES:
• To restore affected abilities to the highest possible level of
function.
• To prevent further disability/ handicap.
• To protect the person abilities.
• To assist the person / patient to use his or her abilities
Principles Of Rehabilitation:
• Rehabilitation should begin during the initial contact with
the patient.
• Restoring the patient to independent or to regain his pre-
illness/pre-disability level of function in as short a time as
possible.
• Maximising independence within the limits of the disability.
• He must be an active participant.
• The activities of daily living are facilitated.
• The individual with a disability is encouraged to wear his
clothing enhances self-esteem and dignity.
• Motivates the patient and helps him to attain social
independence.
• Focus is on the needs of groups of people with specific
condition
• Every patient has a right to the rehabilitation services.
ISSUES IN REHABILITATION:
a) Quality of Life versus Quantity of Life:
• Rehabilitation focuses on continually improving the quality of the
person’s life, not merely maintaining life itself.
• It focus on making the life productive and returning optimum
functioning of the body.
b) Care Versus Cure:
• Rehabilitation gives importance to care and it is provided at the last
stage of treatment.
• When treatment is completed rehabilitation starts.
• Many conditions remain irreversible; therefore, the focus of care is
related to adaptation and acceptance of an altered life rather than
resolving an illness as it depends more on care, exercise like skill
training, acceptance of situation rather than on medication.
c) High Cost of Interdisciplinary care versus Long-term Care
• Rehabilitation is expensive.
• Success is sometimes seen as a return to productive employment.
• Patient with chronic illness needs long term care whereas by
rehabilitation may be the individual becomes so sufficiently
independent that no caregiver is required.
ETHICAL ISSUES:
a) Respect for Autonomy
b) Beneficence
c) Justice
d) Ethical Dilemmas
REHABILITATION TEAM
• Rehabilitation usually encompasses a number of special health
service that may be made available to the individual patient on the
basis of particular need which includes the physician and the nurse
and may also include a physical therapist, social worker, vocational
counselor or other professional personnel when indicated.
• The team evaluates the patient’s need for rehabilitation and
develops a plan to give maximum assistance in achieving
rehabilitation goals.
Types of Rehabilitation team:
1) Multidisciplinary rehabilitation team
2) Interdisciplinary rehabilitation team
3) Transdisciplinary team
1) Multidisciplinary Rehabilitation team:
It is when many different professionals work together towards a
common goal .
2) Intradisciplinary rehabilitation team:
A team of professionals who are all from the same professions , such
as three therapist collaborating on same case.
3) Transdisciplinary rehabilitation Team:
A team composed of member a number of different professions co-
operating across discipline to improve patient care through practice or
research.
Rehabilitation team member:
• Nurse
• Physiotherapist
• Psychologist
• Dietician
• Speech Therapist
• Recreational Therapist
• Social Worker
• Vocational Rehabilitation Counsellor
• Occupational Therapist Rehabilitation Team
• Speech Therapist
• Recreational Therapist
• Social Worker
• Vocational Rehabilitation Counsellor
• Occupational Therapist
PSYCHIATRIST
• Leader of the team.
• Responsible for each intervention
• Evaluates the patient
• Plans.
• Organizes.
• Directs
• Coordinates.
• Controls.
• Motivates.
1) NURSE
• Controls environmental factors.
• Directs personal care of the patient.
• Manages medication.
• Is responsible for skin integrity.
• Helps ADL and adaptive devices.
• Organizes bowel and bladder program.
• Helps the patient manage their time.
• Informs the team about the status of the patient.
• Educates the patient and the family
2) PHYSIOTHERAPIST
• Performs muscle strength testing.
• Evaluates the length and the tonus of the muscle.
• Exercises the patient especially for gross motor function.
• Teaches how to transfer.
• Instructs the use of wheelchair, canes and crutches.
• Offers physical therapy modalities.
• Educates for posture and walking.
3)Occupational therapist :
• Help to develop the skills needed for the activities of day to day life.
4)Speech Therapist:
• work to improve speech and language, conversation skills and the
thinking skills necessary for communication.
5)Psychologist:
• Evaluates the psychological status of the patients
• Tests intelligence, memory and perceptual functioning
• Incorporates the test results into the care plan
• Educates family and patient
• Counseling of the family
6)Social worker :
• Evaluates patients (life-style, family, finances, employment,
environmental factors)
• Maintains a continuing relationship with the patient and family
• Coordinates funding resources
• Provides assistance in locating alternative living situations
• Provide emotional support in stressful situations
7)Respiratory therapists:
• Help the people with breathing disorders, including training in use of
ventilators.
8)Registered Dieticians:
• Advise about healthy diet choices and special dietary needs.
9)Chaplains:
• Support the spiritual, religious and emotional needs of you and your family.
METHODS OF REHABILITATION
• There are different types of rehabilitation available for different types of
disabilities:
1.Medical rehabilitation: Includes restoration of functions by prosthesis,
artificial limbs, etc.
2. Social rehabilitation: Includes restorations of family and social relationship
by replacement in the family
3. Educational rehabilitation: Include specialized training and educational
facilities e.g. Braille for blind, Sign language for dumb and deaf
4.Psychological rehabilitation: Includes restoration of personal dignity
and confidence during the period of growth and development and in
adult life
5. Vocational rehabilitation: Includes restoration of the capacity to
earn a livelihood. This can achieve by community participation and
social legislation for handicapped individual. The community needs to
offer employment opportunity in shops, factories and other business
establishment.
