Rehabilitation
The acute rehabilitation phase usually progresses through
three stages:
- Restoration of damaged function.
- Compensatory strategies for lost function.
- Assisting the individual and family to take back control
over their own lives by maximising the injured person’s
potential and increasing participation on a psychosocial
level.
Definition of Rehabilitation.
There are many definitions of rehabilitation and lack of
consensus can lead to confusion. However a definition is
necessary to enable evaluation and to be clear about the
services and the processes involved. Whichever definition is
preferred the case manager’s role remains as defined by their
own professional code and the British Association of Brain
Injury Case Managers Guidelines and the Case Management
Society UK Standards.
In all cases the Case Managers duty of care is the client,
that is the person with the injury. Rehabilitation is usually
followed by ‘support’ to maintain gains made and to continue
to assist to improve the person’s quality of life. Therefore
the Case Manager’s input should not be time limited but based
on individual need.
HACM design and put integrated rehabilitation/support
packages in place that aim to meet holistic needs by:
- Empowering people.
- Enabling life review.
- Maximising personal independence and functional ability.
- Promoting life enhancing experiences and social
inclusion through access to recreational and leisure
activities.
- Promoting psychological and emotional well-being.
- Providing anticipatory guidance that aims to prevent
problems and further deterioration.
- Identifing contingency plans to respond when crisis
occurs.
- Providing relevant teaching and education, advice
guidance and supportive interventions.
The community rehabilitation programme begins with a
comprehensive holistic assessment that analyses the effect of
impairment and disability on the individual’s living
activities and provides a plan of action that aims to maximise
potential through a whole life approach.
The overall aim of rehabilitation is to help the individual
to achieve independent living and place them in the position
they were before the injury. To achieve this it may be
necessary to train a support worker to provide ongoing support
and to coordinate life long multi-disciplinary intervention.
Rehabilitation is promoted by multi-disciplinary referral.
The decision making process about programme planning and
delivery is through team work and agreed common aims. It is up
to the person with the injury to decide what goals they wish
to achieve because motivational factors are used to help goal
achievement. Gains made are dependent on the person’s
engagement with the programme.
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