principles of rehabilitation,explanation for the different types of of rehabilitation,outcomes,goals and range of scope,palliative ,supportive,restorative and preventive rehabilitation,diets classification
2. Introduction Rehabilitation
• This is by no means unexpected since over a billion people live
with a form of disability, accounting for over 15% of the world
population. Furthermore, according to a recent report, 2.41
billion individuals worldwide live with the conditions that impact
their functions in daily life and would benefit from rehabilitation
services, which equates to 1 in 3 individuals requiring
rehabilitation services throughout the course of their illness or
injury.
3. • The proportion of the worldwide population over 60 will double in
the next 30 years, the majority of whom will live with chronic
diseases, particularly non-communicable diseases.
4. Definition
• Refers to services, and programs designed to assist individuals who
have experienced trauma or illness that results in an impairment
that creates a loss of function (physical, psychological, social or
vocational.
5. • WHO defines rehabilitation as "a set of measures that assist
individuals who experience, or are likely to experience, disability
to achieve and maintain optimal functioning in interaction with
their environments.”
6. Goals of rehabilitation
• Aims to restore, compensate, prevent or slow deterioration in
functioning (sensory, physical, intellectual, mental, cognitive, or
social) to help individuals to reach their optimal levels.
7. Rehabilitation Elements
• Dietz described four elements of rehabilitation in relation to
people with cancer, which has now been utilized and applied
across rehabilitation for a wide range of conditions: preventive,
restorative, supportive, palliative.
8. Preventative Rehabilitation
• Occurs shortly after a new diagnosis or onset of new impairments.
The aim is to provide education, advice and interventions to
prevent or slow onset of further impairments and maintain a
person’s level of ability. This is a common form of rehabilitation in
long-term conditions, such as Cancer, Chronic Obstructive
Pulmonary Disease (COPD), Diabetes and many neurological
conditions. It also underpins supported self-management and can
include interventions aimed at maintaining function for as long as
possible.
9. Restorative Rehabilitation
• Restorative rehabilitation focuses on interventions that improve
impairments such as muscle strength or respiratory function and
cognitive impairment to get maximal recovery of function. This is
a common form of rehabilitation after surgery, illness or acute
events such as a major trauma or a stroke in order to maximise
function.
10. Supportive Rehabilitation
• Supportive rehabilitation increases a
person’s self-care ability and mobility
using methods such as providing self-
help devices and teaching people
compensatory strategies or alternative
ways of doing things. This may include
the provision of assistive equipment or
environmental modifications. This is
sometimes referred to as adaptive
rehabilitation.
11. Palliative Rehabilitation
• Palliative rehabilitation enables people with life limiting
conditions to lead a high quality of life physically, psychologically
and socially, while respecting their wishes. It often focusses on
relieving symptoms, such as pain, dyspnea and edema, preventing
contractures, breathing assistance, psychological wellbeing,
relaxation or the use of assistive device, in order to maximize
functional independence and support comfort, dignity and quality
of life.
12. Rehabilitation Objectives
• Prevention of the loss of function
• Slowing the rate of loss of function
• Improvement or restoration of function
• Compensation for loss of function (compensatory strategies)
• Maintenance of current function
13. Rehabilitation Outcomes
They may include:
1.Prevention and Reduction in Demand for Health Services
2.Integration of out-of-hospital care, so length of stay and unplanned
admissions can be reduced
3.Fewer Hospital Admissions or Readmissions
4.Decreased Length of Stay
5.Increased independence
6.Increased self-management of condition
7.Decreased burden of care
8.Return to role/occupation that is age, gender, and context-relevant
(e.g. home care, school, work)
9.Improved quality of life
14. Good Rehabilitation
• Focuses on good outcomes that are set by the people we treat and
driven by their goals
• Centers on people’s needs, not their diagnosis
• Aims high and includes vocational outcomesIs an active and enabling
process – not passive care
• Relies on interdisciplinary team working
• Responds to changes in people’s needs
• Integrates specialist and generalist services
• Requires leadership for transformational change
• Gives hope
15. Range and Scope of Rehabilitation
Rehabilitation covers an enormous spectrum within our patients’
pathways. It includes support to learn basic communication skills;
exercise classes to improve or maintain optimum health, wellbeing
and occupation; and complex neurological rehabilitation following
major trauma or stroke.
16. • Develop New Skills - Children may require help to develop skills
(habilitation) in order to overcome barriers presented by
developmental difficulties and health conditions to achieve
maximum health and independence.
17. • Maintain Skills and Independence - for progressive conditions (such
as dementia, motor neuron disease and terminal cancer), early
diagnosis, assessment and rehabilitation intervention can help
people to maintain their skills and independence for as long as
possible.
18. • Enhance Performance - Rehabilitation will provide the opportunity
to enhance performance in athletes and sports people following
injury or time away from sport.
19. • Recover from Unexpected Illness - such as depression, anxiety,
psychosis, acute admission to hospital following a stroke, surgery,
a fall, chest infections and cardiac events.
20. • Recover from Major Trauma - Rehabilitation and
rabblement help people to regain and maximize
their skills and independence, including returning
to work.
21. • Manage Long-term Conditions - When people with a chronic or
long-term condition become unexpectedly ill or have an
exacerbation, they benefit from rehabilitation intervention to
help them regain or maximize their independence.
22. • Self-manage Conditions - People with a chronic or long-term
condition are enabled to manage their own health and reduce the
risk of developing secondary complications affecting either their
mental or physical health, such as loss of strength and
cardiovascular fitness, contractures, pressure ulcers, pain, anxiety
and depression.
23. • Access Advocacy - People who are vulnerable and need support
(such as those with cognitive impairment or communication
difficulties) are offered advocacy as part of their rehabilitation
interventions.
24. Summary
• Rehabilitation is aimed at enhancing
function and independence. As a field of
health, it has evolved through different
stages before arriving at its present
model that incorporates different
components of biological, societal and
contextual factors that have effects on
the health and function of individuals
experiencing various health challenges.