Ask Vanessa: Rehabilitation is a holistic and goal-oriented process

Dear Vanessa,

What is rehabilitation and when is it needed? What are the goals of and issues in rehabilitation? And what major conditions require dedicated rehabilitation efforts? How important is patient empowerment? Thank you.

- Will

Dear Will,

Rehabilitation, also called rehab, is the process of restoring the individual to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable. It is a relearning of former skills--relearning the activities of daily living (ADLs) and learning new skills necessary to adapt and live fully in an altered lifestyle. The need for rehabilitation is caused by impairment, disability, handicap, functional limitation, or chronic illness.

Rehabilitation goals are set through a team approach that involves the members of the rehabilitation team which includes the individual and the family. The goals are individually-centered to meet the holistic needs of each person served, and include the following criteria: maximize the quality of life of the individual; address the individual’s specific needs; assist the individual with adjusting to an altered lifestyle; directed toward promoting wellness and minimizing complications; assist the individual in attaining the highest degree of function and self-sufficiency possible; and assist the individual in return to home and community reentry. Several factors affect the rendering of care in rehabilitation. The most common issues include: quality of life versus quantity of care; care versus cure; and high cost of interdisciplinary care versus long-term care.

Spinal cord injuries and traumatic brain injuries are two of the major conditions for which dedicated rehabilitation efforts are required. The patient with spinal cord injury has impaired mobility which translates to loss of function, perceived decreased ability to meet role expectations, and changes in family processes. The patient with traumatic brain injury is a high risk for injury due to neurological deficit resulting in impaired judgment, impaired mobility, impaired coordination, and decreased sensation. The focus of rehabilitation should be on the patient’s abilities, not disabilities. The patient must be empowered through patient education because he is the most important team member. The patient and his family must build knowledge, skills, and confidence to regain physical and psychological functioning following an illness/injury.