Rehabilitation can begin in an acute care hospital. Rehabilitation clinics or stations bear in the broadest range in most cases; they are considered in patients who have a high rehabilitation potential and participate in an intensive therapy or they can withstand (usually ? 3 hours / day). Many nursing facilities provide less intensive programs (usually 1-3 hours a day up to 5 times a week), which last longer and are therefore more suitable for patients who may be less tolerated the therapy well, so for frail and elderly patients. Less differentiated rehabilitation programs and those with a lower number of treatment units can be performed on an outpatient basis or at home and are suitable for many patients. However, an outpatient rehabilitation can be intense (several hours per day up to 5 times a week).
Rehabilitation aims to promote the recovery after a loss of function. This can arise due to a fracture, amputation, a stroke or other neurological underlying disease, arthritis, heart failure or a prolonged sickbed according to some diseases or surgical interventions. In rehabilitation physiotherapy, occupational therapy and speech therapy may be integrated, as well as psychological support and social services. In some patients a full and complete recovery of function is sought for others the goal is the greatest possible independence in activities of daily living (ADL). The results of rehabilitation depend on the nature of the injury as well as the motivation of the patient. Progress can set delayed in the elderly, those with muscle weakness and those with a lack of motivation. Rehabilitation can begin in an acute care hospital. Rehabilitation clinics or stations bear in the broadest range in most cases; they are considered in patients who have a high rehabilitation potential and participate in an intensive therapy or they can withstand (usually ? 3 hours / day). Many nursing facilities provide less intensive programs (usually 1-3 hours a day up to 5 times a week), which last longer and are therefore more suitable for patients who may be less tolerated the therapy well, so for frail and elderly patients. Less differentiated rehabilitation programs and those with a lower number of treatment units can be performed on an outpatient basis or at home and are suitable for many patients. However, an outpatient rehabilitation can be intense (several hours per day up to 5 times a week). The best is an interdisciplinary approach, because a disability can lead to various problems such. B. to depression and loss of motivation regarding the re-acquiring the lost function or to financial problems. Patients may therefore require psychological intervention or the help of social workers or psychiatrists. Also for family members, support may be required to learn how to deal with the disability of the patient and to help him. Transfer To initiate a rehabilitation, a doctor must issue a referral or prescription to a physiotherapist, a therapist or a rehabilitation center. The transfer or regulation should include the diagnosis and the goal of therapy. The diagnostic information may be specific (eg. As by Linkshirninsult residual symptoms of the right upper and lower extremities) or functionally (z. B. general weakness by bedridden). The information on the treatment goal should be as accurate as possible, for. B. practice of the use of a limb prosthesis, maximization of the general muscle strength and endurance. Although vague statements (such. B physical therapy for evaluation and treatment) are sometimes accepted, they are not very helpful and can be dismissed with a request for more detailed instructions. exhibit doctors who are not used to, a referral for rehabilitation, can previously consult a therapist, physiotherapist or orthopedic surgeon. Goals of therapy at the beginning sets out the objectives to restore those functions that are necessary for the ADL, including self-care and mobility such as personal hygiene, bathing, dressing, eating and toilet habits, cooking, cleaning, shopping, medication, regulation of financial affairs, phone calls and travel. The referring physician and the rehabilitation team to determine which skills are available and which are essential for the independence of the patient. Are the ADL functions even improved, destinations can be added to increase the quality of life. The patients improved to varying degrees. Some phases of therapy only take a few weeks, others take longer. In some patients, additional treatment is required to complete basic therapy. Affairs of patients and caregivers The advice of the patient and his family is an important part of rehabilitation, especially when the patient is discharged into normal life. Often it is the nurse who takes over this task as a team. Patients learn how the skills newfound can be maintained and can minimize the risk of accidents (eg. As falls, cuts, burns) to prevent secondary disabilities. Family members are instructed how they can help the patient to be as independent as possible so as not to overprotect the patient (which results in a reduced functional status and increased dependency) or overlook the primary needs of the patient (leading to feelings of rejection can lead to the result of depression, which can impair the physical functioning). An emotional support from family members and friends is essential. This can take many forms. Spiritual support and peer counseling, or religious advisor may be essential in some patients. Geriatric Rehabilitation disorders that require rehabilitation (eg., Stroke, myocardial infarction, hip fracture, amputation of limbs) are common in elderly patients. For many older people, it is also so that they were no longer even before the acute problem in good physical condition. Older people can benefit from rehabilitation, even if they are cognitively impaired. Age alone is not a reason to delay rehabilitation or deny. However, it is possible that elderly patients take longer to recover because their ability to adapt to a foreign environment is not as good. This includes: Physical inactivity lack of stamina depression or dementia Decreased muscle strength, joint flexibility, coordination, agility and balance disorder programs that are specifically designed for the elderly are preferable because older people often have other goals of therapy and usually a less intensive rehabilitation and a very different kind of care need than younger patients. The tailored to the elderly programs elderly patients do not come to that with which to compare their progress in younger patients and thus be discouraged, and the social aspects of time after discharge can be tackled strengthened. Some programs are designed for specific clinical situations (eg recovery Hüftfrakturoperationen.); Patients with similar conditions can then work towards in the group on common goals and encourage each other, thus improving the success of the rehabilitation training.