REHABILITATION

Prepared by :
Khloud Eid Albalawi
Samerah Suleiman Alfifi
Amnah Awdah Alatawi
Amal Eid Alshaman
Fatimah Mohammad Alharthi
Fatimah Rabea Aljohani

Rehabilitation of Health Care

Out line

Introduction .
Definitions of rehabilitation .
Definition of rehab center .
Goal of rehabilitation .
Goal of rehabilitation nursing .
Who needs for rehabilitation .

 Physical and mental disabilities

(Handicaps and mental-retarded)
Types of rehabilitation
Rehabilitation team ( definition and
work of every member of them .
Role of rehabilitation nurse .
Clinical evaluation.
Rehabilitation programs .
Conclusion .

HEALTH

WHOs definition: A state of complete

Physical, mental and social well-being not
merely the absence of disease or
infirmity.

Introduction
Rehabilitation began to emerge as a
separate development with in health care
only after the first world war.
Health promotion & rehabilitation are
essential components of community health
nursing practice involve efforts to reduce
disability and, as much as possible and
restore their function.

REHABILITATION
Definition:
Habilitation:
is the process of education or training an individual
to function in Society
Rehabilitation:
The process of restoration of skills by a person who
has had an illness or injury so as to regain
maximum self-sufficiency and function in a normal
or as near normal manner as possible.

REHABILITATION
Define by WHO as:A combined and coordinated use of
medical ,social ,educational ,and
vocational measures for training and
retraining the individual to the highest
possible level of functional ability and
at enabling the disabled to achieve
social integration .

Rehabilitation Center
a facility providing therapy and training for
rehabilitation. The center may offer occupational
therapy, physical therapy, vocational training, and
special training such as speech therapy.

Rehabilitation services are provided in a variety of

settings including clinical and office practices,
hospitals, skilled-care nursing homes, sports medicine
clinics, and some health maintenance organizations.
Some therapists make home visits. Advice on
choosing the appropriate type of therapy and therapist
is provided by the patient's medical team.

Goals of Rehabilitation
All Rehabilitation Goals Shall
Maximize the quality of life of the individual
Address the individuals specific needs
Assist the individual with adjusting to an altered
lifestyle
Promote maximum functional ability
Optimal health
Be directed toward promoting wellness and minimizing
complications
Assist the individual in attaining the highest degree of
function and self-sufficiency possible
Assist the individual to return to home and community

Goal of rehabilitation nursing:

is to assist the patient to attain and to
maintain optimum health as it is defined
by the patient.

Need for Rehabilitaton

*Need for Rehabilitation Precipitated by:
a- Impairment : Any loss or abnormality of
psychological, physiological, or anatomical structure
or function.
b- Disability :any restriction or lack (resulting from
an impairment) of ability to perform an activity in
the manner or within the range considered normal
for a human being.

Need for Rehabilitaton

c- 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 for that individual.
d-Functional Limitation : any loss of ability to
perform task and obligations of usual role and
normal daily life.
f-Chronic illness: an irreversible presence,
accumulation, or latency of disease state or
impairment that involves the total human
environment.

As traditionally used, impairment refers to a problem

with a structure or organ of the body; disability is a
functional limitation with regard to a particular activity;
and handicap refers to a disadvantage in filling a role in
life relative to a peer group.

Examples to illustrate the differences among the

terms "impairment," "disability," and "handicap."
CP example: David is a 4-yr.-old who has a
form of cerebral palsy (CP) called spastic
diplegia. David's CP causes his legs to be stiff,
tight, and difficult to move. He cannot stand or
walk.

 Impairment: The inability to move the legs

easily at the joints and inability to bear
weight on the feet is an impairment.
Disability: David's inability to walk is a
disability.
Handicap: David's cerebral palsy is
handicapping to the extent that it prevents
him from fulfilling a normal role at home, in
preschool, and in the community.

Type of rehabilitation
Physical therapy to help strength,
mobility and fitness
Occupational therapy to assist the daily
activities
Speech-language therapy to help with
speaking, understanding, reading, writing and
swallowing
Psychiatric rehabilitation also known as
psychosocial rehabilitation, and sometimes
simplified to psych rehab by providers, is the
process of restoration of community functioning

Type of rehabilitation
and well-being of an individual diagnosed in
mental health or mental or emotional disorder and
who may be considered to have a psychiatric
disability.
Cognitive Rehabilitation: is the process of
relearning cognitive skills that have been lost or
altered as a result of damage to brain
cells/chemistry.

Rehabilitation Team

Rehabilitation Teamwork
Multidisciplinary group but operate as a single
unit and not taken any significant interference
from a particular specialty without the consent of
the other team members
Goal of rehabilitation Team work
Provide best treatment for the fundamental needs
of the individual, and the members of this team
works through a coherent and integrated
diagnosis , flexible and dynamic planning ,
appropriate timing for treatment and the balance
in the proceedings

Rehabilitation Team

Physiatrist
Neuropsychologist
Physical Therapist
Nurses
Speech/Language Pathologist
Occupational Therapist
Recreational Therapist
Counselor
Medical social workers

Physiatrist
The Physiatrist is the leader of
the rehabilitation team. He
assesses the patient carefully
and monitor rhe pts progress
. He decides the program as
per the pts need.He will
design a patient oriented
treatment program based on
which the other members of
the team will be decided . His
specialization is physical
medicine and rehabilitation .

Neuropsychologist

Neuropsychologist
Often after a serious illness or brain damage ,
a patient may not able to behave or think as he use to
before the accident . Severe brain damage may be
the cause for this . So a Neuropsychologist
Monitors these changes and then design such
programs that will help the pt recover quickly. A
Neuropsychologist will also educate the family
members of the pt to accept this change in the pt
and ways to deal with it .

Physical Therapist
After a traumatic brain injury a
person may suffer from
musculoskeletal or neuromuscular
issues.This injury affects his daily
activites. The work of a Physical
Rehabilitation Therapist is to
work on improve this problem of
the pt . He will focus on the
development of posture, strength,
physical independence, quality
movement by using aids as
(wheelchair, canes and crutches),
balance coordination and other
sensory motor activities.

Nurses
Nurses who deal with
rehabilitation pts are
trained to take care of the
everyday need of the pt.
Often after severe brain or
physical injury a person
may find it difficult to
take care of oneself, so
these nurses are trained to
take care of pt .

Speech/Language
Pathologist
Aperson suffering from any sort of brain injury may
face difficulty in talking clearly .Therefore, it
becomes difficult for the family members to
understand what the pt is trying to say , sometimes,
the pt may also feel frustrated when he is not able
to communicate properly.In such cases , a speech
therapist helps the pt by checking his condition and
then designing a specific program of exercises and
therapies that would help him communicate with
the society .

Occupational Therapist
The work of an accupational therapist is to
make a patient learn advanced
independence skills that will help him in
various ways in his personal life .The pt
will be taught ,cooking ,
laundering,shopping and banking by an
occupational therapist .

Recreational Therapist
The job of a recreational therapist is to make a pt
indulge in all those activities that the pt enjoys.
He brings a positive attitude in a pt by making
the latter realize that life can be fun and
enjoyable.

Counselor
After any kind of a traumatic by
accident or illness a pt goes
through depression and other
negative feeling . It is very
important that a Rehab Counselor
counsels the pt and adds positive
attitude in him . This is important
as healthy mind will lead to a
faster healing .

Medical social workers

provide emotional support, identify
economic resources and
community agencies and help pt
to make arrangements to leave the
hospital and find follow-up care.

Other Rehabilitation Professionals

Audiologist
Respiratoty therapist
Dance therapist
Dentist
Dietitian
Enterostomal therapist
Podiatrist
Child life specialist
Others

Role of Rehabilitation Nurse

Provider of
care

Educator
and coach

Client
advocate

Leader and
collaborator

Coordinator
of care

Provider of Care
Provides quality evidence based nursing
Focuses on restoring & maintaining
function and preventing complications
Interacts therapeutically with clients and
their support systems
(ARN,1998, OARN, 1998)

Educator and Coach

Wellness and prevention
Self care
assesses their readiness to learn
plans teaching times and strategies

Advocacy skills

Leader and Collaborator

Works with the
team to establish
goals to promote
maximal patient
independence.

Rehab Nurse as Advocate

Patient or unit /
program based
Accessibility of
rehabilitation services
Politically involved at
all levels

Rehab Nurse as Coordinator

Uses holistic,
interprofessional
approach
Identifies and
measures functional
goals for patients
plan and guide care

Clinical Evaluation

Detailed History of the Patient

Physical Examination
Evaluation of Function
PMR Diagnosis
Disease
Impairment
Disability
Handicap

Laboratory
RBC, WBC, Hct
Sedimentation rate
Urinary analysis

Rx, CT, MRI, scintigraphy and

other advanced technics

Therapy and/or rehabilitation

Rehabilitation program
rehabilitation program - a program for restoring someone to good health
The overall objective of the rehabilitation policy is to prevent
disabilities; to help persons with disabilities develop their physical and
mental capabilities as well as their ability to integrate into the
community; and to create a barrier-free physical environment through a
comprehensive range of effective measures, with a view to ensuring that
persons with disabilities can participate in full and enjoy equal
opportunities both in terms of their social life and personal growth

Service Areas
Major service areas covered under the RP include:
(a) prevention and identification;
(b) medical rehabilitation;
(c) pre-school training;
(d) education;
(e) employment and vocational rehabilitation;
(f) residential care;
(g) day care and community support;
(h) development of self-help organizations;
(i) access and transport;
(j) application of information and communications
technologies;
(k) recreational, sports, cultural and arts activities; and
(l) public education.

Categories of Disability Requiring Rehabilitation Services

(a) Attention Deficit/Hyperactivity Disorder;
(b) Autism;
(c) hearing impairment;
(d) intellectual disability;
(e) physical disability;
(f) mental illness;
(g) Specific Learning Difficulties;
(h) speech impairment;
(i)visual impairment.

Physical medicine and rehabilitation

*Physical medicine and rehabilitation (PM&R), also known as

rehabilitation medicine, is a branch of medicine that aims to enhance
and restore functional ability and quality of life to those with physical
impairments or disabilities.

Common conditions that are treated by the rehabilitation

therapists include
Amputation
spinal cord injury
sports injury
musculoskeletal pain syndromes such as low back pain, fibromyalgia, and
traumatic brain injury.
Cardiopulmonary rehabilitation involves optimizing function in those afflicted
with heart or lung disease.
Chronic pain management
Anesthesiologist, and interventional procedures when indicated.
stroke is often treated with the help of a speech therapist and recreational
therapist when possible.

1-Physical rehabilitation
A person with physical disabilities is defined as a person
who has disabilities of orthopedic, musculoskeletal, or
neurological origin which mainly affect locomotors
functions, and constitute a disadvantage or restriction in one
or more aspects of daily living activities.

Proper exercising program is designed to

improve the functioning often physical body.
Includes therapies that will help a patient relearn the basic physical and cognitive
functioning.

Major service requirements of persons with physically disabilities

may include:
(a) medical and community rehabilitation care;
(b) pre-school training;
(c) education services;
(d) residential care;
(e) day care and community support;
(f) employment services and vocational rehabilitation;
(g) barrier-free access and transport;
(h) barrier-free information a nd communication technological
equipment; and/or
(i) use of assistive devices.

Neurological disorders :
are diseases of the central and peripheral nervous system.
In other words, diseases of the brain, spinal cord, cranial nerves,
peripheral nerves, autonomic nervous system,
neuromuscular junction, and muscles.
of the nervous system There are more than 600 diseases
These disorders include epilepsy, Alzheimer disease and other
dementias, cerebrovascular diseases including stroke, migraine
and other headache disorders, multiple sclerosis disease,
neuroinfections, brain tumors, traumatic disorders of the nervous
system such as brain trauma, and neurological disorders as a
result of malnutrition.

The neurological rehabilitation program

A neurological rehabilitation program is designed to meet
the needs of the individual patient, depending on the
specific problem or disease.
Active involvement of the patient and family is vital to the
success of
the program.
The goal of neurological rehabilitation is to help the patient
return to the highest level of function and independence
possible, while improving the overall quality of life
physically, emotionally, and socially.

In order to help reach these goals, neurological

rehabilitation programs may include the following:
-Assistance with activities of daily living (ADLs), such as eating,
dressing, bathing,
toileting, handwriting, cooking, and basic housekeeping
-Speech therapy to help patients with speaking, reading, writing, or
swallowing
-Stress, anxiety, and depression management
-Bladder and bowel retraining
-Activities to improve mobility (movement), muscle control, gait
(walking), and balance

Con't
-Nutritional counseling
-Involvement in community support groups
-Activities to improve cognitive impairments, such as problems with concentration,
attention, memory, and poor judgment
-Help with obtaining assistive devices that promote independence
-Patient and family education and counseling
-Safety and independence measures and home care needs

-Pain management
-Stress management and emotional support
-Vocational counseling

rehabilitation

MENTAL RETARDATION
Mental retardation (MR) is a generalized disorder appearing before adulthood,
characterized by significantly impaired cognitive functioning and deficits in two or
more adaptive behaviors.
It has historically been defined as an Intelligence Quotient score under 70.
Mental retardation is a term used when a person has certain limitations in mental
functioning and in skills such as communicating, taking care of him or herself, and
social skills.
These limitations will cause a child to learn and develop more slowly than a typical
child.
Children with mental retardation may take longer to learn to speak, walk, and take
care of their personal needs such as dressing or eating.
They are likely to have trouble learning in school
The most common causes are: -Genetic conditions -Problems during pregnancy Problems at birth -Health problems

Diagnoses: It may be difficult to assess very young children for MR, so

most clinicians will not give a definitive diagnosis of mental
retardation to children under the age of two unless their symptoms are
extremely severe and/or they have a condition that is highly associated
with this condition (such as Down's Syndrome).

Treatment: Treatments for Mental Retardation are not designed to

"cure" the disorder. Rather, therapy goals include reducing safety
risks (e.g., helping an individual maintain safety at home or school)
and teaching appropriate and relevant life skills.
Interventions should be based on the specific needs of individuals
and their families, with the primary goal of developing the person's
potential to the fullest

Rehabilitation Management Plan

It depends upon the current level of the
child
and the associated conditions such as
epilepsy,
hyperkinesias, behavior problem and
sensory
Handicaps

In overall management, there is very significant role of

counselor to help the parents in understanding and accepting the
child's problem.
This requires a life long adjustment.
In order to assist the parents in dealing effectively with the
situation,
counseling for behavior modification is essential, as a part of the
whole rehabilitation management plan.

The focus of counseling

depends upon the individual needs and requirement
of the mentally retarded and his family.

Parent Counseling : the parent counseling

is done as given below;

(1)To provide information regarding the

condition of the mentally retarded child.
The counselor should explain child's condition
in simple words to the parents and give
enough information regarding
management of his associated medical
problem and other disabilities must be made
available to the parents.
The false hopes should be avoided.

(2) Development of correct attitudes towards

their handicapped child.
Usually parents have wrong beliefs, ideas and thoughts regarding
causes and treatment of their disabled child.

They blame each other for being responsible for the birth of such child
due to lack of awareness.
Parents tend to believe that the child would become normal in due
course of time.
Hence counselor should give correct information on the nature, causes
and treatment of mentally retarded child.

(3)- Parent groups meeting having parents of

mentally retarded children who have been
already helped with the parents of earlier
identified children, will be purposeful for
proper interaction among themselves.
- Parents should be helped to learn the skills
of training and then they should be
demonstrated how their training has helped
the child to learn the few skills, so that
parents can have a feeling of achievement.

Community Awareness :
The society should be made aware of the need to recognize the mentally retarded
persons and give enough care to make them as independent
as possible.
The various modalities of communication for reaching out to the community
should be utilized.

may use physical, occupational, and speech therapies

Cardiac rehabilitation
Cardiac rehabilitation (rehab) is a medically supervised
program that helps improve the health and well-being of
people who have heart problems.
Rehab programs include exercise training, education on heart
healthy living, and counseling to reduce stress and help pt
return to an active life.

Cardiac rehabilitation
Recover after a heart attack or heart surgery.
Prevent future hospital stays, heart problems, and death
related to heart problems.
Address risk factors that can lead to coronary heart
disease and other heart problems.

These risk factors include high blood pressure, high blood

cholesterol, overweight or obesity, diabetes smoking, lack
of physical activity, and depression and other emotional
health concerns.
Adopt healthy lifestyle changes. These changes may include
following a heart healthy diet, being physically active, and
learning how to manage stress.
Improve health and quality of life.
cardiac rehab program will be designed to meet pt needs

elderly rehabilitation

Geriatric rehabilitation covers three areas

1-normal aging due to disuse and deconditioning,

2-cardiovascular problems like vascular disease and stroke,

3-skeletal problems
including osteoporosis and osteoarthritis conditions such as knee
and hip replacements.
Physical medicine Physicians use rehabilitation to work toward the
goal of returning the patient to a pre-injury quality of
life and may use physical, occupational, and speech therapies.

with increased age, patients often face many physical and emotional changes that can
affect level of function and well-being
Rehabilitation maintains functional independence in the elderly. Rehabilitation of
geriatric patients is imperative for the patients' well-being and for society, so that we
can thrive socially and economically.
Essential to geriatric rehabilitation is communication, specifically improving
any sensory impairment, including those related to vision and hearing.
The prevention of falls and osteoporosis can improve the patient's health
and longevity.
Addressing malnutrition can promote healing and vitalize the patient to participate in a
formal rehabilitation program.

Depression is common in the older population if a functional loss of

mobility and an inability to perform activities of daily living (ADLs)
Cognitive impairment, such as delirium and dementia, can affect the
patient's rehabilitation goals.

The Geriatric Rehabilitation Program

provides care to older adults in many of services.
However, they have a variety of services that are specifically designed to
meet their needs:
Geriatric Rehabilitation Inpatient Service inpatient care for older adults
who need help managing multiple health issues associated with aging.
Geriatric Psychiatry Inpatient Service inpatient care for older adults
with behavioral challenges caused by dementias.
Geriatric Day Hospital Service a similar service provided on an
outpatient basis to people who need assistance but can remain in the
community.
Geriatric Rehabilitation Outpatient Clinics specialized assessments for
older adults with complex health issues.

with increased age, patients often face many physical and emotional changes that can
affect level of function and well-being
Rehabilitation maintains functional independence in the elderly. Rehabilitation of
geriatric patients is imperative for the patients' well-being and for society, so that we
can thrive socially and economically.
Essential to geriatric rehabilitation is communication, specifically improving
any sensory impairment, including those related to vision and hearing.
The prevention of falls and osteoporosis can improve the patient's health
and longevity.
Addressing malnutrition can promote healing

Depression is common in the older population if a functional loss of

mobility and an inability to perform activities of daily living (ADLs)
Cognitive impairment, such as delirium and dementia, can affect the
patient's rehabilitation goals and out comes.

Geriatric Rehabilitation Program

provides care to older adults in many of services.
However, they have a variety of services that are specifically designed to
meet their needs:
Geriatric Rehabilitation Inpatient Service inpatient care for older adults
who need help managing multiple health issues associated with aging.
Geriatric Psychiatry Inpatient Service inpatient care for older adults
with behavioral challenges caused by dementias.
Geriatric Day Hospital Service a similar service provided on an
outpatient basis to people who need assistance but can remain in the
community.
Geriatric Rehabilitation Outpatient Clinics specialized assessments for
older adults with complex health issues.

Addiction rebilitation

Drug Rehabilitation

Drug rehabilitation programs involve

programs that are designed to make an addict
free from the addiction of alcohol, prescription
drug and street drugs (cocaine, heroin etc)

Program content
Counseling programs designed to know the
underline cause behind a person becoming an
addict.
Educating the person about the various side
effects of drug abuse and how it impacts
ones social, professional, physical and
personnel life.
Designing programs that will prevent the
relapse of the drug addiction.

Medical rehabilitation

Medical rehabilitation includes treatment

programs that help a person perform better in all
his daily physical and mental activities. Medical
rehabilitation is a follow up treatment after any
kind of treatment program.

Medical Rehab Program

Focused on restoring the health and function
abilities of people after acute or chronic
conditions such as :spinal cord injury ,
amputation, joint replacement or spinal
disorders.

Medical Rehab Program

Programs focus on improving major and
minor skills that are required in the basic
life.
Assessing patient in every step to improve
the activities of basic living

Vocational rehabilitation
Vocational rehab program is designed to
help those people who find it difficult to get
employment or retain it after they have gone
through certain situation that caused mental or
physical disability in them.

Vocational Rehab Program

Vocational Rehab Program

An Occupational Rehabilitation Program is
individualized, focused on return to work, and
designed to minimize risk to and optimize the
work capability of the persons served. The
services provided are integrative in nature, with
the capability of addressing the work, health, and
rehabilitation needs of those served. Such a
program provides for service coordination and
management of those persons served with injuries
or illnesses.

Children's Developmental Rehabilitation

Program
The CDRP provides
habilitation/rehabilitation services
to children with neurological and/or
developmental disabilities from
birth up to age 18. The team offers
assessment, treatment, and
consultation services through a
variety of service delivery models
with interdisciplinary teams.

Children's Developmental
Rehabilitation Program
These programs serve children/adolescents who have
significant functional limitations as a result of acquired or
congenital impairments. The programs use an
individualized, developmental, and age-appropriate
approach to rehabilitation that ensures that care focuses on
preventing further impairment, reducing activity
limitations, and minimizing participation restrictions while
maximizing growth and development. The programs
encompass care that enhances the life of each
child/adolescent served within the family, school, and
community. A major focus is on providing
developmentally appropriate care that acknowledges each
childs/adolescents need to learn and play.

Vestibular rehabilitation

It helps in improving the ear deficit by working on

the central nervous system. Also deals in
improving eye and head coordination.

Vestibular rehabilitation
introduces balance techniques
visual exercisesimproves ability to
maintain gaze while in motion
home exercisesenables independent
condition management
patient/family educationteaches how to
identify dizziness triggers and develop
strategies to minimize effects

Stroke rehabilitation

This treatment type helps to restore damage that

is caused after a stroke, which is the 3rd leading
cause for death worldwide.

Stroke rehabilitation
Minimizing impairments and secondary
complications.
Reducing activity limitations.
Maximizing participation and quality of
life.
Decreasing environmental barriers.
Preventing recurrent stroke.

Warning signs of stroke

Sudden weakness or numbness of the face, arm or leg ,
especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or
coordination.
Sudden, sever headache with no known cause
Learn to recognize a stroke .
Time lost is brain lost.

Aim of Stroke rehab

Stroke rehabilitation aims at helping people
gain maximum normal functioning after the
occurrence of a stroke.
Help the person to get back to normal
lifestyle and be independent in daily
activities.

Conclusion
Rehabilitation is the process of maximizing
an individuals capabilities or resources to
foster optimal independent functioning.
The focus of all rehabilitation should be on the
patients abilities, not on his or her disabilities
Rehabilitation focuses on continually
improving the quality of the persons life, not
merely maintaining life itself.

Referances

http://www.nlm.nih.gov/medlineplus/rehabilitati
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 http://en.wikipedia.org/wiki/Rehabilitation_(pen
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