Rehabilitation is a process of assessment, treatment and management by which the individual (and their family/carers) are supported to achieve their maximum potential for physical, cognitive, social and psychological function, participation in society and quality of living. Client goals for rehabilitation vary according to the trajectory and stage of their condition (Turner-Stokes 2010).
What is Specialist Rehabilitation?
Specialist rehabilitation is the total active care of clients with a disabling condition, and their families, by a multi-professional team who have undergone recognised specialist training in rehabilitation.
Generally, clients requiring specialist rehabilitation are those with complex disabilities. Such clients typically present with a diverse mixture of medical, physical, sensory, cognitive, communicative, behavioural and social problems, which require specialist input from a wide range of rehabilitation disciplines (e.g. rehabilitation-trained nurses, physiotherapy, occupational therapy, speech and language therapy, psychology, dietetics, orthotics, social work etc.) as well as specialist medical input from consultants trained in rehabilitation medicine, and other relevant specialties (e.g. neuropsychiatry).
Some clients will have a ‘profound disability’; these are more severely affected clients who require help for all aspects of their basic care, as well specialist interventions e.g. spasticity management, postural support programmes and highly specialist equipment.
Specialist rehabilitation services may be provided along three main (frequently overlapping) pathways:
Restoration of function
Restoration of function e.g. for those recovering from a ‘sudden onset’ or ‘intermittent’ condition, where client goals are focused not only on improving independence in daily living activities, but also on participatory roles such as work, parenting and other activities.
Disability management, e.g. for those with stable or progressive conditions, where client/family goals are focused on maintaining existing levels of function and participation; compensating for lost function (e.g. through provision of equipment/adaptations); or supporting adjustment to change in the context of deteriorating physical, cognitive, and psychosocial function.
Neuro-palliative rehabilitation focuses on symptom management and interventions to improve quality of life during the later stages of a progressive condition or profound disability, at the interface between rehabilitation and palliative care.