The Rehabilitation Journey - part 1
The dictionary definition of rehabilitation is “the process of returning to a healthy or good way of life”. This process is akin to a physical journey as it is often long, challenging, and affords ample opportunities for reflection. The rehabilitation journey can be separated into 3 distinct phases: acute, sub acute, and chronic or long term - with each phase requiring a different focus.
The acute phase begins immediately upon an individual’s admission to hospital following a traumatic event or sudden deterioration in health. At this time, stabilising the individuals medical condition is the main priority. As they are subjected to a barrage of tests and investigations it’s not uncommon for individuals to feel distressed due to the uncertainty of their current circumstance. Also often accompanying this unfavourable feeling is the inconvenience of pain from their trauma, surgery or underlying medical condition.
It’s no surprise that under these circumstances individuals would exhibit a mixture of negative emotions. Emotions that are notably rationalised by the 7 Stages of Grief i.e. i) shock and denial that this misfortune is happening to them, ii) pain and guilt that they’ve suddenly become a burden on their loved ones, iii) anger towards unsuspecting others and a resort to bargaining with higher powers that they will do anything to be extricated from their current situation, followed by a iv) depression or period of isolation and loneliness during which the individual may begin to process and reflect on their crisis.
Albeit these emotions aren’t very constructive, but working through them is a critical part of the adjustment to illness process. The sooner individuals can come to terms with their condition the sooner they can embark upon improving their quality of life whilst living with a chronic illness. Interestingly, it’s in this acute phase of the rehabilitation journey where physical therapy has the greatest impact in achieving positive outcomes and greater functional gain later in an individual’s life. A physiotherapist’s focus at this stage is to improve an individual’s gross motor skills like sitting, transferring and walking whilst concurrently wrestling the individual’s precarious medical condition and emotional lability.
Admittedly it’s not ideal, but this is also the stage where an individual’s rehab potential is determined. This decision will establish where the individual will go next upon discharge from Hospital and is based on how engaged the individual has been with therapy thus far, the nature of their medical condition, how much social support they have in place, and their cognitive function (do they have the capacity to learn or relearn skills?). Sadly due to the increasing demands on our health system there is not enough resources to provide ongoing rehabilitation for every patient, so it’s unfortunate that rehab candidates have to be cherry picked. Those that don’t make the cut are usually sent home with increased care supports or to a residential care facility if there is no other appropriate discharge destination.
Evidently the acute phase of an individual’s rehabilitation journey is where a lot of the action happens. It can be a very stressful time with a lot of important decisions on the line that will largely depend on how an individual responds to their current circumstance. In this stage nothing is certain but we can be sure that adopting a positive attitude and mindset will be paramount in achieving a good outcome.
To be continued…
