Rehabilitation

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Rehabilitation

• Dr Huma Naqvi

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Rehabilitation - what it is

• The treatment of pathology/impairment
• The management of disability
• The aim of reducing handicap
• Multidisciplinary approach

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Rehabilitation - older people

• The planned withdrawal of support
• Bernard Isaacs

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Rehabilitation what does it mean to me?

• Management of multiple co-morbidities/undiagnosed
  pathology using CGA
• Striving for patients independence and dignity
• A MDT approach work as a team
• Interesting, not boring medicine!

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The rehabilitation process

• Assessment
• Identification of problems, Diagnosis
• Planning
• Analyse the problem(s), set goals
• Treatment
• Intervention to reduce disability
• and/or Care
• Intervention to reduce consequences of disability
• Evaluation or re-assessment

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Rehabilitation myths

• Time limited with clear endpoints
• Discharge from the hospital
• Patient being a passive recipient of a treatment
• Done only by therapist
• Can be done only in hospital
• Appropriate only for people with mobility
  problems
• It doesnt work
• Its too expensive

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A case example

• 78 year old male admitted to community hospital
  from acute hospital
• Inpatient admission for 2/12 following pneumonia
  ITU stay, slow wean
• Hoist transfer, catheterised, on O2
• What did we do mobile with a frame within 2/52
• Home visit with OT equipment and wife to
  provide care

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• Home O2 organised
• D/C home 3/52 after transfer from acute hospital
• Spotted driving in the local town by the ward OT!

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Conclusion

• An enjoyable and interesting subspeciality
• Made me a better doctor!
• Process should start from admission
• Lots of undiagnosed pathology and tests your
  diagnostic skills without numerous inpatient Ix
• MDT led its not only about the doctor!