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an irreversible presence, accumulation, or latency of disease states of impairments that involve the total human environment for supportive care, function, and prevention of further disability.
- Commission on Accreditation of Rehabilitation
- a nonprofit, private, international standard-setting and accreditation body whose mission is to promote and advocate the delivery of quality rehabilitation.
Comprehensive rehabilitation plan
an overall individualized plan of care that is initiated within 24 hours of admission and ready for review and revision by the team within three days of admission for each individual; a planned, orderly sequence of services for a disabled individual designed to help the patient realize maximum potential.
any restriction or lack (resulting from an impairment) of an ability to perform an activity in the manner or within the range considered normal for a human being.
Family centered care
a philosophy that recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions.
any loss of ability to perform tasks and obligations of usual roles and normal daily life.
Gerontologic rehabilitation nursing
a specialty practice that focuses on the unique requirements of older adult rehabilitation patients.
- a disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individual.
- the handicap one individual with a given disability faces may not be a concern or handicap for another individual with the same disability
any loss or abnormality of psychological, physical, or anatomical structure or function
Interdisciplinary rehabilitation team
a team that collaborates to identify individuals' goals and features a combination of expanded problem solving beyond the boundaries of the individual disciplines together with discipline-specific work toward goal attainment.
Multidisciplinary rehabilitation team
discipline-specific goals, clear boundaries between disciplines, and outcomes that are the sum of each discipline's efforts
pediatric rehabilitation nursing
a specialty practice area that focuses on the care of children with disabilities or other chronic condition and their families
Posttraumatic stress disorder
a psychological reaction to the experience of trauma outside the normal range of human experience
Spinal cord injury
- any injury in which the spinal cord undergoes compression by fracture or displaced vertebrae, bleeding, or edema.
Transdisciplinary rehabilitation team
a blurring of boundaries between disciplines, as well as cross-training and flexibility to reduce to a minimum any duplication of effort toward individual goal attainment
Traumatic brain injury
- head injury classified as either penetrating or closed; may also be classified as mild, moderate, severe, or catastrophic
- the process of restring the individual to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable.
- involves learning former skills
- relearning the ADL's
- learning new skills necessary to adapt and live fully within the context of an altered lifestyle.
When does rehabilitation begin?
from the onset of a traumatic event or diagnosis of a chronic illness
What precipitates the need for rehabilitation?
- functional limitation
- chronic illness
- combination of these
HP2010 focus areas related to chronic illness and disability
- access to quality health services
- arthritis, osteoporosis and chronic back conditions
- chronic kidney disease
- disability and secondary conditions
- heart disease and stroke
- mental health and mental disorders
- respiratory diseases
- vision and hearing
Chronic illness characteristics
- is permanent
- leaves a residual disability
- is caused by a nonreversible pathologic condition
- requires special training of the patient for rehabilitation
- requires a long period of supervision, observation or care
Americans with disabilities act definition of disabled
an individual that has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment
acknowledges and incorporates the importance of culture, the assessment of cross-cultural relations, vigilance toward the dynamics that result from cultural differences, the expansion fo cultural knowledge, and the adaptation of services to meet culturally unique needs.
Traits of a culturally competent practitioner
- has the capacity for cultural self-assessment
- values diversity, with an awareness, acceptance, and even celebration of differences in life view, health systems, communication styles, and other life-sustaining elements
- is conscious of the dynamics of difference
- institutionalizes cultural knowledge
- adapts to diversity
when people hold culture in high regard
Issues in rehabilitation
- quality of life versus quantity of life
- care versus cure
- high cost of interdisciplinary care versus long-term care
Quality of life versus quantity of life
rehabilitation focuses on continually imporving the quality of the person's life, not merely maintaining life itself
Care versus cure
many conditions are irreversible, therefore, the focus of care is on adapting and accepting an altered life rather than resolving an illness
High cost of interdisciplinary care versus long-term care
- rehabilitation is expensive, mainly because the care is delivered by a team of highly trained professionals
- studies show that for every dollar we spend on rehabilitation we save an average of three dollars if the individual is able to live independently and return to the workforce, elimination the expense of a caregiver or residential long-term care