REHABILITATION
LECTURE DR MEHER AHSAN
DUHS /DMC
LEARNING OBJECTIVES
• To understand the concept of REHABILITATION
• To evaluate the the public health issues faced by the disabled and the policy makers .
• To the list the types of rehabilitation .
• To review the statistics and legislation regarding the disabled and their rehabilitation.
LEARNING OBJECTIVES
• To list the members of the rehabilitation team.
• To review the actions taken to overcome the barriers related to offering good health care to people with disabilities .
• To list the types of rehabilitation.
DISABILITY
• The reduction of functional ability to lead a fruitful life .It is result of not only physical and / or mental impairment but also the indivisual’s adjustment to this .
WHO IS A HANDICAPPED PERSON
• A person whose physical and /or mental well being is
temporarily or permanently impaired , whether congenitally ot through age , illness or accident with the result that his self dependence ,schooling , or employment is impeded.
DEFINITION OF REHABILITATION
• It is the combined and co-ordinated use of medical, social, educational and vocational measures for training or
re-training the indivisual to the highest possible level of functional ability.
DISABILITY AN IMPORTANT PUBLIC HEALTH AND DEVELOPMENT ISSUE
• 1.) People with disabilities make up 15% of the population.
• 2.) Face widespread barriers in accessing health services ,they face unmet health care needs , worse health care outcomes , and higher rates of poverty than people without disabilities .
DISABILITY A PUBLIC HEALTH ISSUE
• 3) The disadvantage in relation to poorer health in people with disabilities has a greater impact on families ,
communities and health systems .
• 4.) Improved health care in people with disabilities is a HUMAN RIGHT and critical to achieving aspirations such as education ,employment
,caring for and participating in family ,community and public life.
DISABILITY A PUBLIC HEALTH ISSUE
• 5.) Good health care leads to a better overall socioeconomic outcome for people with disabilities and achievement of broader global development.
TYPES OF REHABILITATION • Medical rehabilitation • Social rehab • Vocational rehab • Occupational rehab • Speech therapy • Physiotherapy MEDICAL REHABILITATION
• The process of medical care aiming at developing the
functional and psychological abilities of the indivisual , to enable him to attain self – dependence and lead an active life.
MEDICAL REHABILITATION
• The current view is to consider medical rehab very early in the process of medical treatment
• The techniques used are physiotherapy ,occupational therapy ,and speech therapy .
• These accelerate the natural regeneration process and reduce or prevent sequelae.
MEDICAL REHABILITATION
• For the disabled with functional or morphological destruction medical rehab must focus on promoting physiological processes essential to development of compensatory mechanisms .
• Psychiatric rehab starts with the patients first contact with medical services and continues untill he is fully integrated into society.
SOCIAL REHABILITATION
• This is aimed at integration of a disabled person into society by helping him to adjust to the demands of the family
,community and occupation while reducing any economic and social burdens that may impede the total rehab
VOCATIONAL REHABILITATION
• Provision of vocational services like vocational guidance , vocational training and selective placement designed to enable a disabled person to secure and retain suitable employment.
PHYSIOTHERAPY
• OR physical therapy is the art and science of physical
treatment by means of therapeutic exercise like heat ,cold , light , water, massage and electricity.
• The aims of the treatment are relief of pain and increase
in circulation ,prevention and correction of disability .The maximum return of strength ,mobility and co-ordination.
•
PHYSIOTHERAPY
• Includes performance of electrical and manual tests to determine amount of impairment of nerve supply and strength of muscle .
• Determines functional abilities , range of joint movement ,measurement of vital capacity these act as aids for the physician and to record progress.
OCCUPATIONAL THERAPY
• Medically directed treatment of physically and /mentally disabled by means of constructive activities designed and adapted by professionally qualified occupational therapist
to help in the restoration of useful function.
OCCUPATIONAL THERAPY
• The patient may be referred to an occupational therapist
for the following purposes.
• PSYCHIATRIC PATIENTS
To create opportunities for development of satisfying relationships .
• TO OBTAIN SPECIFIC TREATMENT
To restore physical function ,to increase joint movement , muscle strength ,and co-ordination.
OCCUPATIONAL THERAPY
3.)TO MAKE THE PATIENT LESS DEPENDENT
By teaching every day activities egg dressing eating , writing and use of prostheses and other equipment. 4)TO HELP A DISABLED HOUSE WIFE TO ADJUST TO HOME
ROUTINES.
providing advise and instructions on adaptations of house hold equipment and work simplification.
OCCUPATIONAL THERAPY 5)TO IMPROVE WORK TOLERANCE
and preserve special skills required by the patient for his job.
6)social adjustment and employment potential.
OCCUPATIONAL THERAPY
7) TO GET THE PATIENT TO ACCEPT THE PROLONGED PERIOD OF HOSPITALISATION OR CONVALESCENCE.
8) TO REDIRECT RECREATIONAL INTERESTS.
SPEECH THERAPY
• To study ,examine , appreciate and treat defects of voice ,speech and of spoken and written language as well as utilization of devices and therapeutic treatment .
VOCATIONAL COUNSELLING
• Process of assisting an indivisual to chose an occupation taking into account his /her characteristics and their relation to employment opportunities.
• This is based on free and voluntary choice. The primary objective is to give an indivisual opportunity for personal development and satisfaction from work and giving regard to effective use of manpower resources.
SELECTIVE PLACEMENT
• Placing the disabled in an employment suited to their age ,experience , qualifications physical and mental capacities .
• Placement is normally the last stage of rehabilitation and the patient should be referred as early as possible during medical rehabilitation.
STATISTICS
• Statistics involving disabled persons was often impractical because of
• Lack of proper research facilities
• High cost
Therefore cross sectional studies of the populations in the representative parts of the world AND collection of data from rehab centers and from centers where physical and /or psychiatric disabilities are cared for .
STATISTICS
• In developing countries taking census from the disabled is of no use since no practical action is likely to follow.
LEGISLATION
• In several countries there are no laws governing rehabilitation and therefore both the disabled and
their rights and obligations . Therefore proper legislation needs to be introduced in countries where it doesn’t exist.
• As it is expensive the cost must be borne by the
government ,social security agencies and voluntary groups.
LEGISLATION
• Funds should be provided in…….
• rehab centers , hospitals and other institutions dealing with inpatient and out patients .
• For services provided at home
• Prosthetic appliances ,transportation and social welfare services.
LEGISLATION
• There should be periodic review of rehabilitated patients to ensure physical ,psychological and social benefits are
permanant.
• Pilot rehab centers should be estabilished IN strategic areas.
REHABILITATION TEAM
• The rehab team consists of
• Physicians and nurses trained in field of rehab medicine .
• Physiotherapists ,occupational therapists ,speech
therapists ,audiologists ,social workers, clinical
psychologists , vocational counsillors , prosthetists , placement officers , special educators and recreational therapists .
REHABILITATION TEAM
• 3.) Consultants in specialities closely associated with
rehab must be available eg orthopaedic
• 4.) Neurological ,and plastic surgeons ,internists ,psychiatrists ,neurologists, orthodontists .
WHAT ARE THE PRACTICAL ACTIONS TO ADDRESS BARRIERS TO HEALTH CARE FOR PEOPLE WITH DISABILITIES
• Ensure that people with disabilities are actively involved
and central to all offorts is to strengthen policies and programmes to overcome barriers to their access to health care.
BARRIERS TO HEALTH CARE
2. Make mainstream health care services and programmes accessible to people with disabilities .
3. universal health coverage policies and efforts should be explicitly inclusive of people with disabilities .
agencies inclusive of people with disabilities .
TO OVERCOME BARRIERS TO HEALTH CARE
5. Recognise and proactively address gender disability issues in all efforts to improve access to health care for people with disabilities.
6. Remove physical barriers : accelerate efforts to adopt and implement national accessibility standards .
TO OVERCOME BARRIERS TO HEALTH CARE
7. Invest in rehabilitation services and expedite access to essential assistive devices.
8.Make health care , rehabilitative services and assistive devices affordable .
TO OVERCOME BARRIERS TO HEALTH CARE
9. take action to prevent stigma and discrimination toward
people with disabilities by health policy makers ,health care and medical staff.
10.improve disability , data collection, analysis and its application to inform policy and programming.
