Caring for clients with rehabilitation needs
Definitions & Key takeaways
After events like a stroke, an amputation, or substance abuse, clients may need rehabilitation to return to the highest possible level of physical, psychological, and emotional function. Caring for clients with rehabilitation needs can include assistance with activities of daily living such as bathing, dressing, using the toilet, and eating. They may also need help moving around their home or community.
Communication is key to providing quality care, so caregivers should always listen carefully to the person they are caring for and ask questions if they are unsure about anything. People who have experienced a traumatic event or injury may feel frightened, confused, and overwhelmed and have difficulty expressing themselves. It's important to remember that everyone responds to traumatic events and injuries in their way and that it will take time for the person to adjust and heal.
Introduction0:00–1:11
As a nursing assistant, you will care for clients that have some form of physical or mental condition that may interfere with their everyday activities.
For example, they may have a stroke or other injuries to the brain or spinal cord, heart attack, amputation, or substance abuse.
These individuals require rehabilitation, which is a process that helps a client return to their highest possible level of physical, psychological, emotional, and economic function.
Together, physical therapists, occupational therapists, speech therapists, nursing teams, doctors, psychologists, social workers, dieticians, and clients and their families form the rehabilitation team.
Rehabilitation care is provided by physical, occupational, and speech therapists, and you should not confuse rehabilitation with restorative care, which is provided by the nursing team.
Restorative care includes actions and procedures that support rehabilitation care, and the goal is to maintain the skills learned in rehabilitation.
Now, there are three main phases of the rehabilitation process, and they include the acute, subacute, and chronic phase.
Rehabilitation Phases1:11–3:01
The acute phase refers to the first 24 hours after an injury or surgery and includes techniques and procedures that keep the person alive, such as life-supporting measures, constant monitoring, and prevention of early complications.
The next phase is the subacute phase, which typically lasts 7 days. The goal of this phase is the stabilization of the client’s condition and prevention of immobility complications, such as blood clots, which are clumps of blood that can stop blood flowing through a blood vessel; pneumonia, which is an inflammation of the lungs; pressure ulcers, which are caused by breakdown of the skin and the underlying tissue when resting in the same position for too long; and contractures: a condition where muscles and tendons become permanently shortened and rigid.
Other aspects of this phase include proper nutrition, proper positioning, personal hygiene, skincare, range-of-motion exercises, and urinary and bowel care.
The last phase is the chronic phase of rehabilitation. The chronic phase of rehabilitation covers procedures and techniques that are used to restore or maintain the client’s ability to perform everyday activities, to move independently, and to communicate with others.
This phase is also important for restoring or maintaining the client’s mental health and cognitive skills and educating the client and their family about the condition.
Finally, in the chronic phase of rehabilitation, a person restores old skills or gains new skills to earn money and become financially independent.
Now, there are three main types of rehabilitation, and they include physical rehabilitation, emotional rehabilitation, and vocational rehabilitation.
First, let’s start with physical rehabilitation, which helps clients overcome physical disabilities. Physical rehabilitation can be subdivided into physical therapy, occupational therapy, and speech therapy.
Physical Rehabilitation3:01–4:41
Now, let’s focus on physical therapy, which is provided by physical therapists. Physical therapists primarily focus on the large muscles of the client’s body and gross motor skills.
They help clients regain or maintain balance, coordination, endurance, strength, posture, and flexibility. Physical therapy can be combined with the use of supportive devices, like braces or splints, which help support and rest a weak joint or limb in the ideal position; prosthetic devices, which are devices that replace a missing part of the body; and assistive devices, like canes and walkers, which promote the client’s independence and make everyday activities easier.
On the other hand, occupational therapy is provided by occupational therapists. Occupational therapists focus on small muscle groups; fine motor skills; and help clients become more independent in everyday activities, such as personal hygiene, bathing, dressing, eating, and drinking.
Moreover, an occupational therapist teaches a client to use assistive or adaptive devices, such as swivel spoons or utensils with built-up handles.
Finally, speech therapy is provided by speech therapists. These healthcare professionals help the client restore speech, but they also help them regain or maintain the ability to chew and swallow.
This type of physical rehabilitation is common in individuals with brain conditions, such as a stroke.Switching gears and moving on to emotional rehabilitation.
Emotional Rehabilitation & Vocational Rehabilitation4:41–5:27
During the rehabilitation process, your clients will experience a wide array of emotions: from feeling sad, lonely, and unmotivated to feeling frustrated and angry.
Have patience, develop a good relationship with your clients, understand their emotions, help them, and provide emotional support each day.
Finally, we have vocational rehabilitation. “Vocation” means job or occupation, so vocational rehabilitation helps people regain the skills for their previous job or learn new skills to get another type of job.
This type of rehabilitation is important because it helps clients to have a regular income and be financially independent after the rehabilitation process.Now, let’s focus on factors that can affect the outcome of the rehabilitation process.
Factors that Affect the Outcome5:27–6:43
The first one is the client’s attitude and their coping skills. Positive attitude and good coping skills are associated with a better outcome!
But, it’s important to note that the rehabilitation process depends on the client’s condition and type of rehabilitation.
Sometimes, this can be a long, overwhelming process; therefore, you should encourage your clients daily and have a positive approach!
The second factor is the response of family members and caregivers to the client’s condition. You should help your clients to be independent and responsible individuals because, if not, they will rely on family and caregivers too much.
Eventually, this will decrease their self-esteem and further increase their dependence on the family and caregivers. Finally, we have the client’s age and their overall health status.
Young individuals generally require less time to recover in contrast to older individuals. Additionally, individuals with severe trauma or chronic conditions, such as diabetes, high blood pressure, osteoporosis, or arthritis, typically require more time to recover and are at risk for developing complications during the rehabilitation process.As a nursing assistant, you have one of the key roles in the rehabilitation team.
The Role of Nursing Assistants & Reporting6:43–7:42
You should follow the client’s care plan and carry out specified actions; encourage the client to practice and learn new skills and celebrate all achievements, even if only a little progress is made; and observe and report the client’s response to the rehabilitation plan.
Also, you should observe and report early signs or symptoms of complications, which include changes in vital signs during or after the activity, such as an increased heart rate and difficulty breathing; signs of inflammation around prosthetic or supportive devices, which include redness, swelling, and pain; broken or malfunctioning supportive and prosthetic devices; and difficulties with a new rehabilitation treatment or technique.
Also, don’t forget to report changes in the client’s emotional status, such as signs of depression, crying, withdrawal, suicidal thoughts, or signs of excessive frustration and anger.
Finally, there are several important things that you should keep in mind when caring for clients with rehabilitation needs.
General Considerations7:42–8:24
Let a person do as much as they can and assist them only if the help is needed, or if they are getting too emotional. Do not pity your clients, but understand their position!
Finally, if you find yourself becoming frustrated, talk to the nurse. You need to be emotionally stable to provide proper care; therefore, the nurse may assign you a short reassignment from the specific task or give you a short break.
All right, as a quick recap... The goal of the rehabilitation process is to help clients return to their highest possible level of physical, psychological, emotional, and economic function.
Recap8:24–10:20
Three main phases of the rehabilitation process include acute, subacute, and chronic phases. The acute phase refers to the first 24 hours after an injury or surgery and includes techniques and procedures that keep the person alive, such as life-supporting measures, constant monitoring, and prevention of early complications.
The subacute phase typically lasts 7 days, and the goal of this phase is the stabilization of the client’s condition and prevention of immobility complications.
Finally, the goal of the chronic phase is to restore or maintain the client’s ability to perform everyday activities, to move independently, and to communicate with others.
Now, there are three main types of rehabilitation, and they include physical rehabilitation, emotional rehabilitation, and vocational rehabilitation.
Physical rehabilitation helps clients overcome physical disabilities, and it includes physical therapy, which helps clients regain or maintain balance, coordination, endurance, strength, posture, and flexibility; occupational therapy, which helps clients become more independent in activities of daily living, such as personal hygiene, bathing, dressing, eating, and drinking; and, finally, speech therapy, which helps clients restore speech and regain or maintain the ability to chew and swallow.
As a nursing assistant you should follow the client’s care plan and carry out specified actions; encourage the client to practice and learn new skills and celebrate all achievements, even if only a little progress is made; and observe and report the client’s response to the rehabilitation plan.
Also, don’t forget to report early signs or symptoms of complications and changes in the client’s emotional status.
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