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REHABILITATION
Prepared by :
Khloud Eid Albalawi
Samerah Suleiman A lf i f i
Am nah Awdah A latawi
Amal Eid Alshaman
Fat imah Mohammad A lharth i
Fat imah Rabea Al johani
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Rehabilitation of Health Care
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Out line
Introduction .
Definitions of rehabilitation .
Definition of rehab center . Goal of rehabilitation .
Goal of rehabilitation nursing . Who needs for rehabilitation .
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HEALTHWHOs definition: A state of complete
Physical, mental and social well-being not
merely the absence of disease or
infirmity.
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Introduction
Rehabilitation began to emerge as aseparate development with in health careonly after the first world war.
Health promotion & rehabilitation are
essential components of community healthnursing practice involve efforts to reducedisability and, as much as possible andrestore their function.
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REHABILITATION
Definition:Habilitation:
is the process of education or training an individual
to function in Society
Rehabilitation:
The process of restoration of skills by a person whohas had an illness or injury so as to regainmaximum self-sufficiency and function in a normal
or as near normal manner as possible.
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REHABILITATION
Define by WHO as:-
A combined and coordinated use of
medical ,social ,educational ,and
vocational measures for training and
retraining the individual to the highest
possible level of functional ability and
at enabling the disabled to achieve
social integration .
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Rehabilitation Center
a facility providing therapy and training forrehabilitation. The center may offer occupationaltherapy, physical therapy, vocational training, andspecial training such as speech therapy.
Rehabilitation services are provided in a variety ofsettings including clinical and office practices,hospitals, skilled-care nursing homes, sports medicine
clinics, and some health maintenance organizations.Some therapists make home visits. Advice onchoosing the appropriate type of therapy and therapistis provided by the patient's medical team.
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Goals of Rehabilitation
All Rehabilitation Goals Shall
Maximize the quality of life of the individual
Address the individuals specific needs
Assist the individual with adjusting to an alteredlifestyle
Promote maximum functional ability
Optimal health
Be directed toward promoting wellness and minimizingcomplications
Assist the individual in attaining the highest degree offunction and self-sufficiency possible
Assist the individual to return to home and community
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Goal of rehabil i tation nursing:is to assist the patient to attain and to
maintain optimum health as it is definedby the patient.
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Need for Rehabilitaton
*Need for Rehabilitation Precipitated by:a- Impairment : Any loss or abnormality ofpsychological, physiological, or anatomical structure
or function.b- Disability :any restriction or lack (resulting from
an impairment) of ability to perform an activity in
the manner or within the range considered normalfor a human being.
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Need for Rehabilitaton
c- Handicap:a disadvantage for a given individual
resulting from an impairment or a disability thatlimits or prevents the fulfillment of a role that isnormal for that individual.
d-Functional Limitation : any loss of ability toperform task and obligations of usual role andnormal daily life.
f-Chronic illness: an irreversible presence,accumulation, or latency of disease state orimpairment that involves the total humanenvironment.
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As traditionally used, impairment refers to a problem
with a structure or organ of the body; disability is a
functional limitation with regard to a particular activity;
and handicap refers to a disadvantage in filling a role inlife relative to a peer group.
Examples to illustrate the differences among the
terms "impairment," "disability," and "handicap." CP example: David is a 4-yr.-old who has a
form of cerebral palsy (CP) called spasticdiplegia. David's CP causes his legs to be stiff,
tight, and difficult to move. He cannot stand orwalk.
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Impairment: The inability to move the legs
easily at the joints and inability to bear
weight on the feet is an impairment.
Disability: David's inability to walk is a
disability.
Handicap:David's cerebral palsy is
handicapping to the extent that it prevents
him from fulfilling a normal role at home, in
preschool, and in the community.
f h bili i
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Type of rehabilitation
Physical therapyto help strength,
mobility and fitness Occupational therapy to assist the daily
activities
Speech-language therapy to help withspeaking, understanding, reading, writing andswallowing
Psychiatric rehabilitation also known as
psychosocial rehabilitation, and sometimessimplified to psych rehabby providers, is theprocess of restoration of community functioning
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and well-being of an individual diagnosed in
mental healthor mental or emotional disorder andwho may be considered to have a psychiatric
disability.
Cognitive Rehabilitation: is the process ofrelearning cognitive skills that have been lost or
altered as a result of damage to brain
cells/chemistry.
Type of rehabilitation
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Rehabilitation Team
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Rehabilitation Teamwork
Multidisciplinary group but operate as a single
unit and not taken any significant interferencefrom a particular specialty without the consent ofthe other team members
Goal of rehabilitation Team work
Provide best treatment for the fundamental needsof the individual, and the members of this teamworks through a coherent and integrated
diagnosis , flexible and dynamic planning ,appropriate timing for treatment and the balancein the proceedings
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Rehabilitation Team
Physiatrist Neuropsychologist
Physical Therapist
Nurses
Speech/Language Pathologist
Occupational Therapist
Recreational Therapist
Counselor
Medical social workers
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PhysiatristThe Physiatrist is the leader of
the rehabilitation team. Heassesses the patient carefully
and monitor rhe pts progress
. He decides the program as
per the pts need.He will
design a patient oriented
treatment program based on
which the other members ofthe team will be decided . His
specialization is physical
medicine and rehabilitation .
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Neuropsychologist
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Neuropsychologist
Often after a serious illness or brain damage ,
a patient may not able to behave or think as he use to
before the accident . Severe brain damage may be
the cause for this . So a Neuropsychologist
Monitors these changes and then design such
programs that will help the pt recover quickly. A
Neuropsychologist will also educate the family
members of the pt to accept this change in the ptand ways to deal with it .
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Physical Therapist
After a traumatic brain injury a
person may suffer frommusculoskeletal or neuromuscularissues.This injury affects his dailyactivites. The work of a Physical
Rehabilitation Therapist is towork on improve this problem ofthe pt . He will focus on thedevelopment of posture, strength,
physical independence, qualitymovement by using aids as(wheelchair, canes and crutches),
balance coordination and othersensory motor activities.
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Nurses
Nurses who deal with
rehabilitation pts aretrained to take care of theeveryday need of the pt.
Often after severe brain orphysical injury a personmay find it difficult totake care of oneself, so
these nurses are trained totake care of pt .
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Occupational Therapist
The work of an accupational therapist is tomake a patient learn advanced
independence skills that will help him in
various ways in his personal life .The ptwill be taught ,cooking ,
laundering,shopping and banking by an
occupational therapist .
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Recreational Therapist
The job of a recreational therapist is to make a pt
indulge in all those activities that the pt enjoys.He brings a positive attitude in a pt by making
the latter realize that life can be fun and
enjoyable.
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CounselorAfter any kind of a traumatic byaccident or illness a pt goes
through depression and othernegative feeling . It is veryimportant that a Rehab Counselorcounsels the pt and adds positiveattitude in him . This is important
as healthy mind will lead to afaster healing .
Medical social workers
provide emotional support, identify
economic resources andcommunity agencies and help ptto make arrangements to leave thehospital and find follow-up care.
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Other Rehabilitation Professionals
Audiologist
Respiratoty therapist Dance therapist
Dentist
Dietitian
Enterostomal therapist Podiatrist
Child life specialist
Others
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Role of Rehabilitation Nurse
Provider ofcare
Educatorand coach
Leader andcollaborator
Client
advocate
Coordinator
of care
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Provider of Care
Provides quality evidence based nursing
Focuses on restoring & maintaining
function and preventing complications
Interacts therapeutically with clients and
their support systems
(ARN,1998, OARN, 1998)
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Educator and Coach
Wellness and prevention
Self care
assesses their readiness to learnplans teaching times and strategies
Advocacy skills
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Leader and Collaborator
Works with the
team to establish
goals to promote
maximal patient
independence.
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Rehab Nurse as Advocate
Patient or unit /program based
Accessibility ofrehabilitation services
Politically involved at
all levels
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Rehab Nurse as Coordinator
Uses holistic,interprofessionalapproach
Identifies andmeasures functionalgoals for patients
plan and guide care
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Clinical Evaluation
Detailed History of the Patient Physical Examination
Evaluation of Function
PMR Diagnosis
Disease
ImpairmentDisability
Handicap
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Laboratory
RBC, WBC, Hct Sedimentation rate
Urinary analysis
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Rx, CT, MRI, scintigraphy and
other advanced technics
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Therapy and/or rehabilitation
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rehabilitation program - a program for restoring someone to good health
The overall objective of the rehabilitation policy is to prevent
disabilities; to help persons with disabilities develop their physical andmental capabilities as well as their ability to integrate into the
community; and to create a barrier-free physical environment through a
comprehensive range of effective measures, with a view to ensuring that
persons with disabilities can participate in full and enjoy equalopportunities both in terms of their social life and personal growth
Rehabilitation program
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Service Areas
Major service areas covered under the RP include:
(a) prevention and identification;
(b) medical rehabilitation;
(c) pre-school training;
(d) education;
(e) employment and vocational rehabilitation;
(f) residential care;(g) day care and community support;
(h) development of self-help organizations;
(i) access and transport;
(j) application of information and communications
technologies;(k) recreational, sports, cultural and arts activities; and
(l) public education.
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Categories of Disability Requiring Rehabilitation Services
(a) Attention Deficit/Hyperactivity Disorder;
(b) Autism;
(c) hearing impairment;
(d) intellectual disability;(e) physical disability;
(f) mental illness;
(g) Specific Learning Difficulties;
(h) speech impairment;
(i)visual impairment.
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Physical medicine and rehabilitation
*Physical medicine and rehabilitation(PM&R), also known as
rehabilitation medicine, is a branch of medicinethat aims to enhance
and restore functional ability and quality of life to those with physical
impairments or disabilities.
Common conditions that are treated by the rehabilitation
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y
therapists include
Amputation
spinal cord injury
sports injury
musculoskeletal pain syndromes such as low back pain, fibromyalgia, and
traumatic brain injury.
Cardiopulmonary rehabilitation involves optimizing function in those afflicted
with heart or lung disease.
Chronic painmanagement
Anesthesiologist, and interventional procedures when indicated.
strokeis often treated with the help of a speech therapistand recreational
therapistwhen possible.
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A person with physical disabilities is defined as a person
who has disabilities of orthopedic, musculoskeletal, or
neurological origin which mainly affect locomotors
functions, and constitute a disadvantage or restriction in one
or more aspects of daily living activities.
1-Physical rehabilitation
Proper exercising program is designed to
improve the functioning often physical body.Includes therapies that will help a patient re-
learn the basic physical and cognitive
functioning.
j i i f i h h i ll di bili i
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Major service requirements of persons with physically disabilities
may include:
(a) medical and community rehabilitation care;(b) pre-school training;
(c) education services;
(d) residential care;
(e) day care and community support;
(f) employment services and vocational rehabilitation;
(g) barrier-free access and transport;
(h) barrier-free information a nd communication technological
equipment; and/or
(i) use of assistive devices.
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N l i l di d
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Neurological disorders :
are diseases of the central and peripheral nervous system.
In other words, diseases of the brain, spinal cord, cranial nerves,
peripheral nerves, autonomic nervous system,neuromuscular junction, and muscles.
of the nervous system
There are more than 600 diseases
These disorders include epilepsy, Alzheimer disease and other
dementias, cerebrovascular diseases including stroke, migraine
and other headache disorders, multiple sclerosis disease,
neuroinfections, brain tumors, traumatic disorders of the nervous
system such as brain trauma, and neurological disorders as a
result of malnutrition.
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In order to help reach these goals, neurological
rehabilitation programs may include the following:
-Assistance with activities of daily living (ADLs), such as eating,dressing, bathing,
toileting, handwriting, cooking, and basic housekeeping
-Speech therapy to help patients with speaking, reading, writing, orswallowing
-Stress, anxiety, and depression management
-Bladder and bowel retraining
-Activities to improve mobility (movement), muscle control, gait
(walking), and balance
-
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reh ilit tion
MENTAL RETARDATION
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MENTAL RETARDATION
Mental retardation (MR) is a generalized disorder appearingbeforeadulthood,
characterized by significantly impaired cognitive functioning and deficits in two or
more adaptive behaviors.
It has historically been defined as an Intelligence Quotient score under 70.
Mental retardation is a term used when a person has certain limitations in mental
functioning and in skills such as communicating, taking care of him or herself, andsocial skills.
These limitations will cause a child to learn and develop more slowly than a typical
child.
Children with mental retardation may take longer to learn to speak, walk, and takecare of their personal needs such as dressing or eating.
They are likely to have trouble learning in school
The most common causes are: -Genetic conditions -Problems during pregnancy -
Problems at birth -Health problems
i b diffi l hild f
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Treatment: Treatments for Mental Retardation are not designed to
"cure" the disorder. Rather, therapy goals include reducing safety
risks (e.g., helping an individual maintain safety at home or school)
and teaching appropriate and relevant life skills.
Interventions should be based on the specific needs of individualsand their families, with the primary goal of developing the person's
potential to the fullest
Diagnoses:It may be difficult to assess very young children for MR, so
most clinicians will not give a definitive diagnosis of mental
retardation to children under the age of two unless their symptoms are
extremely severe and/or they have a condition that is highly associatedwith this condition (such as Down's Syndrome).
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Rehabilitation Management Plan
It depends upon the current level of the
childand the associated conditions such as
epilepsy,
hyperkinesias, behavior problem and
sensory
Handicaps
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In overall management, there is very significant role of
counselor to help the parents in understanding and accepting the
child's problem.
This requires a life long adjustment.
In order to assist the parents in dealing effectively with the
situation,
counseling for behavior modification is essential, as a part of the
whole rehabilitation management plan.
The focus of counseling
depends upon the individual needs and requirementof the mentally retarded and his family.
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Parent Counseling : the parent counseling
is done as given below;
(1)To provide information regarding thecondition of the mentally retarded child.
The counselor should explain child's condition
in simple words to the parents and give
enough information regardingmanagement of his associated medical
problem and other disabilities must be made
available to the parents.
The false hopes should be avoided.
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They blame each other for being responsible for the birth of such child
due to lack of awareness.
Parents tend to believe that the child would become normal in duecourse of time.
Hence counselor should give correct information on the nature, causes
and treatment of mentally retarded child.
(2) Development of correct attitudes towards
their handicapped child.
Usually parents have wrong beliefs, ideas and thoughts regardingcauses and treatment of their disabled child.
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(3)- Parent groups meetinghaving parents ofmentally retarded children who have been
already helped with the parents of earlier
identified children, will be purposeful for
proper interaction among themselves.
- Parents should be helped to learn the skills
of training and then they should be
demonstrated how their training has helped
the child to learn the few skills, so thatparents can have a feeling of achievement.
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Community Awareness :
The society should be made aware of the need to recognize the mentally retarded
persons and give enough care to make them as independent
as possible.
The various modalities of communication for reaching out to the communityshould be utilized.
may use physical, occupational, and speech therapies
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Cardiac rehabilitation (rehab) is a medically supervised
program that helps improve the health and well-being of
people who have heart problems.Rehab programs include exercise training, education on heart
healthy living, and counseling to reduce stress and help pt
return to an active life.
Cardiac rehabilitation
Cardiac rehabilitation
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Recover after aheart attackorheart surgery.
Prevent future hospital stays, heart problems, and deathrelated to heart problems.
Address risk factors that can lead tocoronary heart
diseaseand other heart problems.
These risk factors include high blood pressure, high bloodcholesterol, overweight or obesity, diabetes smoking, lack
of physical activity, and depression and other emotional
health concerns.
Adopt healthy lifestyle changes. These changes may include
following a heart healthy diet, being physically active, and
learning how to manage stress.
Improve health and quality of life.
cardiac rehab program will be designed to meet pt needs
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Geriatricrehabilitationcovers three areas
1-normal agingdue to disuse and deconditioning,
2-cardiovascular problems like vascular disease and stroke,
3-skeletal problems
including osteoporosisand osteoarthritisconditions such as knee
and hip replacements.
Physical medicine Physicians use rehabilitation to work toward the
goal of returning the patient to a pre-injury quality oflife and may use physical, occupational, and speech therapies.
with increased age, patients often face many physical and emotional changes that can
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affect level of function and well-being
Rehabilitation maintains functional independence in the elderly.Rehabilitation of
geriatric patients is imperative for the patients' well-being and for society, so that we
can thrive socially and economically.
Essential to geriatric rehabilitation is communication, specifically improving
any sensory impairment, including those related to vision and hearing.
The prevention of falls and osteoporosis can improve the patient's health
and longevity.
Addressing malnutritioncan promote healing and vitalize the patient to participate in a
formal rehabilitation program.
Depressionis common in the older population if a functional loss ofmobility and an inability to perform activities of daily living(ADLs)
Cognitive impairment, such as deliriumand dementia, can affect the
patient's rehabilitation goals.
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The Geriatric Rehabilitation Program
provides care to older adults in many of services.
However, they have a variety of services that are specifically designed to
meet their needs:Geriatric Rehabilitation Inpatient Serviceinpatient care for older adults
who need help managing multiple health issues associated with aging.
Geriatric Psychiatry Inpatient Serviceinpatient care for older adults
with behavioral challenges caused by dementias.
Geriatric Day Hospital Servicea similar service provided on an
outpatient basis to people who need assistance but can remain in the
community.
Geriatric Rehabilitation Outpatient Clinicsspecialized assessments for
older adults with complex health issues.
with increased age, patients often face many physical and emotional changes that can
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affect level of function and well-being
Rehabilitation maintains functional independence in the elderly.Rehabilitation of
geriatric patients is imperative for the patients' well-being and for society, so that we
can thrive socially and economically.
Essential to geriatric rehabilitation is communication, specifically improving
any sensory impairment, including those related to vision and hearing.
The prevention of falls and osteoporosis can improve the patient's health
and longevity.
Addressing malnutritioncan promote healing
Depressionis common in the older population if a functional loss of
mobility and an inability to perform activities of daily living(ADLs)
Cognitive impairment, such as deliriumand dementia, can affect the
patient's rehabilitation goals and out comes.
i i h bili i
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Geriatric Rehabilitation Program
provides care to older adults in many of services.
However, they have a variety of services that are specifically designed to
meet their needs:Geriatric Rehabilitation Inpatient Serviceinpatient care for older adults
who need help managing multiple health issues associated with aging.
Geriatric Psychiatry Inpatient Serviceinpatient care for older adults
with behavioral challenges caused by dementias.
Geriatric Day Hospital Servicea similar service provided on an
outpatient basis to people who need assistance but can remain in the
community.
Geriatric Rehabilitation Outpatient Clinicsspecialized assessments for
older adults with complex health issues.
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Addiction rebilitation
Drug Rehabilitation
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Drug Rehabilitation
Drug rehabilitation programs involve
programs that are designed to make an addictfree from the addiction of alcohol, prescription
drug and street drugs (cocaine, heroin etc)
Program content
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Program content
Counseling programs designed to know the
underline cause behind a person becoming an
addict.
Educating the person about the various side
effects of drug abuse and how it impactsones social, professional, physical and
personnel life.
Designing programs that will prevent therelapse of the drug addiction.
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Medical Rehab Program
Focused on restoring the health and function
abilities of people after acute or chronic
conditions such as :spinal cord injury ,amputation, joint replacement or spinal
disorders.
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Medical Rehab Program
Programs focus on improving major and
minor skills that are required in the basic
life.Assessing patient in every step to improve
the activities of basic living
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Vocational rehabilitation
Vocational rehabprogram is designed to
help those people who find it difficult to get
employment or retain it after they have gone
through certain situation that caused mental or
physical disability in them.
V ti l R h b P
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Vocational Rehab Program
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Vocational Rehab Program
An Occupational Rehabilitation Program isindividualized, focused on return to work, anddesigned to minimize risk to and optimize the
work capability of the persons served. Theservices provided are integrative in nature, withthe capability of addressing the work, health, andrehabilitation needs of those served. Such a
program provides for service coordination andmanagement of those persons served with injuriesor illnesses.
Children's Developmental RehabilitationP
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Program
The CDRP provides
habilitation/rehabilitation services
to children with neurological and/or
developmental disabilities from
birth up to age 18. The team offersassessment, treatment, and
consultation services through a
variety of service delivery modelswith interdisciplinary teams.
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Children's Developmental
Rehabilitation Program
These programs serve children/adolescents who havesignificant functional limitations as a result of acquired orcongenital impairments. The programs use anindividualized, developmental, and age-appropriate
approach to rehabilitation that ensures that care focuses onpreventing further impairment, reducing activitylimitations, and minimizing participation restrictions whilemaximizing growth and development. The programsencompass care that enhances the life of eachchild/adolescent served within the family, school, andcommunity. A major focus is on providingdevelopmentally appropriate care that acknowledges eachchilds/adolescents need to learn and play.
Vestibular rehabilitation
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Vestibular rehabilitation
It helps in improving the ear deficit by working on
the central nervous system. Also deals in
improving eye and head coordination.
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Vestibular rehabilitation
introduces balance techniques
visual exercisesimproves ability to
maintain gaze while in motion home exercisesenables independent
condition management
patient/family educationteaches how toidentify dizziness triggers and developstrategies to minimize effects
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Stroke rehabilitation
Minimizing impairments and secondary
complications.
Reducing activity limitations. Maximizing participation and quality of
life.
Decreasing environmental barriers. Preventing recurrent stroke.
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Warning signs of stroke
Sudden weakness or numbness of the face, arm or leg ,especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance or
coordination.
Sudden, sever headache with no known cause
Learn to recognize a stroke .
Time lost is brain lost.
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Aim of Stroke rehab
Stroke rehabilitationaims at helping people
gain maximum normal functioning after the
occurrence of a stroke.Help the person to get back to normal
lifestyle and be independent in daily
activities.
Conclusion
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Conclusion
Rehabilitation is the process of maximizingan individuals capabilities or resources to
foster optimal independent functioning.
The focus of all rehabilitation should be on thepatients abilities, not on his or her disabilities
Rehabilitation focuses on continually
improving the quality of the persons life, notmerely maintaining life itself.
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