Maximising independence through community rehabilitation

Abstract

Maximising independence through community rehabilitation. Community rehabilitation is now recognized as an integral part of the rehabilitation process. The provision of such community rehabilitation within a person's home or community enables their clinicians to focus on meaningful functional activities and independence needs of a person. Providing rehabilitation in the environment where a person normally functions, whether it is for physical, cognitive or behavioural needs, maximizes outcomes as it ensures the person's learning is occurring in a contextual environment. It also maximizes independence as it enables practice of new skills to occur frequently across the day; consequently skill development is based on regular practice. As skills are acquired these can be progressed within the home or the community environment. Integral to this process is the development of functional goals. Goals must be person centered and aligned with underlying functional needs, thus goal achievement is underpinned by a rehabilitation process where all members of the rehabilitation team are working towards the same functional outcome. Carers can be trained to assist with practice of the program, this allows autonomy as clinicians don't need to be present at all times while practicing tasks or exercises. Consequently the ability to select and train carers are vital skills required by clinicians managing injured people in the community. Allowing the injured person to have a role in carer selection can facilitate a more fruitful relationship. It is expected that as the person's skills develop and evolve there will be an understanding from all involved that the person's need for carers will reduce. At times independence can be limited if clinicians and carers continue therapy and restrict a person's ability to develop confidence in their independence; best practice would indicate treatment plans are reviewed regularly so this doesn't occur. To maximize independence, all these components should be considered.