Domain 4 - Rehabilitation Concepts and Strategies Flashcards
Rehabilitation
Rehabilitation is a component of both illness and disability. Vocational aspects of both chronic illness and disability can put a significant strain on the client and family. Reduction or loss of income make these cases a challenge to manage.
Goals of Rehabilitation
The goals of rehabilitation are Restore clients’ initial function and abilities or
* Maximize functional level.
* Prevent deterioration or complications in client’s health by teaching the client alternative techniques to effectively adapt to their health, behavioral, and/or physical condition and to adhere to health regimen.
* Promote client’s quality of life by providing, services or devices that allow the client to overcome impairment or to augment functioning.
* Facilitate client’s independence
* Modifying client’s environment
* Reduce or eliminate barriers to independent functioning
* Enhance safety.
* Enhance access to timely, safe, quality, and cost-effective services
ADA
Americans with Disabilities Act (ADA)
When did Americans with Disabilities Act (ADA) become enacted
Originally enacted in 1990; Amendments Act of 2008 became effective January 1, 2009
What does the Title I in the Americans with Disabilities Act (ADA) do
prohibits private employers, state and local
governments, employment agencies, and labor unions from discriminating against qualified individuals with disabilities in job application, hiring, firing, advancement, compensation, job training, and other terms, conditions, or privileges of employment
Enacted to provide clear mandate for elimination of discrimination against
disabled persons
How are reasonable accommodations evaluated since ADA was enacted
Reasonable accommodation is evaluated based on both effectiveness and feasibility for the typical employer, and the employer has the final discretion to choose a reasonable accommodation (must prove that it would cause an undue
hardship)
What is Disability management
Disability management is a workplace prevention and remediation strategy that aims to prevent disability from occurring or to intervene early following the onset of an injury or illness known to potentially result in a disability.
Disability management programs may consist of several specific components including:
- prevention of work-related injury or illness,
- support for the worker’s recovery (e.g., medical and vocational rehabilitation, catastrophic case management, and life care planning)
- reasonable accommodations for the worker’s limitations.
What does disability management do for workers?
-assist with return to work (RTW) in timely manner
-improve quality of like
The purpose of disability management programs is to assist the worker to return to work as soon as appropriate, and therefore improve the individual’s quality of life by resuming function and productive
employment.
What does disability management do for employers?
-return experiences and trained workers to job
-reduce unnecessary expenses
-retain engaged, satisfied workers
The purpose is for experienced and trained
workers to quickly return to work. This also reduces unnecessary expenses and maintains engaged and satisfied workers.
What are the goals of disability management
- Connect - care, benefits, case management services to complement each other
- Integrate - sick leave, paid leave, and disability benefits to achieve early return to work
- Coordinate - medical, behavioral, health services
Components of disability management programs include:
- Processing of applications for health benefits, and coordination of benefits to ensure timely access
- Clarification of job limitations and modifications, linking all stakeholders for return to work, coordinating care with treating providers and ensuring appropriate timely treatment, identifying essential job functions in order to seek reasonable accommodation
- Working within ADA regulations to develop modified job and return to work options, with reasonable accommodation and determination
of essential job functions as appropriate - Assisting the worker to return to work with understanding and acceptance from supervisors, gain agreement with job accommodation
options - Safety and illness prevention programs, aiding with reasonable accommodation, identification of job aids, assistive devices, ergonomics
- Education of supervisors, treating physicians, and others about the return-to-work process
Are workers compensation benefits standardized federally or by state?
State
Workers’ compensation is a benefits program created by state law to
Provide medical, rehabilitation, income, death, and other benefits to workers and their dependents due to injury, occupational illness, or death resulting from a compensable work-related claim covered by the law.
What are some examples of reasonable accomodations?
Accessible facilities
Flexi-time
Modifying work schedules
Modifying work sites
Flexi-place
Providing readers and interpreters
Assistive devices
Reassignment
RTW
Return To Work
What kind of workers compensation benefits are provided:
Benefits provided:
* Medical and rehabilitation
* Disability and lost wages
* Survivorship or death benefits
Maximum Medical Improvement
Term to indicate that the injured worker has recovered from injuries to a level at which a physician states that further treatment will not substantively change the medical outcome.
FCE
Functional Capacity Evaluation (FCE)
What is a Functional Capacity Evaluation (FCE)
A systematic process of assessing an individual’s physical capacities and functional abilities. It is a comprehensive exam that can be used to determine job placement, job accommodation, or return to work.
The FCE is used in occupational health case management to directly measure the client’s ability to perform work related activities. It can be part of the initial assessment, used to determine the work conditioning plan or to reassess progress and ability to return to work.
During the FCE the client is evaluated as they perform activities they are required to do in their job. This may include, but is not limited to:
* Squatting
* sitting
* pushing
* pulling
* turning
* standing
* kneeling
* balancing
* navigating stairs
* hand grip
The amount of time the client can perform each of these tasks is important.
FIM
Functional Independence Measure (FIM)
Functional Independence Measure (FIM)
- 18 measure instrument
- Scale rangesfrom 1 (total assistance) to 7 (complete independence)
- Used worldwide in an inpatient rehabilitation setting
- Measures client’s ability to function independently
- Allows for evaluation of the amount of assistance required by the client to safely
and effectively perform basic life functions - Can also be used to assess cognitive abilities (comprehension, expression, social interaction, problem solving, and memory)
Job accommodation
A job accommodation is a reasonable adjustment to a job or work environment that makes it possible for a disabled person to perform job
duties.
The job accommodation is individualized and focused on access. It can be the use of voice recognition software or an adjustable height desk to accommodate a wheelchair.
Job Analysis
A process to identify and determine in detail the job duties and requirements and their relative
importance for a given job.
Key information is gathered through interviews, questionnaires, or direct observation to develop a description or specifications of the job. It is not a
description of the person.
The purpose is to establish and document the job relatedness of employment procedures such as training, selection, compensation, and performance appraisal.
Job Placement
It is assisting an injured worker to find employment by matching the skills, knowledge, and abilities of the worker with a potential job.
Work Adjustment
The use of real or simulated work activity under close supervision at a rehabilitation facility or other work setting to develop appropriate work behaviors, attitudes, or personal characteristics
Work Conditioning
An intensive, work-related, goal-oriented conditioning program designed specifically to restore systemic neuromusculoskeletal
functions (e.g., joint integrity and mobility, muscle performance (including strength, power, and endurance), motor function (motor control and motor learning), range of motion (including muscle length), and cardiovascular/pulmonary functions (e.g., aerobic capacity/endurance,
circulation, and ventilation and respiration/gas exchange).
The objective of the work conditioning program is to restore physical capacity and function to enable the client to return to work.
Work Hardening
In contrast to work adjustment, which focuses on more personal issues, work hardening is a program that is a highly structured, goal-oriented, and individualized intervention program, providing clients with a transition between
the acute injury stage and a safe, productive return to work, and focuses on endurance.
Treatment is designed to maximize the worker’s ability to return to work safely with less likelihood of repeat injury
Work Modification
Altering the work environment to accommodate a person’s physical or mental limitations by making changes in equipment, in the methods of completing tasks, or in job duties.
