Life of a Rehab Physio Flashcards
Role of Occupational Therapist
Modify things for ADLs
usually don’t perform walking related tasks
Train UL, toilet, shower, grooming and self care
perform home assessments with patients
Role of Nursing Unit Manager (NUM)
coordinate all of the care of the patient
Role of nurse
see patient everyday
performs tasks related to medications and daily needs (helps patients toilet, feed, etc)
Role of speech pathologist
communication with patient
Swallowing assessment
Different diets based on requirements - diet, fluids, etc
Role of dietician
what foods is the patient eating
determine diet so patient gets nutrients/minerals required
nutritional status of food
If patient is malnourished, physio may be affected as patient has no energy
Role of Rehabilitation consultant (specialist doctor)
comes in after meeting and agrees/disagrees with Mx
Consulted on rehab plan coordination in conjunction with NUM
Role of social worker
ensures patients are paying bills in hospital
organise services
assist with discharge planning and services at discharge
organise helpers for patient (physical/time/emotional)
provide minor counselling
arrange neuropsychologist who performs cognitive evaluations
Determine if patient has ability to make choices about life/finances –> if no, then organises power of attorney
Priority 1 (immediate)
immediate and significant safety concerns that can only be addressed through treatment
falls
Priority 2 (2x / day)
unmotivated. educate patient on benefits of exercise
highly motivated
risk of decline or risk of falls
patients that are doing well in rehab and you can see benefit of seeing them 2x per day
Priority 3 (1x / day)
highly motivated and able to exercise independently. Semi supervised patient
severely cognitively impaired patient
patient fatigues quickly. may only be able to be seen 1x per day as patient fatigues after 1 session
must fit rehab around patients schedule
how patient fits within schedule of MD team
Priority 4 (2-3x a week)
patient need physio but is independently functioning. Monitor 2-3x per week
Priority 5 (not for treatment)
in rehab for other things such as speech, but do not physio
patient refuses physio
someone who is medically unstable, can treat until medically stable
When would you see new patient on rehab ward
ASAP - after ‘immediate/P1 patients)
Components of discharge planning
Goals: SMART. What does patient need to do physically to get home safely?
Timeframe:
Destination: adapt the goals depending on whether patient is going home or to a care facility. Ensure family involvement and proper equipment set up
What will discharge timeframe depend on
ICU stay length (prolonged ventilation and deconditioning)
Acute ward stay length
Home set up / family support
Level of cognition
Services available
Factors to consider for destination
Respite is a temporary/interim location - high level care, awaiting home mods, patient almost ready for home
Stairs at home
financial
SOcial support
Who does discharge planning need to involve
Patient
Medical staff - MD team
Family and carers
Discharge planning - Services
COMPACKS
Transition Care
Commonwealth Home Support Program
Homecare packages
NDIS
COMPACKS
low level support for short term needs post discharge, useful when a patient risks readmission without services
assistance with personal care, domestic assistance, transport and social support
when a patient does not have access to other services
Transition care
short term care for high care needs patients post hospitalisation to regain functional independence
Commonwealth Home Support Program
for older people requiring basic support with an ACAT assessment
help with housework, personal care, meals and food prep, transport, shopping, allied health, social support and planned respite
Homecare packages
for complex needs beyond CHSP, includes coordinated services
help with household tasks
equipment
minor home modifications
personal care
clinical care - nursing, allied health and physio
4 levels
NDIS
for people under 65 with significant disabilities and lifelong condition requiring individualised support plans
funding for supports and services related to
- ADLs
- transport to enable community/social participation
- help with household tasks
- home mods
- mobility equipment
- allied health
- etc
