A Practical Approach to Interdisciplinary Complex Rehabilitation

1st Edition - February 1, 2022
Editors: Cara Pelser, Helen Banks, Ganesh Bavikatte
Language: English
Paperback ISBN:
9 7 8 - 0 - 7 0 2 0 - 8 2 7 6 - 4
eBook ISBN:
9 7 8 - 0 - 7 0 2 0 - 8 2 7 7 - 1

An interdisciplinary team (IDT) approach is most effective in complex physical rehabilitation, but implementing a successful IDT can be challenging. This new book will help re… Read more

A Practical Approach to Interdisciplinary Complex Rehabilitation

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An interdisciplinary team (IDT) approach is most effective in complex physical rehabilitation, but implementing a successful IDT can be challenging. This new book will help readers to understand more about the variety of professions that contribute to successful IDT working and how team members collaborate for the benefit of the rehabilitation patient and their personalised goals.

This is a comprehensive, practical, evidence-based guide to complex rehabilitation from an IDT perspective, exploring the dynamic and diverse roles and challenges of the team. The fifteen chapters are written by clinicians who are highly experienced across a range of disciplines and settings, from early acute rehabilitation to community rehabilitation.

A Practical Approach to Interdisciplinary Complex Rehabilitation
will be an invaluable resource for all members of the team, including medical, nursing, dietetics, neuropsychiatry, occupational therapy, physiotherapy, psychology, rehabilitation coordination, speech and language therapy, and vocational rehabilitation therapy.

Cover Image
Title Page
Copyright
Table of Contents
Introduction
Contributors
Acknowledgements
Chapter 1 Complex rehabilitation in an interdisciplinary team context
Abstract
Chapter Outline
Aim
Objectives
Overview
What do we mean by ‘rehabilitation’?
A framework for defining rehabilitation
Models of rehabilitation
Team working in rehabilitation
The clinical rehabilitation pathway
Summary
References
Chapter 2 Medical management in rehabilitation
Abstract
Chapter Outline
Aims
The role of the doctor within the specialist rehabilitation team
Medical causes of complex disability
The medics role in symptom management
Medical urgencies encountered in specialist rehabilitation
Prognosis
Summary
References
Chapter 3 The role, impact, and reflections of the rehabilitation nurse
Abstract
Chapter Outline
Aims
Introduction
Definition, roles, and responsibilities of a rehabilitation nurse
Family and carer support
Formulating nursing goals and assessing outcomes
Caring for patients with reduced mental capacity
Discharge planning
Community rehabilitation nurse
Development of the rehabilitation nurse role
Summary
References
Chapter 4 Prolonged disorders of consciousness
Abstract
Chapter Outline
Aims
What is a prolonged disorder of consciousness?
Assessment approaches within a pathway model of rehabilitation
Challenges in providing assessment, care, and treatment for PDOC
Evolving and innovative practice in PDOC diagnosis
Developing effective and evidence-based team working for PDOC
Summary
References
Chapter 5 24-hour approach to physical management
Abstract
Chapter Outline
Aims
Introduction
Physical consequences of injury/illness
Muscle wasting
Muscle weakness
Altered muscle tone
Hypotonia
Spasticity
Rigidity
Clonus
Dystonia
Associated reactions
Spatial neglect
Apraxia
Ataxia
Other movement disorders
Contractures
Fractures
Amputation
Altered blood pressure
Vestibular dysfunction
Respiratory compromise
The role of the interdisciplinary team in 24-hour physical management
Physical management modalities
Positioning
Seating
Transfers
Stretching
Orthoses
Taping, strapping, and support garments
Electrical stimulation
Constraint-induced movement therapy
Mechanical adjuncts
Medical management
Prosthetics
Environmental adjustments
Assistive technology
Discharge planning
Summary
References
Chapter 6 Adjusting to life after illness or injury
Abstract
Chapter Outline
Aims and objectives
What do we mean by adjustment?
Using models of adjustment and grief to understand emotional reactions to injury
Factors impacting the adjustment process
The impact of psychological factors on interdisciplinary team rehabilitation
Positive adaptation and growth
The impact of injury or illness on the family
Supporting patients and families; what can we do to help?
Summary
References
Chapter 7 Mental health in complex rehabilitation
Abstract
Chapter Outline
Aims
Introduction
Psychiatry within a rehabilitation setting
Liaison psychiatry
Neuropsychiatry
General psychiatry
What is ‘mental health’ and how do we assess it?
Environmental influences
Psychotropic medications and their role in rehabilitation
Incidences of risk in rehabilitation
Risk assessment
Risk formulation
Risk of causing potential harm to others
Risk of causing potential harm to self
Risk as a result of injury/illness
The Mental Capacity Act and the Mental Health Act
Mental health illnesses in complex rehabilitation
Depression
Anxiety
Psychoses in rehabilitation
Frontal lobe injury
Functional neurological disorder
Summary
References
Chapter 8 Working with behaviour that challenges
Abstract
Chapter Outline
Aims and objectives
What do we mean by ‘behaviour that challenges’?
Why does it occur?
Assessment of behaviour from an interdisciplinary perspective
Methods of assessment
‘There are no triggers’
Supporting the person with behaviour that challenges
Behavioural approaches
Antecedent approaches
Positive behaviour support
Environmental modification and managing cognitive difficulties
Consequential approaches; responses to behaviour
Therapeutic relationships and communication
Psychological therapy
Reflections on learning; working with behaviour that challenges
Summary
References
Chapter 9 Cognition; an assessment and rehabilitation
Abstract
Chapter Outline
Aims
Introduction
Attention
Memory
Rehabilitation of memory
Perception
Rehabilitation of cognitive–perceptual impairment
Apraxia
Cognitive fatigue
Management of fatigue
Executive functions
Executive function in daily life
Rehabilitation of executive dysfunction
Summary
References
Chapter 10 Communication disorders in rehabilitation: an interdisciplinary approach
Abstract
Chapter Outline
Aim
Overview
Definition of communication
Role of speech and language therapists
The communication cycle
The impact of communication disorders
Definition of a communication disorder
Types of communication disorders
Dysphasia
Dysarthria
Dyspraxia
Dysphonia
Dysfluency
Dyslexia
Dysgraphia
Dyscalculia
Cognitive communication disorders
The impact of communication disorders on the patient and their family
Case study 1: Acquired dyslexia
Case study 2: Dyscalculia
Case study 3: Cognitive communication disorder
Supporting families
IDT working
Supporting communication for mental capacity assessments
Case study 4: Supporting a mental capacity assessment
Assistive technology and alternative and augmentative communication
Case study 5: Utilising AAC with a communication disorder
Summary
References
Chapter 11 Dysphagia in rehabilitation: an interdisciplinary approach
Abstract
Chapter Outline
Aims and objectives
Overview
Definition
Incidence
Mechanism of swallowing
Causes of dysphagia
Assessment of dysphagia
Bedside assessment
Cervical auscultation
Videofluoroscopy
Fibreoptic endoscopic evaluation of swallowing
The effect of dysphagia on the rehabilitation journey
Rationale for IDT working
Interdisciplinary management of dysphagia
Environment
Physical and sensory impairments
Communication
Diet and fluid modifications
Medical management
Pharmacy
Managing risk
Key learning points
References
Chapter 12 Nutrition and dietetics in rehabilitation
Abstract
Chapter Outline
Aims
Objectives
Nutrition and dietetics in rehabilitation
Nutritional aims during rehabilitation
Nutrition support
Oral nutrition support
Enteral feeding
Parental nutrition support
Other nutritional considerations in rehabilitation
Hydration
Pressure ulcers and wound healing
Bowel habits
Medication
Bone health
Factors affecting weight gain and strategies to improve outcomes
Dietetics role within the IDT
Catering
Nursing and health care assistants
Occupational therapy
Physiotherapy
Psychology
Speech and language therapist
Therapy assistants
Medical team
Ethical/difficult decisions about nutrition
Example 1: Nil by mouth (NBM) and the need for artificial nutrition support
Example 2: Family and team disagree
Example 3: Excessive weight gain
Summary
References
Chapter 13 Early vocational rehabilitation within an interdisciplinary context
Abstract
Keywords
Chapter Outline
Aim
Objectives
Introduction
Models of service delivery
Embedding vocational rehabilitation practice into the interdisciplinary team
Specialist vocational rehabilitation
Providing patient-centred vocational rehabilitation
Vocational rehabilitation interventions
Summary
References
Chapter 14 A patient's perspective
Abstract
Chapter Outline
Introduction
Elly's story
Marie's story
Chapter 15 Supporting the socioeconomic needs of patients and their families within the context of a complex rehabilitation setting: creating opportunities through collaboration, rehabilitation, and beyond
Abstract
Chapter Outline
Aims
Introduction
Risk factors and prevalence
The socioeconomic impacts of major injury and illness
The wider impact on family networks
Multiagency working; supporting the multifaceted needs of patients and families
The Life-Link Clinic
Summary
References
Chapter 16 Conclusion
Index