Rehabilitation, whose and what for?

The term rehabilitation. What does it mean to you and how do you associate yourself with this? Prior to my practical training at the rehabilitation ward at Central Hospital Central Finland, I didn’t have a clear understanding of what to expect. Previously I associated rehabilitation with drug users and abusers and even people who have been incarcerated.

According to the Ministry of Social Affairs and Health, rehabilitation is designed to further the functional capacity, independent coping, well-being, possibilities for participation and employment of people dealing with ill health, disability or incapacity.

Interestingly, Finland is one of the few countries that invests a lot in rehabilitation. Not only do they provide most of the rehabilitation services free of charge but also  entitles its citizens to a rehabilitation allowance whilst participating in rehabilitation. Isn’t that beautiful? Definitely a country that clearly cares for the welfare of its people:)

In  Finland, municipalities organise medical rehabilitation, for example in health centres and hospitals. One may be eligible for rehabilitation organised by their municipality if they have a municipality of residence in Finland. Rehabilitation organised by municipalities includes rehabilitation counselling, examinations aimed at finding the need for rehabilitation, treatment that improves work and functional capacity, rehabilitation periods, assistive device services, adaptation training and, rehabilitation guidance. (Rehabilitation, Infopankki.fi).

Rehabilitation provided by Kela can be: vocational rehabilitation (ammatillinen kuntoutus), rehabilitation for persons with severe disabilities, discretionary rehabilitation and, rehabilitation psychotherapy. In order to get rehabilitation through Kela, one needs a doctor’s statement describing that he/ she needs rehabilitation because of an illness or impairment. Rehabilitation may be directed towards such goals as maintaining and restoring the physical capacity to function, choosing a suitable education or line of occupation, helping to finish an education, staying in or returning to work life, and adjusting to life with an illness. (Kela, 2018).

Vocational rehabilitation is organised by employment pension insurance institutions (työeläkelaitos) and the Social Insurance Institution of Finland (Kela). Medical rehabilitation is organised by municipalities and Kela. If one is suffering from an occupational disease or he/ she has been injured in an accident, they may be eligible to receive rehabilitation from their insurance company (vakuutusyhtiö). Kela may provide financial support for ones psychotherapy, but he/ she must find a suitable therapist themselves. Kela’s rehabilitation is intended for those who are covered by Finnish national health insurance (sairausvakuutus). (Ministry of Social Affairs and Health, 2018).

Back at the rehabilitation ward at the central hospital, therapy was provided for mostly neurologic patients and a few geriatric patients. Majority of the neurologic patients had previously suffered from brain infraction thus leading to paralysis on either side of the body. The patients would somehow need help getting in and out of bed and onto and off their wheel chairs, as well as getting onto and off the toilet seat. Full or even partial paralysis due to stroke can last anywhere from few weeks to several months and maybe even years in some patients. The situation in other countries  however depicts a shortage of resources. According to Willems and friends, 2012,  a mismatch between existing rehabilitation resources and need, an inefficient use of those resources resulting in poor flow across the system, or both ( Willems, D., Salter, K., Meyer, M., Mcclure, A., Teasell, R., and Foley, N., 2012, 110. )

Generally, neurologic patients are people who have suffered incapacity of some of their body muscles and as such cannot perform tasks that would otherwise require their muscles. Tasks such as breathing require our body muscles, but when they fail then intensive care for such patients is required as their lives depend entirely on the breathing machines. According to Ingvild and colleagues, 2013, randomized controlled trial demonstrates that a multidisciplinary rehabilitation programme had positive overall effects on disease activity, pain, function and well-being, and should be considered an important complement to medical disease management in persons with AS ( Ingvild, aud, Cristina, Petter, Birger, and Hanne, 2013, 265.)

Most of the patients therefore that come to the ward would spend their first few weeks of rehabilitation at the hospital where they have the full attention of the physiotherapists, speech therapists, occupational therapists, nurses and doctors. After some time, the patients would be referred to their own heath care centres or other rehabilitation services where they can continue their recovery.

In conclusion, rehabilitation is such an important aspect of any society in that it enables individuals to adjust their way of lives in order to accomodate the new changes. Governments that invest in rehabilitation services of its citizens benefit a lot. The people are able to be self independent despite their limitations.

 

Reference:

Kjeken I., Bo, I., Ronningen, A., Spada, C., Mowinckel, P., Hagen, KB., and Dagfinrud, H. 2013.  A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial. Journal of Rehab Med. 45(3):260-7

Rehabilitation for Improving Functional Capacity. Ministry of Social Affairs and Health. Accessed on 16th May 2018. Retrieved from http://stm.fi/en/rehabilitation

Rehabilitation. Infopankki.fi.Accessed on 16th May 2018. Retrieved from https://www.infopankki.fi/en/living-in-finland/health/rehabilitation

What is Rehabilitation? Kela. Accessed on 16th May 2018. Retrieved from http://www.kela.fi/web/en/what-is-rehabilitation

Willems, D., Salter, K., Meyer, M., Mcclure, A., Teasell, R., and Foley, N. 2012. Determining the Need for In-Patient Rehabilitation Services Post-Stroke: Results from Eight Ontario Hospitals. Journal of Healthc Policy. 7(3): 105–118.

 

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