Rehabilitation

Act as soon as you can

Posted by | Rehabilitation, Workplace Wellness | No Comments

When someone gets injured or unwell one of the most important things to do is act as soon as possible.  It’s an obvious thing do to, but for a bunch of reasons it doesn’t always happen (or doesn’t happen comprehensively) in practice.  However, when done, the health and cost-saving outcomes are significant.

The diagram below is a very simple way of illustrating the need for early intervention (no, it wasn’t done by my 5-year-old nephew; I did it on my iPad.  Plus I’m much better at drawing than he is).

Here’s a typical story that this diagram sums up:

1. Jon injures his back

2. He takes time off work.  He also stops exercising and no longer really does stuff around the house because he’s in a bit of pain.  He also stops seeing his friends as often

3. After a number of weeks there are some changes in Jon:

  • He starts developing a mild depression.  He feels alone and he doesn’t do anything with his days, so he doesn’t have the best view of himself
  • He’s fighting with his wife much more than he used to
  • He’s putting on weight and his fitness and strength are declining

4. This becomes the norm for Jon.  His life is now much different than it was:

  • He’s obese and has early type 2 diabetes
  • He and his wife have divorced
  • He’s in pain most of the time
  • He’s clinically depressed
  • He never sees his family or friends

Not good.  Not good at all.  However, this outcome is often avoidable:

An important way to increase the likelihood of a successful outcome is to intervene as early as possible.  This means instituting effective treatment for the injury, and as much as possible encouraging the individual to be active in all areas of their life – keep them in their job or at least in the workplace, ensure they are physically active, and encourage healthy levels of social interaction.

Naturally all the levels to which these are encouraged must be dictated by the individual’s impairment, so as usual it’s about individualising your approach while adhering to the fundamentals.  But odds are, if you intervene early and comprehensively, everyone involved will benefit.

A new way to reinforce rehabilitation messages

Posted by | Rehabilitation, Self management | No Comments

Michelle, a rehab nurse specialising in head injury rehabilitation, recently used BE Intent’s wellbeing software to provide support to one of her clients (Sarah) as part of her vocational return.

Sarah was about 4 months into her head injury rehab and had returned to her fulltime office role.  She was still receiving support from Michelle and the team as needed, but the main focus was on promoting independence and getting back into her work.  Sarah still had problems with fatigue and as such her pacing and scheduling skills were essential to achieve a graduated and successful increase in her work duties.

Michelle gave us her information on fatigue- and self-management and using this we created a tailored programme for Sarah in BE Intent.  This meant that, while she was at her desk, Sarah would receive reminders every hour to take a break and pace herself; at the same time, she would also receive a “nugget” of wisdom about managing her fatigue, which reinforced the messages she received during her initial care with Michelle and the team.

We sat down with Sarah for a cup of tea to talk about her experience with BE Intent as part of her return to function.  Two of the main areas in which she noticed BE Intent’s influence were:

  • Being reminded of her fatigue management skills during the day, especially in periods of increased workload – times that she needed these skills the most.
  • The feeling that she was being supported in the workplace without the need for too much practitioner input

So Sarah found the tool to be a fantastic support during her recovery.  It meant that the material and messages that Michelle and the multidisciplinary team had taught Sarah during the early stages of her rehabilitation could be reinforced while she was back at work, speeding Sarah’s return to her normal lifestyle.

That’s a great outcome for all involved and we’re really glad that we could help.  We’re looking forward to helping other clients and health professionals.

Supporting clients in their independence

  • Working with Michelle, we created a fatigue management education package using BE Intent’s software
  • Because it was using material that Michelle and her team already had, it was evidence-based and it aligned with the messages Sarah had received during earlier stages of her recovery
  • Once all set up, Sarah received regular reminders throughout the day to motivate her to employ the self management skills she’d been taught
  • As a result, Sarah found the tool a fantastic adjunct to the support she received from her health professionals

A quick note:  to protect privacy we haven’t used the client’s or the therapist’s real names.

Where wellness is needed most

Posted by | Rehabilitation | One Comment

Here at BE Intent we’re in the process of modifying our online wellbeing toolbox to support people who are managing injuries or health conditions.  So we’ve asked ourselves what we need to change to achieve this.  The answer:  Ummm….not that much really.

The fact is that the main determinants of general health and wellbeing are a large part of what is needed for rehabilitation and health condition management.  Naturally an individual will have therapies that are needed as part of their management plan, such as medication, but in most cases adherence to healthy activities such as exercise and good nutrition are central parts of their recovery.

This is true for many longer term health conditions, such as heart disease, chronic pain, diabetes, traumatic brain injury and depression; as well as applying to some acute injuries and the prevention of long term disability.

Effective habits for health and rehabilitation

Some of the most effective things we all have access to for health and rehabilitation are exercise, nutrition/eating and sleep.

Exercise. Regular exercise of sufficient intensity is a powerful tool in the prevention and management of a bunch of medical and psychological conditions – afflictions that have a bearing on recovery from other illnesses.  For example, if someone breaks their wrist their recovery is much tougher if they have diabetes and depression.  Thus, exercise can be employed during rehabilitation to address these factors that compound disability.

Moreover, regular exercise has a positive impact on many of the psychological components of illness and recovery – such as providing structure, giving a sense of achievement and challenging any illness beliefs or roles the individual may have gotten into.

Sleep. We all know what it’s like to have a few nights of poor sleep – you just don’t function as well.  In fact sleep deprivation has such an impact on our physical and mental state that it is used as a form of torture.  When we’re unwell and our body and mind is functioning at a heavily reduced level, we just aren’t in a state to recover as quickly.  So it’s important that during rehabilitation we get enough sleep.

Food. A good diet is focused on much more than making sure we don’t eat too many calories.  We need the right balance of food types and nutrients to ensure that we’re feeling mentally and physically vital and to help the body’s recovery mechanisms function effectively – which we need if we’re going to get better within a reasonable timeframe.

Focus on being well, not on being sick

Being injured or unwell doesn’t necessarily mean that we should reduce our healthy behaviours; indeed, the opposite is often true.  The focus should be on getting as healthy as possible, using the input of a health professional to ensure that the activities are safe and are modified where needed.

This focus on a healthy lifestyle needs to be delivered in the form of a structured, goal- and time-bound plan that is progressively increased.  And, as always, education is a really important part of this to help create client engagement and increase the odds of long term uptake of healthy behaviours…and ultimately improved health outcomes.

Summary

  • A focus on general wellness is extremely important during rehabilitation
  • Exercise, nutrition and sleep are 3 very important determinants of wellness and need to be factored into a comprehensive rehabilitation / illness management plan
  • The overall rehabilitation needs to be underpinned by the basics of any plan: clear objectives, time-bound courses of action, and regular review and progression
  • The input and education of the client is a key factor for success

Image: Arvind Balaraman / FreeDigitalPhotos.net

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