The Rehabilitation Process
Key Points
- Rehabilitation aims to return individuals to their prior level of function after major health events.
- Recovery speed is influenced by comorbidities, age, motivation, and available resources.
- Therapy intensity and setting (inpatient vs outpatient) are adjusted to patient needs and progress.
Pathophysiology
After acute illness or injury, functional systems often decline due to tissue injury, deconditioning, and reduced participation in daily tasks. Rehabilitation provides structured retraining to restore mobility, cognition, communication, swallowing, and self-care capacity.
Coexisting illness can slow tissue repair and reduce exercise tolerance. Aging-related physiologic reserve loss further limits recovery pace and increases complication risk.
When measurable progress stops (plateau), care focus may transition from restoration to long-term function maintenance and supportive care.
Classification
- Inpatient rehabilitation: Intensive therapy during facility-based stay.
- Outpatient rehabilitation: Scheduled therapy visits while living at home.
- Recovery modifiers: Comorbidities, age, motivation, social support, transportation, and insurance coverage.
- Restorative transition: Long-term support plan when prior baseline cannot be regained.
Nursing Assessment
NCLEX Focus
Common priorities include identifying barriers to progress and selecting interventions that preserve participation safely.
- Assess baseline function versus current status across ADLs, mobility, and communication.
- Identify barriers such as pain, fatigue, low motivation, cognitive impairment, or transport limitations.
- Monitor tolerance and response to therapy-directed activities.
- Report stagnation or decline trends that may indicate plan adjustment needs.
Nursing Interventions
- Encourage resident participation in therapy goals during routine care activities.
- Reinforce therapist techniques and prescribed assistive-device use.
- Support motivation with realistic milestones and positive feedback.
- Coordinate with family/support network to sustain recovery routines.
- Document objective functional change to guide team reassessment.
Plateau Mismanagement Risk
Continuing unchanged interventions after prolonged non-response can increase frustration, fatigue, and avoidable decline.
Pharmacology
| Drug Class | Examples | Key Nursing Considerations |
|---|---|---|
| analgesics | Post-injury pain contexts | Time activity around pain control to improve participation and movement quality. |
| antidepressants | Mood-support contexts | Mood symptoms can impair engagement; monitor participation trends and report concerns. |
Clinical Judgment Application
Clinical Scenario
A resident recovering from hospitalization has improving transfer ability but refuses therapy sessions after repeated fatigue episodes.
Recognize Cues: Functional gains present, but participation is dropping. Analyze Cues: Fatigue and motivation barriers are threatening continued recovery. Prioritize Hypotheses: Priority is preserving engagement while avoiding overexertion. Generate Solutions: Break tasks into shorter sessions, coordinate timing with rest/pain management, and reinforce meaningful goals. Take Action: Communicate barriers to therapy and nursing team, then implement adapted routine. Evaluate Outcomes: Participation improves and progress resumes without excess fatigue.
Related Concepts
- promoting-joint-mobility-and-activity - Daily activity reinforcement sustains rehabilitation gains.
- members-of-the-therapy-team - Interdisciplinary roles define rehabilitation implementation.
- assisting-with-ambulation - Ambulation training is a common functional-recovery target.
- caregiver-role-strain - Family support capacity strongly affects post-discharge rehabilitation success.
- documenting-and-reporting-data - Function-focused documentation guides progression decisions.
Self-Check
- Which factors most commonly delay rehabilitation progress?
- When should recovery planning transition toward restorative-focused care?
- How can CNAs support motivation without exceeding resident tolerance?