The Rehabilitation Journey- part 3
After weathering the acute and sub acute phases our hero arrives at the final stages of their rehabilitation journey. Similar to mountaineering the last ascent before the summit is often times the most challenging. The adjustments that need to be made when transitioning from hospital to community living can be particularly tough if the individual has become institutionalised, a very common occurrence as some individuals can spend up to a year in hospital rehabilitating from a severe trauma and/or brain injury.
It’s easy for such individuals to become accustomed to the 24 hour care and supervision that’s inherent of a hospital environment. The contrast between hospital and community living is stark as most individuals will receive little to no care supports upon discharge. Often a greater dependence on family members is required, which unfortunately can contribute an added stressor to the family unit. Other individuals, that don’t have a supportive network, will need to be completely independent in all aspects of life in order to thrive in the community.
In addition to the prerequisite independence with functional tasks individuals also need to be good managers of their time, because for the first time in a long time they are once again the directors of their own day to day agendas. There are no more timetables, routine observations or preordained meal times. Rather than waiting for the day’s events to unfold individuals must be proactive in order to get things done. It’s very easy to slip into a sedentary lifestyle upon returning to a life in the community especially when individuals are out of work or unfit to work in their current circumstance, hence why time management is of the essence.
The amount of therapy input is also dramatically reduced once the individual leaves the nest of inpatient rehab. Consequently the intensity of rehab becomes muted and so is the individual’s rate of progress. It should be expected that any functional gains at this stage will come very slowly, and the onus is now on the individual to drive their own advancement as supervised therapy sessions are few and far between. Independent practice is more important than ever if individuals wish to make further progress, and in the same vein they must find their own way to stay motivated to ensure they stay their course.
Although the path is thwart by challenges the endgame is clear. Individuals have already overcome the uncertainties at the start of their rehabilitation journey and have accomplished their main goal of returning home. The air of this final phase is described by the 7 Stages of Grief as “Acceptance and Hope”, which involves a very gradual acceptance of the new way of life and a feeling of possibility in the future. Despite reaching this tail-end of the rehabilitation process our hero’s journey proceeds with no end as they continue to grow in the company of their underlying health condition. As the popular Tony Robbins’ saying goes: “if you are not growing, you are dying.”
