Tailor-made rehabilitation – Planète sante
After hospitalization in acute care or following an operation, some people are not yet fit to return home. A stay in rehabilitation can be retained, “provided that the evaluation shows a potential for improvement”, specifies Dr. Emilia Frangos, chief physician of the Internal Medicine and Rehabilitation Department at the Clinique de Joli-Mont and at the Loëx Hospital in Geneva. In a minority of cases, the state of health worsens despite hospitalization. Thus, when the prospect of returning home is not possible, the whole life project must be modified. The organization of placement in an institution is then done with the help of a social worker. Several beds are reserved for people awaiting placement.
A stay in rehabilitation is planned very early in the course of care. In Geneva, depending on their problem, the person is admitted to one of the sites dedicated to rehabilitation at the University Hospitals of Geneva: the Joli-Mont Clinic (geriatrics and orthopedics), the Loëx Hospital (geriatrics, amputation), Beau-Séjour (cardiology, internal medicine and oncology) and Bellerive (internal medicine, oncology and neurology). “The objective of rehabilitation is to help the person regain their mobility and autonomy for a return home in the best possible conditions and as close as possible to their initial state”, notes Dr. Frangos.
Multidisciplinarity at the center
Doctors, nurses and multi-professional health workers unite their skills in an interdisciplinary charge in accordance with the needs of each and everyone: “It’s real teamwork. Interprofessionalism in all its splendour,” enthuses the geriatrician. In the three days following admission, an initial assessment (medical and functional) is carried out and studied during a conference bringing together doctors, nurses, physiotherapists, occupational therapists, dieticians, nurses or liaison nurses and assistants. social Relatives are consulted to find out about the person’s situation before hospitalization and to agree on final objectives in the light of the acute medical episode: can they manage on their own in their daily activities (toilet, clothing, meals)? Is she eating enough? Can she walk alone? What aids are needed? The situations are very individual, as are the objectives to be achieved at the end of such a stay, for example: walking rehabilitation, pain treatment, independent management of equipment, of a new treatment, recovery of capacities breathing and oxygen weaning, provision of auxiliary means (help for walking, shopping, cleaning), etc.
At the pace of each and everyone
There are many therapeutic interventions. To the medical care in connection with the mentioned pathologies, can be added physiotherapy sessions, occupational therapy with scenarios of daily life (toilet, dressing, etc.), nutritional advice (deficiencies , malnutrition), work with a speech therapist (swallowing disorders) or psychological support (anxiety, depression, etc.) whether or not associated with hospitalization. As with the youngest, the partnership with the elderly is strongly encouraged through several tools: in each room, a care plan, a list of stakeholders and therapeutic objectives.
The nursing staff is also at the heart of rehabilitation, notes Tamara Bürki, nurse at Joli-Mont in Geneva: “Our role is not limited to giving medication. We are very much in relationships and empathy, including with families. We move at the patient’s pace and stimulate them in the activities of daily living to help them regain their autonomy and mobility.”
Each week, the care team meets to measure, using clinical scales, the progress of their patients and reassess the objectives if necessary. The discharge is also carefully prepared, in collaboration with relatives, the attending physician and the care network (imad, etc.) for the establishment of home support structures if necessary.
MARTIAL, 78, on a rehabilitation stay at Loëx Hospital
“My doctor sent me to the emergency room for the first time because my heart was not working well and I had too much water in my body. After a stint in Joli-Mont, I was able to return home. But some time later, I couldn’t move, my left leg was paralyzed. I went back to the emergency room and was transferred to Trois-Chêne. Today, I am in rehabilitation at Loëx Hospital to resurface. I do occupational therapy, it’s great: I relearned to walk, sit down and get up without being afraid that the chair would go away. I have physiotherapy sessions every day: I ride my bike, I go up and down the stairs, I walk in the hallway. I have many problems in the head and in the body. I was able to talk to a psychologist, it did me a lot of good. If my condition improves, I will be able to go home, to help my wife and to see my daughter, a puppeteer for children.”
JEAN-PIERRE, 74, in rehabilitation at Loëx Hospital
“I had a motorcycle accident with multiple fractures. I broke my ankle, femoral neck, wrist, forearm… My knee was also abused. I was put in braces and I had seventeen stitches. From a medical point of view, I am on the right track. The current went well with the doctor who takes care of me. I do physio, ergo, I have a good follow-up in radiology. On the other hand, my brain is running at full speed and I can’t sleep. So I asked to see a shrink. We had a meeting with all the caregivers as well as the social worker and someone from the care network. I hope to get home soon so I can be there for my wife.”
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