Many older adults and seniors may seek a skilled nursing facility for a short-term rehabilitation stay. The main goals are usually to provide physical, occupational, or speech therapy after a surgery, accident or stroke. Individuals may be dealing with pain related to fractures, post-surgical conditions, spinal cord injury, or head injury. While these therapies are necessary, the individual will experience a variety of other emotional needs that should not be ignored. Healthcare professionals need to be aware of these needs and be prepared to effectively help.
Reactions to Disability and Loss
Receiving short- and sometimes, long-term treatment may bring about certain losses to the individual that carry significant emotional reactions. Very basic things like activities of daily living (ADLs) or independent activities of daily living IADLs) may become impaired leaving the person feeling helpless. Social roles (e.g. being a grandfather or a career person) may be lost for a while and leave the person feeling depressed. There may be other worries associated with a rehab stay including financial security, future living arrangements, and social support.
Common Reactions to Rebab Conditions
Changes in one’s physical abilities and the pain associated with rehab can bring on a variety of emotional reactions. It is not uncommon for people to experience anxiety and depression. Some will express anger about their condition while others may withdraw.
Depending on the individual’s personality, one may experience decreased self-esteem, stress, fear of more loss, post-traumatic stress disorder, and distorted body image. Some reactions may be biological including disruption in sleep and appetite. It is not uncommon to fear pain and becoming addicted to opioids.
Other reactions include:
- Fear of becoming dependent
- Feelings of vulnerability
- Guilt
- Fear of further loss
- Retaliation
- Aggression and agitation
- Fear of losing relationships
What Do People Want During and After Rehab?
Most people want life to go back to the way it was before the accident took place or surgery was required for their condition. While some will be able to return to their normal lives, others will live with alterations in their lifestyle due to certain losses. Some people will want to go back to work, resume their busy lifestyle, and be with their grandkids and family. Others will seek functional autonomy.
Perhaps more than anything, people want their immediate needs met while they are in rehab. There will be moments of frustration, sadness, pain, and fear. Healthcare professionals must be aware of these needs in order to intervene. People in rehab want high quality care and attention. They want quality of life in rehab and after it. They want to be mobile again.
What Can Healthcare Professionals Do?
Beyond providing the necessary therapies (physical, occupational and speech), the interdisciplinary team should become sensitive to the many emotional and social needs of their patients. They should look for signs and symptoms of depression, anxiety, anger, fear or denial. Once they see them, they should provide reassurance, support and kindness.
Providing emotional support requires open and honest communications. Some conversations may be difficult for both the patient as well as the caregiver. The environment should be kept as positive as possible and any obstacles to achieving good outcomes (e.g. refusing therapy) should be addressed and handled appropriately.
Final Thoughts on the Emotional Needs of the Rehab Patient
The healthcare professional should be educated on rehab conditions and reactions that are commonly associated with them. They should be ready to take on difficult and emotional conversations with their patients, while remaining supporting and positive. Keeping a close eye on the needs of the moment can make the rehab stay a more pleasant experience and create better health outcomes for their patients.
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