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The German
recommendations for
post-discharge
neuro-rehabiliation:
aiming at inclusion
in all areas of society
Maren Brede...
Rehabilitation goals for brain injured persons
Source: Transferred from en.wikipedia to Commons. Author: The original uplo...
Rehabilitation goals for brain injured persons
Paris as seen
with left
homonymous
hemianopsia.
What do I want to reach aft...
Phase E in neuro-rehabilitation
Neurological-neurosurgical rehab model:
defines phases A – F in terms of medical
entry and...
Three groups of persons described
Impairment regarding functioning, activities and
participation
(see ICF):
 Non-visible ...
Services for
participation
in the
educational
sphere
Combining different services and assistance
Services securing
the res...
Framing individualised transition
What remains to be done
at the individual (case) level?
Both funders and providers
need ...
Framing individualised transition
What remains to be done
at the intra-organisational level?
 Providers to come forward w...
1665 steps …
Inclusion
+individual
participation
greater coverage,
more flexible delivery
better integration of services
f...
Thank you
for your attention!
References:
 Bundesarbeitsgemeinschaft für Rehabilitation, BAR (2013):
Empfehlungen zur Pha...
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RIWC_PARA_A074 the german recommendations for post discharge neuro-rehabilitation aiming at inclusion in all areas of society

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A074 the german recommendations for post discharge neuro-rehabilitation aiming at inclusion in all areas of society

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RIWC_PARA_A074 the german recommendations for post discharge neuro-rehabilitation aiming at inclusion in all areas of society

  1. 1. The German recommendations for post-discharge neuro-rehabiliation: aiming at inclusion in all areas of society Maren Bredehorst, MPH, PhD Bundesarbeitsgemeinschaft für Rehabilitation (BAR) e.V. German Federal Rehabilitation Council RI World Congress, 25-27 October 2016, Edinburgh Parallel Session C: The future of rehabilitation, recent advances
  2. 2. Rehabilitation goals for brain injured persons Source: Transferred from en.wikipedia to Commons. Author: The original uploader was Nunh-huh at English Wikipedia. Paris as seen with full visual fields What do I want to reach after discharge from in-patient (medical) rehabilitation? Is this a realistic goal? How can I get there?
  3. 3. Rehabilitation goals for brain injured persons Paris as seen with left homonymous hemianopsia. What do I want to reach after discharge from in-patient (medical) rehabilitation? Is this a realistic goal? How can I get there? Source: Transferred from en.wikipedia to Commons. Author: The original uploader was Nunh-huh at English Wikipedia.
  4. 4. Phase E in neuro-rehabilitation Neurological-neurosurgical rehab model: defines phases A – F in terms of medical entry and exit criteria for patients and of respective treatment requirements (VDR 1995) → issued by funders, to trigger new services (mainly in-patient facilities or day clinics) Phase E: describes the transition from medical rehab into a stable arrangement with best possible participation in society → various services from various sectors are potentially relevant!
  5. 5. Three groups of persons described Impairment regarding functioning, activities and participation (see ICF):  Non-visible deviation of functions: e.g. difficulties with speech, seeing, hearing; reduced psycho-physical or cognitive capacity; changes of personality…  Visible deviation of functions: gross motor skills, fine motor skills 1. Mild impairment→ good chance to return to work /school with specific support (primary job market) 2. Medium impairment → major efforts in occupational rehabilitation /schooling required (possibly secondary job market) 3. Considerable impairment → constantly high level of care required (possibly day care centre) Source: BAR (2013) Empfehlungen für die Phase E der neurologischen Rehabilitation
  6. 6. Services for participation in the educational sphere Combining different services and assistance Services securing the results of medical rehabilitation Services for participation in the social sphere Services for participation in the occupational sphere Information, counselling, planning, initiation, coordination Income support and supplementary assistance
  7. 7. Framing individualised transition What remains to be done at the individual (case) level? Both funders and providers need to develop their staff in terms of:  neuro-competency - information, counselling, coordination, case management - different kinds of therapies, care and other aspects of service  participatory goal setting - empowering the client - involving relatives and others (e.g. employer, colleagues) in planning and the rehabilitation process
  8. 8. Framing individualised transition What remains to be done at the intra-organisational level?  Providers to come forward with concepts and cooperations for rehabilitative services in the community/in residential care  Funders to further clarify which kind and scope of services are required and will be refunded on which legal basis
  9. 9. 1665 steps … Inclusion +individual participation greater coverage, more flexible delivery better integration of services from / within different sectors develop local / regional solutions adapt and extend available structures, involve people with acquired brain injury (& their families) in the planning processes Image: Benh LIEU SONG - https://commons.wikimedia.org/wiki/File:Tour_Eiffel_Wikimedia_Commons.jpg … or 7 lifts to get up !
  10. 10. Thank you for your attention! References:  Bundesarbeitsgemeinschaft für Rehabilitation, BAR (2013): Empfehlungen zur Phase E der neurologischen Rehabilitation. Frankfurt/M.  Bundesministerium für Arbeit und Soziales, BMAS (2015) Rehabilitation and integration of people with disabilities. Bonn.  Deutsche Vereinigung für Rehabilitation, DVfR (2014): Phase E der Neuro- Rehabiliation als Brücke zur Inklusion. Heidelberg.  Verband Deutscher Renten- versicherungsträger , VDR (1995): Phasenmodell in der neurologisch- neurochirurgischen Rehabilitation

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