Whoever told you Rehab nursing isn't a specialty obviously wasn't a rehab nurse!
Rehab is a MULTIDISCIPLINARY team approach to restoring maximal function and independence to people with loss of function due to illness or injury. It's about what the patient CAN do, not what they can't. It starts with discharge planning and everything is geared to meeting the functional goals necessary to achieve the discharge plan.
Much of rehab nursing is done with your hands in your pockets. You spend 30 minutes cueing someone how to put his shirt on, rather than 1 minute doing it for him. In between cues, you encourage him for his efforts and try to help him through his frustration. This approach is taken with ADLs, mobility, toileting, med management, cooking, cleaning, financial management, etc. Every aspect of life is addressed; if it isn't independence isn't realistic, another way must be found and implemented.
Acute rehab requires a minimum of 3 hours of therapy daily, and the patients are seen by a physician specializing in physical medicine and rehabilitation daily. These units have stoves, washing machines, cars (to practice transfers), etc. One I know of even has a putting green! Usually the patients with long term deficits, like strokes, cord injuries, etc. receive counseling for adjustment to their disability as part of their program.
Nursing homes provide a variety of services to residents, from care of the advanced Alzheimers patient, to those who have minimal needs for supervision and/or assistance with ADLs. Many are not confused and are quite independent! There are games, trips, entertainment; the key is that these people are "residents", not "patients", and the goal is to make it as "home-like" as possible. Nursing homes do offer therapy, but it's not as intensive as acute rehab.
Some nursing homes have "short-stay" or subacute units that are geared to people who are planning discharge home or to a less restrictive environment. These units are similar to acute rehab in philosophy, but are not as intense in their therapy requirements, the patients are not seen by physicians daily, and usually don't have the resources for counseling by specialists in disability adjustment.
Sorry this is so long, but I hope it helps.
[This message has been edited by mn nurse (edited December 07, 1999).]