Long term care vs rehab

~magnolia~ · Sep 30, 2020

I've worked in a long term care home that had a floor dedicated to rehab. This floor was in collaboration with the hospital and the goals and patient care plan differ; patients in rehab were short term about 6 months, vs long term care where more permanent. the goal in rehab is lots of physical activity so that they can be as independent as possible and be discharged. Some patients don't want to do the work, and so they are not as keen. You also have to consider that some of them prefer to have everything done for them ie cooked meals and cleaning services, This is just the reality of life and I'm not one to judge. In rehab, your patients are more alert, and in long-term care, they tend to be in their own reality aka dementia. Anyways hopes this helps and hope that a nurse with more rehab experience comments

amoLucia · Oct 1, 2020

I see this is an older post just visited - OP may have made her job decision.

Rehab can be considered as a half-way step between hospitalization and home for pts. It is temporary as determined by pt progress and insurance coverage for time & costs. Nobody stay in rehab forever. Pts are EXPECTED to go somewhere AFTER rehab.

Therapy is truly the fundamental foundation of rehab. True rehab units are very busy. Pts are in therapy/gym (sometimes at bedside) 1 or 2 or 3 times/day, wkends also, for extensive exercises needed for gen'l physical strengthening & ADL adapting. Social service usually is aggressively pursuing discharge plans early as family involvement is most likely to be necessary for safe home discharge.

As PP comments, rehab pts may tend to be younger - so they have greater determination and initiative to improve to go home and return back to careers and prior lifestyles. Many older pts may not have the same motivation or enthusiasm or even the physical ability to do as much. Some of this may also be connected to depression resulting from reality setting in.

Staff SHOULD be focused on helping pts to do as much for themselves as poss, rather than staff doing just because it's faster for staff. This is a BIG issue in improving independent ADL skills for pts.

One concern is that those rehab/LTC facilities are staffed by NH guidelines. Lots of CNAs, few nurses - just like in the NHs and stretched to the max (or should I say, minimum) ratios.

I speak from personal experience as an in-pt.

OP - if you read this, what did you do?