Posts in this category are not easily categorised! They will cover any aspect of rehabilitation and a range of topics peripheral to rehabilitation, matters that should be discussed and considered but may not be – yet.
The Mental Capacity Act (MCA) is a well designed, useful piece of legislation that governs decision-making for people who lack the mental ability to make decisions (in England and Wales). Unfortunately it has been blown right off course by well-meaning but clinically inappropriate guidance which has rendered it unused and unusable. The principles of the …
PDOC stands for Prolonged Disorder of Consciousness; the term covers two previously defined states: the vegetative state, and the minimally conscious state. This post considers the question, “Does a person in a prolonged disorder of consciousness experience pain?” This question covers both pain caused by care or treatment, and also pain arising secondary to consequences …
Doctors make decisions, and are particularly used to making difficult decisions which involve not simply clinical facts, but family, ethical, legal and societal factors. Nevertheless, we are lucky to have an ultimate fall-back, the legal system, when decisions are ‘impossible’. In England and Wales, this is the Court of Protection which, fortunately, has some exceptionally …
One Friday 2nd July 2021 (at 05.00 hrs) I took part in a debate organised by Professor Barbara Wilson and hosted, virtually, in Melbourne, Australia. The debate concerned the use of goal attainment scaling (GAS). Two speakers supported its use clinically, in audit, and in research and two speakers opposed its use. At the outset …
The role of an Advanced Clinical Practitioner could be characterised as a role searching for a purpose. This post suggests a purpose, to meet the rehabilitation needs of people with Long Covid. They could, eventually, help increase and improve all rehabilitation services. This post reviews how the role emerged over the last 30 years or …
I have learned much about making decisions on people in a prolonged disorder of consciousness from The Honourable Justice Hayden, Vice President of the Court of Protection. This post discusses a comment made at the most recent case I attended. He referred, indirectly’ to the saying in the Hippocratic corpus: “‘The physician must… have two …
Today (May 26th 2021) I attended a Zoom-based seminar on Social Care research run by the Research Design Service (South Central) of the National Institute for Health Research (NIHR). It was excellent. I will discuss it here. Anyone who wishes to see the slides can download then from this webpage here. The talks will also …
This post concerns training in and education about empathy in the practice and delivery of rehabilitation. This blog suggests that education to increase empathy is needed, and is possible. This education is through academic study to a small degree, but is best achieved through a study of the humanities. The blog points out that education …
One December 18th 2020 the UK National Institute for Health and Clinical Excellence (NICE) published its guidance on managing the long-term effects of COVID-19. (here) On re-reading it, they are in reality suggesting that everyone should have access to “integrated, multidisciplinary rehabilitation services“. They also state (correctly) that one cannot know who has actually had …
Two incidents precipitated this blog. During discussion after a talk on an evidence-based definition of rehabilitation (e.g. as here), I was asked whether services provided by Social Services (and others) could also be considered as providing rehabilitation. My reply was that rehabilitation is a process and, as its intended outcomes relate to social participation, and …
