Rehabilitation Matters Archives - Page 3 of 4

Rehabilitation is holistic, or is it?

Rehabilitation usually promotes itself as holistic, considering the patient as a whole and being patient-centred. Using the biopsychosocial model should indeed enforce a holistic, patient-centred approach. (here) Nevertheless, there are counter-forces at play, forces that we sometimes encourage. The primary countervailing power is a desire to categorise, classify, and develop small specialise treatment programmes. For […]

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Using the MCA in health services

Derick Wade

The Mental Capacity Act (MCA) is a well-designed, helpful 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 off course by well-meaning but clinically inappropriate guidance, rendering it unused and unusable. The principles of the Act are straightforward –

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Pain in PDOC

Derick Wade

PDOC stands for Prolonged Disorder of Consciousness; the term covers two previously defined states: vegetative and minimally conscious. 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 pain arising secondary to consequences of nerve damage, such as

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Advanced Clinical Practitioners

Derick Wade

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

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Do no harm

Derick Wade

I have learned much about making decisions about 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

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Humanities in rehabilitation

Derick Wade

This post concerns training in and education about empathy, “the ability to understand and share the feelings of others” [OED]*, in the practice and delivery of rehabilitation. This blog suggests that education to increase empathy is needed and is possible. This education is best acquired by studying the humanities, “learning concerned with human culture, especially literature, history,

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Reflection on progress

Derick Wade

This post was precipitated by reading two papers and following references and links in the papers. The post draws attention to the serendipity that can occur on reading a paper, and the enormous changes that have occurred over 40 years. On a practical level, a paper on ‘gamification’ led me to social network measures, and

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Predicting benefit?

Derick Wade

Can you predict who will benefit from rehabilitation? When I was the editor of Clinical Rehabilitation, I saw a steady stream of studies that attempted to predict who would benefit from a rehabilitation intervention. One term commonly used was responder analysis, which assumes that a person who responds (to rehabilitation) can be identified and then

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Nursing home rehabilitation

Derick Wade

In March 2020 (pre-Covid lockdown), NHS England and NHS Improvement published a policy document, “Enhanced Health in Care Homes Framwork” (Version 3. 29 November 2023). This proposes that all nursing and care homes introduce expert medical and rehabilitation services, including mental health and palliative care. This post reviews the proposal, showing how it could be

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