4. Step Three – Deliver care


The delivery of care follows good planning and selection of rehabilitation interventions.


4 steps process to providing rehabilitation care


It is important to include the following simple steps in order to ensure adherence to interventions and good results.


  • Explain – begin by explaining what the rehabilitation intervention entails, the steps involved and the correct sequence. Explain the safety precautions required and indications to seek emergency care as well (link)
  • Demonstrate – go through the steps involved for the person, videos can be used to demonstrate if it is not possible to personally demonstrate. Try to use cues or tips to enable them remember.
  • Practice - ask the person or if assistance from a caregiver is required, the caregiver to repeat what you have demonstrated. This is to confirm that what you demonstrated has been understood and the exercise can safely be practiced at home.

Ask the person to provide feedback as well. Communicate with the person about how the exercise is feeling as they are doing it and monitor throughout the session.

Ask them about the intensity of the exercise by using the modified BORG perceived rate of exertion scale – use this information to either increase or decrease intensity.  Note that the BORG scale is explained later in this module.



Question

A female with a stethoscope around the neck - sitting – standing

Remember Kofi?

Kofi has muscle weakness, is unable to walk or transfer from sitting to standing and has bladder problems. Kofi therefore has stopped going to the farm.

One of Kofi’s goals is to go through a sit-to-stand exercise motion when getting up from using the toilet every day in a week without support.

You begin by explaining what the sit-to stand exercise is and the steps involved. You use a chair in the consulting room to demonstrate to Kofi how to do the exercise. You then send Kofi home with instructions on how to perform the exercises.

Kofi however reports for review in a week and he complains of inability to perform the exercises.

Which of the following do you think is the best reason why Kofi cannot perform the exercises at home?

Select all that apply.

  •  a. You did not ask Kofi to repeat the exercises in your presence
  •  b. You did not demonstrate the exercises multiple times to Kofi
  •  c. You did not explain the details of the exercise to Kofi
  •  d. You did not give instructions to Kofi

If you chose a, you are correct.

You should have asked Kofi to repeat what you had demonstrated to him. This is to confirm that he has understood the exercise details and he can safely practice it at home.