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Role of Psychological Health in Post-Acute Care

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If left untreated, mental health issues can present enormous obstacles for rehabilitation patients.

Consider the situation of a typical patient on a post-acute rehabilitation unit. Prior to his or her arrival, the patient has almost always experienced a recent trauma—a stroke, heart attack, amputation, or other major medical affront.

Second, they’ve likely had surgery and/or other major significant interventions that bring physical pain, fatigue, and other challenges. Finally, they’ve had to endure a hospitalization, which disrupts their normal routine, sleep schedule, diet, and other habits that help keep people emotionally grounded.

In this context, it’s easy to see why patients arriving at a post-acute care center may struggle in the beginning. Given the circumstances, a first reaction to the challenge of rehab might be something like, “You must be joking! Just let me relax and recuperate for a few days.”

But clinicians know that every day of missed rehab decreases the chances of a successful discharge, and, fortunately, most patients find the inner strength to rise to the occasion and get to the gym.

Who doesn’t? Those patients with mental health issues, which, if untreated, can become insurmountable barriers to a successful rehabilitation and discharge back to the community.

High Stakes

The stakes are always extremely high on a post-acute care unit. First and foremost, a post-acute care stay is usually a life-altering event for the patient, as the outcome often means the difference between a return to one’s normal life in the community and admission to a long term care center. From the center’s standpoint, excellent outcomes are critical, too.

When patients achieve a successful outcome, they return to the community, essentially serving as positive emissaries for the treating center. Conversely, the friends and family members of a patient who does not do well may share negative perceptions of the center in their communities.

Referral sources such as hospitals and insurance companies also closely scrutinize centers’ post-acute rehab outcomes and incorporate these data into their decision making about where to steer their referrals. These entities look at the percentage of successful discharges back to the community, length of stay, and the number of post-acute patients that require rehospitalization. A center’s success in meeting these benchmarks determines its ability to survive in the ever-changing health care landscape.

Identifying Psychological Issues

One of the best ways for centers to improve their post-acute outcomes is to aggressively identify and treat the psychological issues that might otherwise serve as barriers to patients putting forth their best efforts in the gym. As a side effect of this approach, physical and occupational therapists will have more time to spend in the gym—relieved of the need to address the nonphysical issues that interfere with patients’ participation in treatment. Invariably, these professionals will appreciate the lowered prevalence of noncompliant patients so they can focus on their primary responsibilities.

Unfortunately, most post-acute care centers lack a proactive approach to mental health issues, especially on the rehab unit. It’s not uncommon for centers to wait much too long to bring behavioral health services into play, often not until the patient is already failing in rehab and it’s too late to help them achieve a successful outcome and discharge.


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Source: Provider Magazine