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Rehabilitation Potential and How It Is Determined

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

September 30, 2019

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Question

What is rehabilitation potential and how is it determined?  

Answer

Rehabilitation potential is a projection about the future status of a patient based on present observable behaviors often called positive prognostic indicators. The rehabilitation potential is determined upon completion of the initial evaluation and updated and/or revised as needed as treatment progresses.  It is determined using objective diagnostic procedures, clinical observation of the patient and standardized tests. A prognosis is a prediction about the future status of a resident based upon current observable behaviors.  Prognostic statements and rehab potential together support the clinical judgment that the rehabilitation program is appropriate and will be successful if implemented. The diagnosis or prognosis is never the sole factor in deciding that a service is or is not skilled.  Positive prognostic behaviors are signs of good rehabilitation potential.  The following are examples of clinical indicators usually considered to be positive prognostic signs when they are intact:  Stimulability, orientation, ability to follow directions, attention span, self-expression (thoughts, feelings, needs), ability to solve problems, ability to imitate, medical stability, motivation to walk, talk, and achieve self-help skills, recent history of independence with functional skills/High PLOF, ability to self-monitor and/or self-correct, supportive family/caregivers, learning potential, recent onset, eye contact, awareness, initiation level, previous response to intervention, and responsive to cues/strategies. 

Negative prognostic rehabilitation behaviors may indicate poor rehabilitation potential. These signs may include the presence of intractable pain, poor orientation, inability to concentrate under maximum structure, extreme depression/uncooperativeness, medical instability, lack of ability to initiate activity, lack of self-control (impulsivity), absent or inadequate arousal, lack of ability to demonstrate mobility and/or self-care activities, and limited family/caregiver support. 

Record conditions that may affect medical status or success of therapy such as: 

  • Weight-bearing status
  • Use of oxygen
  • Pulse Oximetry parameters
  • Aspiration precautions
  • Total hip precautions
  • Statement of specific cardiac precautions from a physician

 

  

 

 

 

 

 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS

In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA. 


Related Courses

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4096Level: Intermediate2 Hours
  'Excellent research backed information'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Supervising Assistants, Students, and Aides: Upholding Your Ethics in a Challenging Health Care Environment
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4377Level: Intermediate2 Hours
  'Very informative'   Read Reviews
This presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA

Dementia Management: Techniques for Staging and Intervention
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3649Level: Intermediate2 Hours
  'We’ll layer out'   Read Reviews
This seminar provides an overview of types of dementia including characteristics at each stage, protocols for staging clients with dementia and related treatment strategies. Documentation and treatment planning based on dementia staging results is reviewed. Behavior management and communication strategies for this population are discussed as well as techniques for nursing to follow. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Bullying Among Older Adults: Not Just a Playground Problem
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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Course: #4692Level: Introductory1 Hour
  'Extremely relevant topic, taught in such a real way, easily able to connect to speaker and engage, understand information spoken about'   Read Reviews
In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.

Ethics: A Clinical Perspective for Therapists
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

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Course: #4693Level: Intermediate3 Hours
  'One of the best ethics courses I’ve taken- very clear & interesting to listen to'   Read Reviews
This seminar provides practical information about ethics from a clinical perspective. Basic principles of ethics as they relate to healthcare and physical therapy are reviewed. Behaviors that are considered unethical by most credentialing bodies are considered, as well as health care/therapy codes of ethics. The CELIBATE and RIPS methods for analyzing ethical dilemmas are reviewed with case studies to demonstrate use.

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