Rehabilitation after major trauma

Once you have recovered enough from a traumatic injury and are well enough to leave the acute hospital, staff will discuss the next steps in your recovery with you. You may need help to improve your mobility or your ability to do everyday tasks.

Rehabilitation services provide care and support to help you regain physical function after severe trauma. Rehabilitation can begin as soon as you are stable, while you are still in hospital, and the type of rehabilitation depends on your individual needs.

The aim is to increase your independence and physical function after injury, and to help you return to as much of your previous ability as possible. Where returning to doing things the way you used to is not possible, rehabilitation helps you explore new ways of doing them. It can also help you recover mentally and emotionally from the trauma you have experienced.

Planning your rehabilitation#

Your healthcare team or case manager will assess your physical health before the trauma alongside your current injuries and treatments.

Before you leave the acute hospital, they will review your situation and discuss the rehabilitation options available to you. The options may depend on factors such as:

• the type of service you need
• the availability of a bed or place at a suitable service
• any compensation, insurance or funding you may be entitled to
• whether the hospital where you were treated works with particular rehabilitation providers
• the services available to you as a public or private patient, and what you can afford to pay

Your hospital healthcare team may arrange to move you to a rehabilitation service where you can begin the next phase of your recovery. This may be part of the same hospital or a move to a new facility.

Types of rehabilitation services#

There are different public and private rehabilitation services that offer treatment by specialists. In general, these fall into two categories:

• Inpatient rehabilitation – you remain in a hospital setting but move to a specialist rehabilitation centre or ward, with the goal of maximising your independence.
• Ambulatory or community rehabilitation – this can be delivered at a centre or in your own home.

For both inpatient and ambulatory programs, patients are usually referred by a doctor.

How rehabilitation can help#

Your program will be tailored to your needs. Depending on your injury, rehabilitation may help you regain movement and strength, relearn skills or learn new ones. Support can include:

• help to increase movement, strength and endurance
• help to learn how to look after yourself with an injury or disability
• help with moving around, using aids or wheelchairs
• pain management
• help for emotional and mental health difficulties
• help to return to work, leisure and family activities
• help with home modifications, arranging home care services, or discharge to supported accommodation if required

The healthcare professionals on your rehabilitation team may include nurses, doctors, physiotherapists, occupational therapists, podiatrists, psychologists, speech pathologists, prosthetics and orthotics specialists, and pharmacists.

Depending on your injury or age, specific rehabilitation services may address:

• orthopaedic (musculoskeletal) rehabilitation
• post-amputation rehabilitation
• neurological (nervous system) rehabilitation
• cardiac (heart and lungs) rehabilitation
• hand therapy
• burns rehabilitation
• paediatric rehabilitation

Choosing a rehabilitation service#

If you are in a position to choose your rehabilitation service, it can be helpful to ask about:

• the types of activities and care you can expect
• the duration of services such as physiotherapy (for example, one hour twice a day for three weeks)
• the aims and expected outcomes (for example, return to full or partial movement, improvement in cognitive function, or learning new skills to cope with limb loss or ongoing brain injury)
• the estimated length of stay, noting that this may not be possible to predict accurately
• any costs that may be involved, such as fees for equipment
• how any dietary, language or religious needs will be managed

It can also help to take someone along, such as a family member or friend, to make sure you fully understand your options.

At the rehabilitation service#

When you arrive, the team will assess your capacity following your injuries and design a program to suit your particular needs. They will develop the program in consultation with you and your family.

Costs#

To find out what costs you may need to pay, including standard charges and out-of-pocket expenses, talk to the rehabilitation service provider. Costs vary depending on your needs and on whether you are a public patient, a private patient, or eligible for funding through an insurer, a compensation scheme or another funding source.

If you have private health insurance, contact your insurer to find out whether your cover pays for rehabilitation services. Your hospital team may do this and arrange a move to a private service for you. Be aware that some policies provide only a limited period of inpatient rehabilitation, after which you may need to continue as a public patient or pay for ongoing rehabilitation yourself, if you are able to.

If your injury resulted from a transport or workplace incident, a relevant insurer or compensation scheme may approve various rehabilitation services to help you recover and return to work. Ask which services they cover and which require a medical referral or prior approval.

Discharge from rehabilitation#

Discharge from rehabilitation services involves addressing your ongoing care needs, and is planned and coordinated in partnership with you, your carer and your family. Discharge planning begins when you are admitted to the rehabilitation service and is reviewed regularly. Any eligibility for longer-term disability support is also considered as part of this process.

Key points#

• Rehabilitation helps you transition from hospital to home and can begin as soon as you are stable.
• It can improve your mobility, strength and function, and support your mental and emotional recovery.
• Programs are tailored to your needs and developed in consultation with you and your family.
• Costs vary with your needs and whether you are a public patient, a private patient, or covered by an insurer or compensation scheme.
• Discharge planning starts on admission and addresses your ongoing care needs.