Impatient Rehabilitation

In detail

Patients who have been hospitalised for acute care may require continued monitoring and are therefore unable to return home directly from the surgical or medical unit, for example after heart failure, respiratory failure, weight loss with denutrition or severe infection.

In other cases, patients may need additional help to perform everyday tasks such as washing and dressing, eating and drinking, transfers and mobility. Transitional care enables these patients to prepare for their return home and, most importantly, allows them to regain their independence and facilitates active recovery.

On admission to the clinic, a team of medical, physiotherapy, occupational therapy, psychology, nutrition and dependency specialists assess the patient’s situation. The result of this evaluation is the basis for the patient’s personalised rehabilitation programme.

Both the patient and their caregivers can benefit from patient education, aimed at restoring independence and avoiding potential hazards. This transitional period is also used to plan any human or material aids which the patient may need to ensure they return home in the best possible conditions.

In detail

Rehabilitation aims to restore as much of the patient’s previous functional capacity as possible, provide posture training and deliver preventive outcomes through physiotherapy, occupational therapy, aquatic therapy and other physical exercise, as appropriate.

On admission, patients benefit from a comprehensive, multimodal evaluation in order to rapidly identify rehabilitation goals and develop an intensive, personalised, multidisciplinary programme. This programme is reviewed each week, in consultation with the different therapists.

Organisation

After a stroke, in cases of certain chronic disabling neurodegenerative conditions (multiple sclerosis, Parkinson’s disease, myopathies) or following a neurosurgical procedure, a patient’s functional capacity can be severely diminished, resulting in significant loss of independence. Early-stage specialised treatment is essential for optimal recovery.

On admission, patients benefit from an individual evaluation by a multidisciplinary team that can include a physiotherapist, occupational therapist, sports instructor, neuropsychologist, speech therapist and dietitian. In close consultation with the patient, they develop a rehabilitative therapy programme which is reviewed and adapted to the patient’s progress on a weekly basis.

The first priority is for the patient to recover their everyday independence and return to their usual activities, both socially and professionally. This remains a focus of the programme throughout the patient’s stay.

Patients have access to state-of-the-art therapy tools such as the C-Mill and the Armeo, as prescribed for their treatment.

These programmes often require longer stays and aftercare once the patient returns home. Our team, in collaboration with the clinic’s social worker and outside structures such as nursing homes, provides the necessary support to ensure a safe return home.

Organisation

We care for patients experiencing sequelae relating to:

• Prolonged hospitalisation, hospitalisation in intensive care, or hospitalisation of a person suffering from a pre-existing pathology or age-related vulnerability
• Heart failure
• Pulmonary deconditioning from chronic or acute respiratory failure
• Major operations
• Denutrition (due to illness)
• Oncological condition or treatment (surgery, chemotherapy, radiation)
• Organ transplant
• Serious infectious disease
• Chronic inflammation
• Multimorbidity
• Failure to thrive

For patients who require dialysis, we have a partnership with the dialysis centre at Hôpital de Nyon.

Patients are monitored by specialists, with an on-call medical team and a nurse on duty 24/7. Patients benefit from physiotherapy and occupational therapy sessions, as well as a programme of physical activities adapted to their condition.

We also provide, as required:

• Intravenous treatments and transfusions
• Biological monitoring including gasometric analysis
• Oxygen therapy with respiratory physiotherapy
• Wound and eschar management with complex dressings
• Stoma management
• Nutritional advice
• Enteral and parenteral nutrition
• Patient education
• Management of difficulty with articulation or swallowing
• Psychoneurological care with cognitive stimulation
• Psychiatric and psychological care

The patient’s progress is discussed at weekly multidisciplinary meetings to plan their discharge. Patients also meet with a transition nurse to set up the necessary home support or, when required, arrange for admission to a nursing home.

Organisation

Patient care comprises all measures required to minimise functional limitations, enable optimal independence in the day-to-day environment, and where possible reduce the need for additional care and admission to a nursing home.

A multidisciplinary geriatric evaluation provides a detailed assessment of the patient’s health and functional limitations. Based on this evaluation, the clinic’s specialists – physiotherapist, occupational therapist, sports instructor, neuropsychologist, speech therapist and dietitian – compile an individual treatment programme with realistic goals. The patient’s progress is reviewed on a weekly basis.

When the patient is ready to be discharged, the team consults with the patient, their family and the relevant services to prepare their return home in the best conditions, and arrange and coordinate continued care.