Care Programs - Pulmonary Rehabilitation

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Why Pulmonary Rehabilitation

The goal of rehabilitation is to restore a patient to the fullest medical, physical, mental, emotional, social, and vocational potential possible.

Pulmonary rehabilitation is increasingly recognized as an important component of the comprehensive management of patients with severe symptomatic lung disease.

Most frequently, pulmonary rehabilitation becomes necessary as respiratory function deteriorates as a result of disease. With therapeutic strategies such as lung volume reduction surgery and lung transplantation now available to patients formerly deemed untreatable, pulmonary rehabilitation is considered essential as an adjunct to surgery. This is done both to optimise the condition of patients prior to surgery as well as to ensure long term maintenance of their health status post surgery.

The major objectives is to control, alleviate and, if possible, reverse the symptoms and pathophysiologic processes leading to respiratory impairment. An equally important aim is to improve the quality of the patient's life and to attempt to prolong it. This, in turn, leads to

reduced healthcare costs and burden of care.

Pulmonary Rehabilitation

Pulmonary rehabilitation is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems, for example, pulmonary rehabilitation may benefit people who have chronic obstructive pulmonary disease, sarcoidosis, idiopathic pulmonary fibrosis, or cystic fibrosis. Your doctor may recommend pulmonary rehabilitation before and after lung surgery to help you prepare for and recover from the surgery. For example, people who have surgery for lung cancer or COPD.

Benefits of Pulmonary Rehabilitation

Pulmonary rehabilitation can't cure your lung disease or completely relieve your breathing problems. However, pulmonary rehabilitation does have many benefits including:

Improve your quality of life
Help you function better in your daily life
Increase your ability to exercise
Decrease the symptoms of your disease or condition
Help you manage anxiety and depression
Assist recovery after lung surgery

Admission Criteria

The criteria for pulmonary rehabilitation admissions include the following:

Acute exacerbations in patients with chronic obstructive pulmonary disease.
Pre and post major surgery in patients with chronic obstructive pulmonary disease.
Multiple readmissions, especially ICU admissions.
Early to moderate disease stage of respiratory failure.
Patients must be over 18 years.
Medically stabilising with cardiovascular stability.
Ability and will to participate actively in the programme.

Program

The pulmonary rehabilitation programme is focused on providing time limited, patient centered, outcomes based rehabilitation that is tailored on the specific needs of each patient; thereby ensuring that all medical, physical and psychosocial needs are addressed. Therapy and other interventions by the multidisciplinary team, are structured in accordance with the needs identified in the initial assessments, which measure functioning across all functional areas. Appropriate referrals are made after discharge and resources are provided. A follow-up assessment will be arranged to ensure maintenance of improved health status.

Program Overview

The program components includes the following:

Specialised nursing care.
Initial assessment by all team members (including rehabilitation doctor).
Daily visits by rehabilitation doctor in order to address any acute condition or co-morbidities.
Individual interventions according to patient needs, including:
- Activity tolerance and energy conservation to ensure optimal function.
- Breathing and oxygen optimisation.
- Stress management, given that stress wastes energy that is already compromised.
- Good nutrition, for optimal health and energy.
- Cardiac optimisation.
- Stabilisation of the medication regimen.
- Patient and family education to ensure that questions are answered and health aspects are well understood.
- Lifestyle modification to enhance quality of life.
Strong focus on patient and family education and support.

Outcomes

Outcomes of pulmonary rehabilitation in patients show the following benefits:

An increase in exercise endurance.
An increase in exercise work capacity.
A significant reduction of dyspnoea.
Improved quality of life and productivity.
Reduced health related costs.

Multidisciplinary Team

Our multidisciplinary team consist of the following members:

Rehabilitation doctors take overall responsibility for the patient’s safety and wellbeing by specifically managing the patient’s medical problems.
Nurses provide daily support, medical care and nursing care.
Physiotherapists provide daily physical and mobility training.
Occupational therapists provide functional and energy conservation training as well as assit with ADL education.
Speech therapists provides breathing control and communication training.
Psychologists provides counselling and family support.
Social workers liaise with homes and family, they also assist with discharge planning.
Dieticians provide nutrition services.
Case managers are responsible for overall care coordination including pre-authorisation, arrangements with acute hospitals, updates to funders and discharge planning.
Patient relations officer is responsible for patient, family, clinical and funder relations coordination as well as managing family concerns.