The Positive Side

Spring/Summer 2004 

Better Living through Rehab

Rehabilitation can put you back in the driver’s seat

By Peter Williams

WHAT DO YOU THINK OF when you hear the word rehabilitation? For most people, the word is often associated with prison or drug and alcohol issues. Guess again. In its broadest sense, rehabilitation means optimizing a person’s choices to participate in active living through a range of services, programs and policies. Rehabilitation can be about going back to work, getting to the gym, making your own meals or increasing your ability to manage side effects and tolerate treatments. For some people, rehabilitation may simply be the key to keeping things from getting any worse.

The goals of rehabilitation include:

  • improving overall health
  • improving quality of life
  • assisting people to be their physical, mental and spiritual best — at work, home and play
  • increasing independence and self-sufficiency
  • enhancing self-esteem

Rehabilitation is most effective when it includes a holistic approach to health care, which means treating the person as a whole — mind, body and spirit. It acknowledges that HIV has more than a physical impact and that one’s spiritual, emotional, social and mental well-being must also be considered.

Secondly, rehabilitation involves an interdisciplinary approach. This means drawing on a range of people, services and expertise, such as some of the people listed in the “Who’s Who,” and perhaps also one’s family and friends. Interdisciplinary, as opposed to multidisciplinary, implies that not only are there many people working to improve your quality of life but that they’re working in a coordinated fashion, communicating with each other for the best results possible.

Finally, and most importantly, rehabilitation has a client-centred philosophy that puts the person living with HIV/AIDS (PHA) in the driver’s seat.

Unlike someone who may be long-term or permanently disabled by a car accident, many PHAs experience alternating periods of illness and wellness. This is referred to as an episodic condition. For many people HIV is an unpredictable roller-coaster ride. Even when a person’s feeling fine and their counts are stable, the knowledge that the roller-coaster might take an unexpected dive at any moment has an impact. This is a common concern among PHAs when it comes to back-to-work or other employment issues.

Private insurance companies and Canada Pension Plan can make it very risky, if not impossible, for PHAs on disability insurance to re-enter the work force or even volunteer their time in some cases. Education and policy change are needed to create more effective and flexible insurance plans, and understanding the concept and impact of an episodic condition is essential to this. In addition, episodic is a common theme for a number of other disability groups. Finding what PHAs have in common with other groups means a stronger voice when lobbying for change.

The Who’s Who of Rehab

Some of the professionals under the rehab banner include:

Physical Therapists test and measure people’s strength, range of motion, balance and coordination, posture, muscle performance, respiration and motor function. They provide services that help restore function, improve mobility, relieve pain and prevent or limit permanent physical disabilities.

Occupational Therapists help people increase their ability to perform daily tasks at home and at work. They help people improve basic motor functions and reasoning abilities and compensate for permanent loss of function.

Physiatrists are physicians who specialize in physical medicine and rehabilitation.

Speech Language Pathologists treat a wide range of speech, language and swallowing disorders.

Vocational and Rehabilitation Counsellors assist people with physical, mental or emotional disabilities to plan careers, deal with societal and personal problems relating to their disabilities, and find and keep satisfying jobs.

Recreation Therapists assist people to achieve an independent and rewarding leisure lifestyle in order to improve health and well-being.

Human Resource Professionals help determine workplace policy that supports people to stay in the workplace, negotiate benefits and insurance policies, and assist with retraining programs for people who need to work differently.

There are also many natural health practitioners whose services can be of great help, including:

Acupuncturists. This ancient Chinese treatment involves the insertion of very thin sterile needles into the body at specific points according to the meridian charts (pathways of energy). Many people use it to control such conditions as headaches, arthritis, low back pain and allergies, as well as withdrawal symptoms when stopping drugs or cigarettes.

Chiropractors. Chiropractic is a method of care in which the spine, pelvis and other articulating joints are manipulated to restore mobility, ease pain and stimulate the body’s own balancing of function.

Massage Therapists use techniques designed to promote circulation, enhance lymphatic flow and ease musculoskeletal pain. Massage can often aid in respiration, allay symptoms of abdominal cramping and nausea, and, above all, provide a relaxed sense of well-being.

Naturopaths see disease as an attempt by one’s body to rid itself of toxins and restore balance. They use products and procedures to boost the body’s natural healing powers. The patient plays an active role in staying healthy. Naturopaths use a holistic approach to healing which can include herbs, nutrition, supplementation, homeopathy and traditional Chinese medicine.

 

Much of the info in this article is based on the Module 7 Guide for the Care of Persons with HIV Disease: Rehabilitation Services.

Peter Williams is an education consultant with the Canadian Working Group on HIV and Rehabilitation (CWGHR), a national, multi-sector nonprofit that promotes innovation and excellence in rehabilitation in the context of HIV disease. CWGHR engages in research and education by bringing together health care and rehabilitation professionals, PHAs, private sector and government to promote enhanced care, treatment and support for PHAs. For more info, visit CWGHR at www.hivandrehab.ca or call 416.324.4183.

Illustration: Edward Schnurr

The Dish on Disability

When talking about rehabilitation, the word disability naturally comes up. According to the World Health Organization, disability breaks down into to several layers:

impairment: any problem in body function or structure (such as pain, weakness, decreased range of motion)

activity limitation: any difficulty in carrying out a task or action (such as difficulty walking, bathing, getting dressed)

participation restriction: any problem in involvement in life situations (such as difficulty maintaining employment, education, social life)

These concepts may help you understand the various levels or ways in which HIV can affect a person. They may also be useful when you’re seeking a referral from a doctor or filling out forms and you need to describe how HIV affects you.

 

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