193 Summary tative mindset and integrate exercise moments into their daily contact with rehabilitants. In addition, the team members take the learning style of the rehabilitant into account and offer information in diverse ways and at multiple times. Staff members work in accordance with current scientific knowledge on geriatrics and rehabilitation. The rehabilitation team and management also have a shared vision on rehabilitation and the challenging rehabilitation environment. 4) Environmental aspects The overall layout of the rehabilitation ward is challenging and provides safety for rehabilitants to practice independently. This can be achieved, for example, by means of a seating area in the bedroom that invites rehabilitants to get out of bed, relevant areas within walking distance, or handrails in the hallways. Treatment takes place on the ward as much as possible and rehabilitants can use the exercise facilities throughout the day. Rehabilitants have their own bedroom, but can also use a common room. This gives them the opportunity to dose their number of stimuli. This cluster further states that the food must be tasty, healthy and (protein) enriched, prepared as much as possible with readily available products. 5) Exercise and peer support Exercises in a challenging rehabilitation environment focuses on goals regarding mobility, activities of daily living, grief, cognition and communication. Rehabilitants are encouraged to work on their rehabilitation throughout the day, for example through homework exercises. Daily therapeutic activity occurs via task-oriented training. In addition, group therapy is used to achieve rehabilitation goals and to stimulate peer support. Joint meals contribute to peer support and achieving the rehabilitation goals. In a challenging rehabilitation environment, the daily rhythm of the rehabilitant is followed. This means that there is no fixed planning. Informal caregivers are welcome on the ward throughout the day, but other visitors have visiting hours. eHealth is used to make exercises more fun and challenging and can support monitoring and visualizing changes in functioning of rehabilitants. Using the conceptualization described above, a self-assessment tool for teams was developed in Chapter 6, the CREATE-tool. This tool consists of 70 statements divided over the five described clusters. A representation of the inter-
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