99 Professionals’ perspectives of a Challenging Rehabilitation Environment Category 1: Themes Involving Rehabilitation Processes This category consists of seven main themes: (1) rehabilitant; (2) goals; (3) exercise; (4) daily schedule; (5) involving client system; (6) nutrition; and (7) technology. Theme 1.1: Rehabilitant A CRE is suitable for all diagnosis groups, although the principles of CRE must be introduced to rehabilitants and their informal caregivers to stimulate self-reliance. During the rehabilitation process, attention should be paid to potential cognitive problems, sometimes pre-existent or sometimes newly emerged. One nurse practitioner stated: Especially in CVA patients, depression is quite common and very often underestimated. ... But this has to be included, because if the mood is not right, there is a very negative impact on the rehabilitation process. As an elderly care physician said, it is important to take the rehabilitant’s resilience into consideration in their day program: But 1 time 24 minutes is not the same as 24 times 1 minute. And those 24 times 1 minute is what you want in a CRE. You can also spread patients with limited abilities over the day so that they can still continue in therapy, despite their limits. Theme 1.2: Goals In GR, it is important to work on the rehabilitant’s own goals for motivation, self-reliance and independence. Sometimes, rehabilitants need guidance from professionals or informal caregivers to describe their goals. A manager with a background as a physical therapist explained: It starts with a good talk and actually motivating the rehabilitant. Everyone is motivated for something, but maybe not for your goals. 4
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