1. GEM, rehab and Transition care. Is time the real healer Dr Craig Whitehead

2. What are we talking about Rehabilitation is the most abused word in the medical lexicon Rehabilitation is the most abused word in the medical lexicon Patients want rehab even if it probably wont work Patients want rehab even if it probably wont work Acute care often use rehab as a discharge option primarily rather than a therapeutic tool Acute care often use rehab as a discharge option primarily rather than a therapeutic tool Rehab is assisted recovery expending two resources therapy and time Rehab is assisted recovery expending two resources therapy and time

3. Assisted recovery: Who gets in Patients who should have just gone home Patients who should have just gone home Patients who have no need for physical therapy but need time to adjust psychologically to going home or into care Patients who have no need for physical therapy but need time to adjust psychologically to going home or into care Patients who will predictably get better with a given dose of therapy in a given time. Less therapy more time Patients who will predictably get better with a given dose of therapy in a given time. Less therapy more time

4. Assisted Recovery: Who gets in Is there a role for low dose therapy over a longer time. “ Slow Stream Rehab”. A popular but unproven idea Is there a role for low dose therapy over a longer time. “ Slow Stream Rehab”. A popular but unproven idea Some patients need a minimum type and dose of therapy regardless of time Some patients need a minimum type and dose of therapy regardless of time Where recovery is not certain and a dose of therapy is needed to see if recovery is likely Where recovery is not certain and a dose of therapy is needed to see if recovery is likely Complex assessment without attention to improving function. “Evaluation” Complex assessment without attention to improving function. “Evaluation”

5. Time and recovery Interaction between duration in a program and therapy given Interaction between duration in a program and therapy given Separating the two is difficult Separating the two is difficult Time in a program is rarely sufficient to allow the patient’s goals being met Time in a program is rarely sufficient to allow the patient’s goals being met Referral to a program often fails to consider the dose and type of therapy a patient requires Referral to a program often fails to consider the dose and type of therapy a patient requires