Rehabilitation

Services
in the
COMMUNITY HEALTH CARE
Community
Michael M. Manio, MD, MHPEd, PhD
HKMU LiPACE Health Care
Email: mmmanio@hkmu.edu.hk
Dr. Mike
BS Biology
Doctor of Medicine
MHPED in Health Professions Education
PhD in Medicine, HKU
LEARNING IS
FUN!

University Lecturer

Researcher

Health Advisor
 Our Talk
Today

Topics We'll Cover

Goals and principles of
rehabilitation
Roles and functions of allied
health services in
rehabilitation
Holistic rehabilitation plan
Rehabilitation programmes
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Rehabilitation
What is it and Why people need it?

a set of interventions designed to

optimize functioning and reduce
disability in individuals with health
conditions in interaction with their
environment
Community Health Care

NOITATILIBAHER
the process of returning to a healthy or good
way of life, or the process of helping someone

to do this after they have been in prison, been

very ill, etc.
Community Health Care

NOITATILIBAHER

is an essential part of universal health coverage

along with promotion of good health,
prevention of disease, treatment and palliative
care
Community Health Care

NOITATILIBAHER
helps a child, adult or older person to be as
independent as possible in everyday activities

in education, work,
and enables participation
recreation and meaningful life roles such as
taking care of family.

Community Health Care

NOITATILIBAHER
Globally, an estimated 2.4 billion people are
currently living with a
health condition that
benefits from rehabilitation

Community Health Care

NOITATILIBAHER

The need for rehabilitation worldwide is

predicted:
to increase due to changes in the health and
characteristics of the population. For example, people
are living longer, but with more chronic disease and
disability.

Community Health Care

NOITATILIBAHER
Largely unmet
In some low- and middle-income countries, more than
50% of people do not receive the rehabilitation services

they require. The existing rehabilitation services in 60-

70% of countries have been disrupted due to the COVID-
19 pandemic.

Rehabilitation
Main goal
People with disabilities would want to
lead as normal a life as possible and to
contribute to society as much as they can.
Rehabilitation
Services
Objective aim to acknowledge the equal rights of
people with disabilities
Rehabilitation
Services
Objective to be full members of the community by
assisting them in developing their physical,
mental and social capabilities to the fullest
possible extent
Rehabilitation
Main goal
by promoting their integration into the
community.
Exercises to improve a
person’s speech, language
and communication after a
brain injury

EXAMPLES OF
REHABILITATION
Modifying an older
person’s home
environment to improve
their safety and
independence at home
and to reduce their risk of
falls.
Exercise training and
education on healthy
living for a person with a
heart disease.

EXAMPLES OF
REHABILITATION

Making, fitting and

educating an individual to
use a prosthesis after a leg
amputation
Positioning and splinting
techniques to assist with
skin healing, reduce
swelling, and to regain
movement after burn
surgery
EXAMPLES OF
REHABILITATION

Prescribing medicine to
reduce muscle stiffness for
a child with cerebral palsy.
Psychological support for
a person with depression.

EXAMPLES OF
REHABILITATION

Training in the use of a

white cane, for a person
with vision loss
Inpatient or outpatient
hospital settings

HIGHLY
Private clinics
PERSON-
CENTERED

Community settings such as

an individual’s home
 physiotherapists
occupational therapists
speech and language
therapists and
audiologists
orthotists and prosthetists
clinical psychologists
physical medicine and
rehabilitation doctors
rehabilitation nurses
Nutritionist/Dietitian
Did you
know?
HEALTH
WORKERS
 REDUCE THE IMPACT OF A BROAD
RANGE OF HEALTH CONDITIONS

noitatilibaheR diseases (acute or chronic), illnesses or injuries.

fo stifeneB
helping to achieve the best outcome possible
can help manage or prevent complications
associated with many health conditions, such as
spinal cord injury, stroke, or a fracture.
 MINIMIZE OR SLOW DOWN THE
DISABLING EFFECTS OF CHRONIC

noitatilibaheR HEALTH CONDITIONS

fo stifeneB
cardiovascular disease, cancer and diabetes by
equipping people with self-management
strategies and the assistive products they
require, or by addressing pain or other
complications
 AN IMPORTANT PART OF UNIVERSAL HEALTH COVERAGE

noitatilibaheR Ensure healthy lives and promote well-being for all at all ages.
fo stifeneB


Misconceptions
about
rehabilitation

is not only for

people with
long-term or
physical
impairments

a core health service

for anyone with an
acute or chronic
health condition,
impairment or injury
and available for
anyone who needs it.

not a luxury health

service that is available
only for those who can
afford it.

 Roles and
Functions of
Allied Health
Services
Allied Health Professions
provide system-wide care to assess, treat,
diagnose and discharge patients across social
care, housing, education, and independent and
voluntary sectors
1. Art Therapists
CREATIVE
use art as a form of psychotherapy to EXPRESSION
encourage clients to explore a variety of issues
including emotional, behavioural or mental
health problems, learning or physical
disabilities, life-limiting conditions, neurological
conditions or physical illnesses
2. Dramatherapists
therapy to use performance arts as a medium EXPLORING
for psychological therapy ISSUES

autism and dementia to physical/sexual abuse

and mental illness in an indirect way leading to
psychological, emotional and social changes

3. Music
therapists
engage clients in live musical
interaction so as to promote an
individual’s emotional wellbeing and
improve their communication skills MUSIC
develop and facilitate communication
skills, improve self-confidence and
independence, enhance self-
awareness and awareness of others,
and improve concentration and
attention skills.

4. Chiropodists/
podiatrists
provide essential assessment,
evaluation and foot care
Many of these fall into high risk
categories such as patients with FOOT CARE
diabetes, cerebral palsy, peripheral
arterial disease and peripheral nerve
damage where podiatric care is of
vital importance

5. Dietitians

qualified health professionals who

assess, diagnose and treat diet and
nutritional problems at an individual
and wider public health level HEALTHY
MEAL

6. Occupational
therapists
OTs support people with a range of
interventions to enable them to
return to or optimise participation in
all the things that people do; for
example, caring for themselves and SUPPORT

others, working, learning, playing and

interacting with others.

7. Operating Department
Practitioners

are highly skilled healthcare

practitioners that support patients of
all ages during each phase of the
patient’s perioperative care

TEAM

8. Osteopaths

Their work is centered on the

principle that the skeleton, muscles,
ligaments and connective tissues of
an individual need to function
smoothly together so as to maintain WELLBEING

wellbeing

9. Prosthetists and
Orthotists

Prosthetists are autonomous

registered practitioners who provide
gait analysis and engineering
solutions to patients with limb loss

ARTIFICIAL

Orthotists are autonomous registered

practitioners who provide gait analysis
and engineering solutions to patients
with problems of the neuro, muscular
and skeletal systems

10. Paramedics

are responsible for assessing the

patient’s condition and then giving
essential treatment. They use high-tech
equipment such as defibrillators, spinal
and traction splints and intravenous OT

drips, as well as administering oxygen

and drugs.

11. Physiotherapists

address problems of impairment,

activity and participation and manage
recovering, stable and deteriorating
conditions

RECOVERING

neuro-muscular, musculo-skeletal,
cardio-vascular and respiratory
systems – through advice, treatment,
rehabilitation, health promotion and
supporting behavioural change.

12. Speech and language

therapists

children and adults to help them

overcome or adapt to a vast array of
disorders of speech, language,
communication and swallowing.

OVERCOME

13. Radiographers
Diagnostic radiographers use a range
of techniques to produce high quality
images to diagnose an injury or
disease.

Therapeutic radiographers play a vital

IMAGING
role in the treatment of cancer. They
are also responsible as they are the
only health professionals qualified to
plan and deliver radiotherapy.
Radiotherapy is used either on its own
or in combination with surgery and/or
chemotherapy.

In Summary

Goals and Principles of

rehabilitation
Roles and functions of allied
health services in rehabilitation
REHABILITATION

 OBJECTIVE
aim at assisting persons with

Rehabilitation disabilities to become full members

of the community by developing their
Services physical, mental and social
capabilities to the fullest possible
extent and by promoting their
integration into the community.
WHO

 SWD, through subvention to NGOs,

SERVICE provides a full range of social

PROVISION
rehabilitation services for persons with
disabilities.

AND At the end of March 2020, there were

14 845 pre-school places, 19 162 day

STATISTICS places and 14 372 residential places

with relevant breakdown of service
places
 Holistic approach means thinking about the big picture. ... In a
rehabilitation medical setting, holistic refers to addressing the whole
plan person, including their physical, mental, and emotional
health, while taking social factors into consideration
NEW PROVISIONS
ON-SITE PRE-SCHOOL
OF FACILITIES AND REHABILITATION SERVICES
INITIATIVES

providing rehabilitation training for children

studying in about 850
kindergartens/kindergarten-cum-child care
centres
NEW PROVISIONS SPECIAL CHILD CARE CENTRES

OF FACILITIES AND AND RESIDENTIAL SPECIAL

CHILD CARE CENTRES
INITIATIVES

To further strengthen support for pre-

school children with special needs and their
parents.
Strengthened care and nursing support for
children with severe disabilities receiving
day and residential care services.
NEW PROVISIONS
PARENTS/RELATIVES RESOURCE
OF FACILITIES AND CENTRES
INITIATIVES
Parents/Relatives Resource Centres (PRCs)
enable parents, relatives and carers in need
to attain mutual support, learn more about
their family members with disabilities.

To strengthen the support for persons of

ethnic minorities with disabilities and their
parents/relatives.
NEW PROVISIONS
DISTRICT SUPPORT CENTRES FOR
OF FACILITIES AND PERSONS WITH DISABILITIES
INITIATIVES

A district-based approach, provide one-stop

community support services for persons
with disabilities and their family
members/carers..
NEW PROVISIONS
INTEGRATED COMMUNITY CENTRES
OF FACILITIES AND FOR MENTAL WELLNESS
INITIATIVES

Early prevention to risk management for ex-

mentally ill persons, persons with
suspected mental health problems, their
families/carers and residents living in the
serving district
NEW PROVISIONS
MOBILE VAN FOR PUBLICITY
OF FACILITIES AND SERVICE ON MENTAL WELLNESS
INITIATIVES

To raising public awareness on their mental

wellness, developing positive help-seeking
attitude/behavior towards mental illness and
providing early prevention, identification and
intervention.
NEW PROVISIONS
SUPPORT CENTRES FOR PERSONS
OF FACILITIES AND WITH AUTISM
INITIATIVES

To strengthen support for young persons

with high functioning autism and their
parents/carers, and provide professional
support services to service units serving
autism cases.
NEW PROVISIONS PILOT SCHEME ON PROFESSIONAL
OF FACILITIES AND OUTREACHING TEAMS FOR PRIVATE
RESIDENTIAL CARE HOMES FOR
INITIATIVES PERSONS WITH DISABILITIES

The teams also provide consultation, training

and support for the residents’ family members
and staff of the private RCHDs
To improve the care and support provided for
the residents, and promote their participation
in community networking activities with a
view to achieving social inclusion.
 HOME CARE SERVICE FOR PERSONS
NEW PROVISIONS WITH SEVERE DISABILITIES AND
OF FACILITIES AND INTEGRATED SUPPORT SERVICE FOR
PERSONS WITH SEVERE PHYSICAL
INITIATIVES DISABILITIES

Personal care, nursing care, rehabilitation

training, etc.) and carer support.
ISS also provides special subsidies for
eligible persons with severe physical
disabilities in need of constant attention
and care for purchasing medical equipment
and medical consumables.
 “VACANCY ENQUIRY SYSTEM FOR
NEW PROVISIONS RESIDENTIAL RESPITE SERVICE FOR
PERSONS WITH DISABILITIES,
OF FACILITIES AND RESIDENTIAL RESPITE SERVICE FOR
INITIATIVES THE ELDERLY AND EMERGENCY
PLACEMENT FOR THE ELDERLY”

It provides a dedicated search function for

the public to search for vacancies that suit
their needs through such filtering criteria as
gender, age range, type of disability/care
level of the applicant, type of residential
care homes and location preference
REHABILITATIONS
PROGRAMMES & 1. Pre-school Rehabilitation Services
2. Services for School Age Disabled
SERVICES Children
3. Services for Physically Handicapped
Persons
4. Services for Mentally Handicapped
Persons
5. Services for Ex-Mentally Ill Persons
6. Services for Visually Impaired Persons
7. Services for Hearing Impaired Persons
8. Vocational Rehabilitation Services
REHABILITATIONS
PROGRAMMES & 9. Employment/ Business Opportunities
SERVICES and Social Enterprise
10. Day Training Services
11. Residential Care Services
12. Community Support Services / Self-
help Organisations of People with
Disabilities / Chronic Illness
13. IT for Persons with Disabilities
14. Funds for Specific Groups
15. Special Needs Trust
How can I apply for rehabilitation services if my family
member or I am in need?

If you want to apply for community support services, you can directly
approach the service unit for service. If you or your family member wants
to receive day training or residential services, you can approach your
school social worker, medical social worker, family caseworker or staff of
respective rehabilitation unit to make the application vide our Central
Referral System for Rehabilitation Services.
 My elderly mother will be discharged from hospital
soon. She is so frail that she can no longer take care of
herself. What can we do?

Patient or her family members can approach the Medical Social Services
Unit of the hospital the patient is attending. Medical Social Workers
would assess the needs of the patient and introduce or refer appropriate
social support services e.g. home help service, elderly day care centre, for
her.