PRM doctor’s service
According to the definition that is accepted in most of Europe, rehabilitation is a medical specialty that is responsible for the prevention, diagnosis, treatment and rehabilitation management of people with disabling medical conditions and co-morbidity across all ages.
Most rehabilitation teams are led by a PRM specialist. PRM specialist is responsible for the evaluation, monitoring and treatment of patient’s health – nervous system, cardio-respiratory system, bladder and bowel management, condition of the skin.
It is the PRM specialist who identifies the patient’s main problems, formulates a preliminary treatment plan and chooses the specialists. PRM specialists also monitor the treatment in order to plan the continuity of services.
Haapsalu Neurological Rehabilitation Centre provides physiotherapy services mainly for children and adults with neurological disorders, focussing primarily on spinal cord injuries and brain injuries.
Physiotherapy is a field of rehabilitation that is based on exercises, positioning, massage, and physical modalities (e.g. cryo-, thermo- and electrotherapy) and aims to restore, either in full or in part, the patients’ movement and functional ability in order to facilitate their integration into a normal living and working environment. Movement and functional ability can be adversely affected by injuries, diseases, ageing, environmental factors, etc.
The physiotherapy process concentrates on the patient’s movement and aims to find the best possible solutions for the patient to function in everyday life; from the point of view of both motor development and recovery. Physiotherapy is a form of co-operation between the specialist – physiotherapist – and the patient and their family/friends, in the course of which the physiotherapist identifies the patient’s problems and offers possible solutions for solving or eliminating those problems by demonstrating the right movement patterns, adapting assistive devices, recommending exercises, or implementing manual mobilization. Cryo-, thermo-, electro- and/or hydrotherapy are also used to achieve the set objectives.
Structure of the physiotherapy process:
- Physiotherapeutic assessment
- Evaluation of movement components – joint range of motion, muscle strength and endurance, muscle tone, etc.
- Evaluation of motor and mobility skills – balance, coordination, posture, transfers (including gait function), etc.
- Evaluation of operational capacity in everyday life, including the need for assistive devices
- Goal setting and action planning
- Physiotherapy where the main focus is on active exercises and functional training (learning to transfer, gait training, etc.). If necessary, manual mobilization techniques, stretching therapy methods, massage, cold applications, thermotherapy, electro- and magnetotherapy, and hydrotherapy procedures are used to complement the therapy. Finding the appropriate assistive devices that support the patient’s movement function, adapting them and teaching how to use them is also an integral part of physiotherapy. An important role in ensuring the maximal success of the physiotherapy process is played by the patient receiving the service, their motivation, willingness, cooperativeness and perseverance.
- Follow-up or final physiotherapeutic assessment
Occupational therapy is the use of specially chosen activities to influence the patient’s physical and psychological condition in order to help them achieve maximum independence in their daily activities.
Goals of occupational therapy:
There are certain circumstances that can limit an individual’s capability to care for self, work, pursue ones hobbies, play and communicate. Occupational therapy aims to prevent the loss of patient’s operational capacity and/or any of its components, improve/develop their operational capacity and restore it, regardless of the limitations imposed by the individual’s quality of life.
Objectives and outcomes of occupational therapy:
- The individual uses their capabilities in versatile and numerous ways
- The individual has achieved optimum independence
- The individual leads a full life
Occupational therapy process:
Determining the patient’s/client’s problem
Occupational therapist studies and evaluates the patient’s operational and working capacity. The occupational therapist and the patient work together to assess the influence of factors limiting operational capacity on the patient’s everyday life.
Based on the previously determined problem and the patient’s existing capabilities, the occupational therapist and the patient select the appropriate therapeutic activities that would improve the patient’s operational capacity in the best possible way.
Activities are adjusted for occupational therapy according to the patient’s personal rehabilitation and development objectives. Patients are supported in understanding and solving their problems. This is achieved through utilizing the patient’s personal development and reserves of strength. Occupational therapy is offered either in the form of individual therapy or group therapy as a part of collective activities.
Methods of occupational therapy:
Occupational therapy is the conscious and targeted utilization of an activity. Occupational therapy makes use of a wide range of activities that are analyzed and adjusted according to the goals set to restore, maintain and improve the patient’s operational capacity (e.g. pottery helps to cure hand or arm injuries and mental disorders).
By practicing daily activities (e.g. grooming, cooking, errands outside the home) the occupational therapist helps the patient to reach optimum independence in their everyday life. If necessary, the therapist also selects the suitable assistive devices and plans the appropriate adjustments to the patient’s living quarters.
Occupation therapy for children uses play to promote the child’s overall development (including motor functions, expressing their feelings, concentration).
If necessary, the occupation therapist also advises and instructs the patient’s family and caring staff, and counsels day centre/kindergarten personnel and specialists who adapt the patients’ homes.
Speech and language therapy aims to facilitate the (re)integration of people with speech disorders into everyday life. The therapy is provided for both children and adults.
The work of a speech-language pathologist includes:
- identifying speech disorders, in the course of which the individual’s oral and written language production and comprehension are analyzed, and the need for augmentative and alternative communication methods is assessed (if necessary, other specialists are also included in this process)
- conducting speech therapy sessions, where the patient is influenced and guided using psychoeducational methods aimed at eliminating, reducing or compensating for the speech disorder
- assessing speech therapy outcomes, providing advice to people with speech disorders, to their loved ones and to other specialists, determining the availability of regular speech therapy near the patient’s place of residence
The speech and language therapy at HNRC is also a part of the rehabilitation process that aims to facilitate the (re)integration of people of different ages and with various speech disorders into everyday life.
Psychological counselling aims to help the client achieve maximum independence, considering their personality, needs and environment.
Psychological counsellors first familiarize themselves with the client’s situation, analyze it together with the client, and help to determine the internal and external resources that could bring about changes in the client’s feelings.
The duration of psychological counselling depends on the nature of the client’s problem and their level of motivation, and can range from a couple of sessions to long-term co-operation.
The social counselling service aims to provide information on social rights and protection of legitimate interests and help to solve specific social problems in order to promote the client’s independence.
Nursing and caring
The Nursing and Caring Department has 102 beds, 26 of which are for children. The department occupies three floors. The rooms have 2 to 4 beds.
The Nursing and Caring Department aims to create an environment for the patient where their physical, mental and psychosocial health can be maintained or restored in the best possible way by using evidence-based nursing and caring.
The goals are achieved via professional nursing.
Nursing and caring aims not to do things for the patient, but to attend to them and provide them, and their families, with directions and instructions so that the patient can achieve autonomy and independence from others as quickly as possible.
Nurses and carers are members of the team that develops the short- and long-term goals forming the basis of a successful treatment plan according to which all following actions are taken.
We make every effort to make your hospital stay for you and your loved ones as comfortable as possible.
We wish that when coming to our hospital and when leaving it you would always feel welcome!
- Professional nursing activities
- Timely drug administration
- Timely and appropriate care
- Retaining patient’s daily regimen
- Following bladder management
- Following bowel management
- Tracking fluid balance
- Maintaining skin integrity
- Assisting patients with their activities of daily living
- Professional advice