Rehabilitation Matters

This website is designed to enhance the understanding of rehabilitation and to elevate the quality of rehabilitation practices. It seeks to share valuable research and information related to rehabilitation while ensuring that all patients have access to effective rehabilitation services. It offers educational resources for everyone, equipping health and social care professionals with specialized knowledge and skills in rehabilitation. Additionally, it promotes better organization and funding for rehabilitation services. As our tagline suggests: Everything related to rehabilitation, for everyone involved in rehabilitation.

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Articles

Holistic rehabilitation thinking - 2

1 week ago | rehabilitationmatters.com | Derick Wade

My first post on rehabilitation thinking discussed the crucial role of expertise when considering three aspects of rehabilitation: the process, the professional, and the person. I finished by introducing a fourth viewpoint, holistic rehabilitation thinking. This post expands on holistic thinking.
Rehabilitation thinking - 1

1 week ago | rehabilitationmatters.com | Derick Wade

In 2002, I wrote that “… rehabilitation is a way of thinking and not a way of doing.” The editorial did not develop the rehabilitation thinking hypothesis much. I have been asked to give a talk on “What is really important in rehabilitation?”. This is a challenging title. My initial idea was to structure my reply around the process, highlighting specific aspects of diagnosis, formulation, planning, intervention, and evaluation that I considered most essential. This seemed boring.
Social participation and rehabilitation.

1 month ago | rehabilitationmatters.com | Derick Wade

Last edited: March 27, 2025 The patient had previously been active intellectually, creatively, physically, and socially; after his ischaemic brain damage a year ago, he was left requiring 24-hour care, with aphasia limiting communication. While discussing his future, his daughter mentioned the magnitude of his losses and how it would distress him.
PDOC clinical features

2 months ago | rehabilitationmatters.com | Derick Wade

Last updated: February 22, 2025 I have been assessing patients with disordered consciousness since working in neurosurgery in 1976. Initially, most patients were people who soon recovered consciousness.
Prolonged disorders of consciousness (PDOC) services

Feb 10, 2025 | rehabilitationmatters.com | Derick Wade

Last modified: February 10, 2025 On 6 February 2025, three speakers at a seminar organised by COPPA (the Court of Protection Practitioners Association) considered “Withdrawal of treatment applications in the Court of Protection for patients in PDOC”.
Knowing the patient.

Jan 12, 2025 | rehabilitationmatters.com | Derick Wade

Recently, I saw a patient in a care home to give a second opinion on rehabilitation needs, and the team gave me a detailed report on their observations. I read the 15-20 page report, which included standardised assessment and personal observations. One colossal omission struck me: no information about the patient beyond gender and age. None! Later, I met many family members; at least one family member visited daily and had done so for five months. I asked them to tell me about the person.
Being a Prolonged Disorder of Consciousness (PDOC) expert

Dec 29, 2024 | rehabilitationmatters.com | Derick Wade

I often appear as an expert witness in the UK Court of Protection, giving evidence and my opinion on the best interests of someone with a prolonged disorder of consciousness (PDOC). Generally, this is when continuing active medical treatment is considered, and their best interests are in doubt or dispute. I will discuss my role at a meeting in Manchester on 6 February 2025. I will explore and discuss my thoughts in this post, as this makes me reflect on my role.
Acquired Brain Injury rehabilitation

Nov 21, 2024 | rehabilitationmatters.com | Derick Wade

I have agreed to talk, on 6 December 2024, to medical trainees about Acquired Brain Injury rehabilitation. I decided to write a post to help me set out six principles, but as I wrote this post, I realised there was a gaping hole around the term: acquired brain injury, sometimes abbreviated to ABI. It needs to be made clear what is included or excluded. For example, multiple sclerosis is usually acquired after age 21, but it is not necessarily considered an acquired brain injury.
Recuperation, recovery, and rehabilitation.

Oct 10, 2024 | rehabilitationmatters.com | Derick Wade

Rehabilitation is associated with many R words: restoration, reablement, recuperation, reactivation, recovery, reintegration, and other variations on the theme. Is this a helpful disaggregation of the rehabilitation process, or does it confuse and obfuscate? This post explores the question. This is essential because many people draw distinctions between these and other terms, such as intermediate care, using their distinctions to select patients who may or may not receive their service.
Resolving complex clinical cases.

Oct 7, 2024 | rehabilitationmatters.com | Derick Wade

I am asked to provide second opinions when the local team has difficulty, usually when the patient and family disagree with the rehabilitation team, or there are disputes about funding more rehabilitation. I enjoy the challenge and typically find a way forward. This post is my reflection on how I approach challenging and complex cases. I rarely make an undiscovered diagnosis or know of any untried successful treatment. I have the luxury of time and an absence of any preconceptions.