Rehabilitation (rehab) services are provided in many different places, including:
Acute care and rehab hospitals
Long-term care facilities
In the home by home health agencies
Inpatient rehab centers
Outpatient rehab centers
Community health settings
Industrial health centers
Veterans Affairs medical centers
Military health care centers
Here are some general questions to ask when trying to choose rehab facilities and services:
Does my insurance company have a preferred rehab provider that I must use to qualify for payment of services?
What is the cost? Will my insurance company cover all or part of the cost?
How far away is the facility? What is the family visiting policy?
What are the admission criteria?
What are the qualifications of the facility? Is the facility accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)?
Is the facility well-maintained, clean, and safe?
Has the facility handled treatment for this type of condition before?
What are the staff's credentials?
Is therapy scheduled every day? How many hours a day?
What rehab team members are available for treatment? How is the patient and family included in planning care?
What type of patient and family education and support is available?
Is there a doctor on site 24 hours a day?
How are emergencies handled?
What type of discharge planning and assistance is available?
What can be done if care is unsatisfactory?
Exercise is key. A rehab program should have supervised exercise training at least twice a week. This should include endurance training, interval training, resistance and strength training, upper and lower limbs, and walking exercise. Flexibility, inspiratory muscle training, and neuromuscular electrical stimulation can also be included.
Look for a customized approach. Rehab treatments should be customized for each person. This helps to achieve the best personal functional gains. A customized approach can be done in different types of rehab settings.
Community-based and home-based programs. If the frequency and intensity of the programs are the same, community-based and home-based rehab programs are as effective as hospital-based programs.
Programs for COPD. For people with chronic obstructive pulmonary disease (COPD), a traditional pulmonary rehab program with supervision is the most effective option. If someone with COPD is unable to go to a traditional program, then home-based exercise is an option. But it may be less effective.
Help at home for shortness of breath. Standardized home-based pulmonary rehab programs improve shortness of breath (dyspnea) in people with COPD. This is a finding from the 2020 Global Initiative for Chronic Obstructive Lung Disease (GOLD).
CARF stands for Commission on Accreditation of Rehabilitation Facilities. It is a private, not-for-profit organization that accredits rehab programs with some of the following services:
Adult day services
Behavioral health services
CARF helps to promote and assure standards of quality for these programs. It focuses on optimal outcomes for people served.