Acute Care Rehab – Benefits, Challenges, and Treatment

On some occasions, people experience health issues that are acute and should be addressed as promptly as possible. Acute care rehab programs are established specifically for this purpose. Taking part in some of these programs may prove to be very beneficial for a patient’s health and even survival. Patients may choose among different acute care treatment modalities depending on their individual preferences and needs. None of these options, however, are without challenges.1

What is Acute Care Rehabilitation? 

Acute care rehab treatments are most commonly designed to assist people suffering from urgent health issues. As such, acute care treatments are usually intensive and short-term. Some of the health issues most commonly addressed during acute care rehab include:1,2,3,4

• Heart attack
• Some types of stroke
• Chronic obstructive pulmonary disease (COPD)
• Pneumonia
• Surgery-related issues

Even though these issues most commonly arise as a consequence of old age, people suffering from alcohol or drug addiction belong to the group that also experiences some of these health problems.5

Patients may need to ask their doctors whether they would be better suited to a hospital-based treatment or some form of outpatient treatment. Regardless of which treatment modality they select, their acute care rehab program will most likely last at least three hours per day and five days a week. Patients will also likely receive a personalized treatment that will consist of physical, occupational, and speech therapy, as well as daily assessments.2

What is Sub-Acute Care?

Patients experiencing acute health issues are commonly enrolled in sub-acute care treatments. These treatments require less intensity than acute care but are much more sophisticated than conventional nursing home care. Sub-acute care usually consists of regular treatments lasting less than three hours per day. It is often practiced in the following cases, among others:6 

• Intensive wound care
• Pain management
• IV antibiotic therapy
• Dialysis
• GI tube issues
• Stroke
• Cardiac and pulmonary problems
• Eating disorders

As in acute care rehab, patients in sub-acute care facilities are provided with regular therapy depending on their needs. People who suffered from severe neural damage are introduced to speech therapy to regain as much functionality as possible. A panel of experts is commonly employed to take care of different aspects of a person’s recovery.6

While it is usually performed in acute care or rehab hospitals, sub-acute care can also take place in skilled nursing homes and recovery units attached to surgery centers. In some circumstances, sub-acute care of adequate intensity can also be accomplished in a home setting.6

What is Post-Acute Care?

Patients who survived the acute phase of an urgent condition are frequently referred to post-acute care. Facilities offering this form of care focus on helping their patients regain strength and more easily transition back to their pre-disease lives. The main goal of post-acute care treatments is to preclude patients’ hospital readmissions and long-term facility placement.7

In the majority of aspects, post-acute care is similar to acute care. It lasts around three hours per day on average and is conducted in a hospital, skilled nursing, or home setting. Post-acute care treatment also involves a panel of experts of various specialties who regularly assess the patients. Data, however, points out that inpatient post-acute care treatments tend to be much more effective than their skilled nursing and home counterparts.8

Studies have identified numerous potential benefits of post-acute care programs. The most glaring one concerns mortality: a 62-percent reduction in 1-year mortality was shown in patients who received post-acute care treatment. Furthermore, participation in post-acute care programs led to improvement in mental health, better motor function, and decreased levels of hospital readmissions in patients.7

Characteristics of the Acute Care Model of Addiction Treatment

In order to deliver the best care to patients, experts developed acute care (AC) models. In the nineteenth century, the earliest AC models for other diseases were applied to addiction treatment. Since then, most drug and alcohol addiction rehab programs have utilized the principles of AC models. These have included the following:9

• Programmatic delivery of services. Addiction treatment has consisted of a number of encapsulated activities, including patient screening, admission process, initial non-individualized treatment (known as ‘detoxification’), and aftercare treatment.
• Symptom elimination focused on single issues.
• The crucial role of professionals during each treatment phase.
• Services that are commonly delivered in a prearranged and time-limited manner.
• Philosophy of lifelong recovery. Patients are taught that recovery is achieved at the end of treatment so there is no need for further expert help.
• Intermittent treatment evaluation. The evaluation of patients takes place during time-limited examinations conducted on a short-term basis.
• Relapse and treatment readmission is perceived as a failure.

Even though these principles led to highly successful treatments, many attempts were made to improve them. Recovery management (RM) is a good example of a treatment philosophy that shifted focus to ongoing post-treatment support and quality of life of patients.9

How Does Acute Care Treatment Work?

Acute care treatment usually involves a short-term, highly structured treatment. It commonly starts with a screening process during which patients are evaluated for admission purposes. Once the patients receive the initial diagnosis, they are placed in a setting where they will be carefully monitored. A panel of experts in various specialties takes care of different aspects of patients’ problems. Which specialists will be employed depends on the patient’s health situation.10

People who suffered from severe injuries or issues such as stroke may need a combination of speech, occupational, and physical therapy. Addiction sufferers, on the other hand, will most likely need the greater involvement of experts working in the field of mental health. All types of therapies are conducted on an intensive, daily basis. Yet, regardless of patients’ issues, most acute care programs are designed to last for a relatively short time, until the patient’s situation is stabilized. People who might need longer treatment are commonly referred to long-term care facilities.2,10

Why Acute Care?

There are various reasons why acute care treatment may be recommended to certain patients. First of all, they might need urgent treatment that requires constant monitoring. Keeping patients at hand may make doctors more likely to adequately respond to acute issues that may arise. It is also important that patients are spending their time in a good atmosphere, which could best be achieved in a setting specifically designed for such a purpose. The medical specialization that characterizes acute care programs presents a crucial factor in bringing effective treatments to patients.9

Several requirements need to be satisfied in order for patients to receive quality treatment. In the first place, acute care program participants need to be given enough space so they can focus on their treatment. The proficiency of therapists involved in the treatment presents another vital component. Without exhibiting sufficient competence, doctors may not be able to build trust in patients. Besides showing knowledge, therapists need to display a sufficient level of empathy in order to connect with patients on an emotional level.11

Who Benefits from Acute Care?

Different sorts of people can benefit from acute care treatment. In the case of addiction, this applies to the majority of patients regardless of how severe their issue is. The main difference has to do with what comes after the treatment. Whereas patients with milder forms of disease might only need short-term treatment to perform well, severe addiction sufferers would almost certainly need additional treatment to reach sobriety.9

What Are the Challenges of Acute Care?

Even though it possesses many benefits, acute care rehab faces many challenges. One of the biggest issues affecting patients concerns the lack of prolonged professional support. Acute care facilities discharge most of the patients after several days, when their condition stabilizes. This approach was criticized for not offering continuous care that would prevent many of these patients from experiencing a relapse.9

Some problems have an impact on clinicians working in acute care facilities. A focus group study identified that major issues most acute care clinicians deal with include restricted living conditions, challenges associated with varying job demands, and constant uncertainty present at the workplace. These issues were found to prominently affect the quality of life of acute care workers, although such an impact was not described as unbearable.12

What Is the Alternative to AC Models of Care?

To address some of the challenges associated with acute care (AC) models of care, researchers developed alternatives. Recovery-oriented systems of care (ROSC) present one of the alternative models. This model focuses on offering continuous and long-term support for patients. In addition to formally recognized treatment institutions, ROSC promotes cooperation with various informal networks. By incorporating actors whose activities might not normally involve the provision of care, this approach widens the scope of opportunities for sustained care of different types of patients.9

The ROSC model is based on the recovery management (RM) philosophy. RM views patients as complex individuals with dynamic needs and preferences. It, therefore, encourages more significant pre-recovery engagement of both clinicians and patients, as well as continuous aftercare support for people recovering from health conditions.9

Frequently Asked Questions