Harriet Radermacher

Neurological rehabilitation in the community.

There is increasing pressure on health services around the world to provide more resources and facilities in the community. This is partly as a counterbalance to the increasing cost of hospital services and partly a recognition of the importance of local health facilities. Rehabilitation has generally been a hospital-based specialty and there now needs to be a change of focus, or at least an additional focus, towards community rehabilitation. This review article summarizes some of the models of community rehabilitation and the evidence for their effectiveness. Although there is a reasonable body of evidence for both the acceptability and effectiveness of community rehabilitation there is a clear need for further research.

Community Rehabilitation in Neurology: Models of disability

Introduction In the context of community rehabilitation it is particularly important to define the underlying philosophy of service delivery. The predominant model underlying most healthcare provision across the world is the so-called ‘medical model’. However, in recent years disabled people themselves and their lobbyists have been promoting an alternative view of disability – the ‘social model’. This chapter will describe the principles of each model to ensure that the reader can take on board the purpose and implications of the different approaches to disability. However, it is important to emphasize that these two models of disability are not entirely incompatible. A comprehensive health service probably needs to draw on some aspects of both models so that health professionals and disabled people can work together to ensure that high-quality rehabilitation is delivered to all those that need it in an equitable and participative fashion. The purpose of models Models attempt to provide a framework through which the understanding of a concept can be easily grasped. The challenge is to make sense of often complex and multifaceted concepts in simple ways. Creating models offer ways in which to make sense of the world. Ultimately, however, they are artificial constructions of ideas that are not created so as to fit neatly into rigid frameworks. Thus, probably there are no models that adequately reflect the entirety of a concept. Different models propose explanations for the same concept in different ways, but really they may only represent different components of the same concept.