Helen’s evaluation just one month into the second Rehab Cycle was quite simply remarkable.
At eight months following the onset of GBS (and one month after the start of this Rehab Cycle), Helen exceeded all expectations in her interventions. Her respiratory functions improved to where her tracheostomy tube could be removed. She was able to transfer herself to and from her bed to her newly chosen wheelchair and could furthermore move independently in it.
The Evaluation display (Table 3) illustrates the final evaluation showing the goals attained, as well as the cases where Helen’s performance exceeded what was expected. This is noteworthy as many of the intervention targets were exceeded.
At eight months following the onset of GBS... Helen exceeded all expectations in her interventions.
While certainly a positive development for Helen’s recovery and wish for independence, matching her hope and optimism, this exceptional evaluation exemplifies the difficulty for her health care professionals in making an accurate prognosis.
To Helen’s elation and despite falling short of her initial hopes for her hand function, all three cycle goals were met. Her perspective on her rehabilitation and recovery just one month after the start of this Rehab Cycle shows well her significant and substantial progress:
I can move the wheelchair on my own now and this gives me a little more independence and freedom – but this little bit is so much to me! I don’t need to be accompanied any longer. Actually, my own hope and goal [of improving hand function] wasn’t met, but a lot of small essential aspects improved.
My lungs are better and I can breathe at night now just wearing a face mask, I can raise my legs a little better and move my arms while I am lying. Even transferring works out well now, and this was pretty difficult for me.
My hope has and continues to grow, because I am continuously able to do more things. I’d say that this strengthens my optimism.
The therapists also really keep my optimism up; they understand how to best motivate me, and I have a good relationship with them. I also feel quite intensely that I’m more stable now. Maybe this results from an inner strength, In fact, I have to say that this disease has made me feel stronger.
Regarding my optimism, I need it to have hope. Optimism relates to the content of my hope. And my hope also depends a lot on my environment. If I’m somewhere where I don’t feel comfortable, I can’t recover very well, and my optimism and hope feel diminished. Here, I really feel optimally supported.
How I am looked after and treated actually lets me experience my hope and optimism. I can definitely sense if someone treats me only to do a job or if he or she works out of joy and achieving success. This influences me very much. Now, I feel that my strength is coming back.
However, Helen would still have continued challenges to confront on her path to rehabilitation. Her mobility was still very limited due to the impaired use of her arms and hands. Her respiratory functions were still somewhat hindered despite the strides made. Furthermore, her health insurance would not cover all of her rehabilitation costs, leaving financial worries on the horizon.
My hope has and continues to grow because I am continously able to do more things. I'd say that this strengthens my optimism.
Figure 3: ICF Evaluation Display; 1, 2, 3: Relation to Cycle Goals; SP: Relation to Service-Program Goal; G: Relation to Global Goal; * ICF Qualifier rates the extent of problems (0 = no problem to 4 = complete problem) in the components of body functions (b), body structures (s), activity and participation (d) and the extent of positive (+) or negative impact of environmental (e) and personal factors (pf).