F ew would question that staff members can also be affected by patients' psychological reactions to disability. Further, they must face their own personal feelings about each patient s history, attitude, and behavior. O n the other hand, negative reactions may be difficult to suppress in cases where the patient killed or maimed someone while intoxicated or was injured while committing a crime. W ith increasing efforts to control health care costs, lengths of inpatient rehabilitation stays have decreased dramatically and steadily over the past decade. With less time allotted to each patient, rehabilitation is now less of a holistic practice.
Emphasis is placed on medical management and daily living skills acquisition.
Addressing the psychological needs of the patient with neurological impairments has, of necessity, become less of a rehabilitation team priority. N earing discharge, many patients are apprehensive about their ability to return home and live a normal life with their family. In turn, family members are concerned about their ability to care for and support the patient outside the hospital. O ften, apprehensions are outweighed by the attractiveness of returning the patient to a more familiar environment. P sychological distress typically extends well past the time of discharge.