Rehabilitation after major trauma

Once you have recovered sufficiently from a traumatic injury and are well enough to leave the acute hospital, staff will discuss the next steps in your recovery with you. You may need help to improve your mobility or function. Rehabilitation services can provide help and care to assist with your physical state after severe trauma. Rehabilitation can begin as soon as you are stable while you are in hospital and the types of rehabilitation will depend on your individual needs.

Rehabilitation services aim to increase your independence and physical function after injury and to return you to as much of your previous ability as possible. Where it is not possible for you to return to doing things as you used to, the rehabilitation process will help you explore new ways of doing things.

Rehabilitation planning

Your healthcare team or case manager will complete an assessment noting your physical health before the trauma and your current injuries and treatments. Before you leave the acute hospital they will come and review your status and discuss the rehabilitation options available to you. These may depend on:

• the type of service you need
• the availability of a room/bed at one of those services
• the type of compensation you have, if any (for example, whether you are eligible for compensation from TAC or WorkSafe, or if you are covered by the Department of Veterans’ Affairs)
• the type of private health insurance you have, if any
• the services available to you as either a private or public patient, and what you can afford to pay
• whether the hospital you were treated in has preferred rehabilitation providers.

Your hospital healthcare team may organise to move you to a rehabilitation service where you can begin the next phase in your recovery from traumatic injury. This may be part of the same hospital or a move to a new facility.

Types of rehabilitation services in Victoria

There are different types of public and private rehabilitation services in Victoria that offer treatment by specialists. These include:

• inpatient rehabilitation – you remain in a hospital setting, but move to a specialist rehabilitation centre or ward, or to a private hospital (if you have compensation or private health insurance cover for rehabilitation)
• ambulatory rehabilitation – this is a community-based service that aims to improve or help you regain your movement function (for example the ability to walk) and maximise your independence. Ambulatory rehabilitation can be delivered in a person’s home or at an ambulatory care centre
• community rehabilitation – this can be delivered at a centre or at home.

For both inpatient and ambulatory rehabilitation programs, patients can be referred by general practitioners or other doctors.

How rehabilitation services can help you

Your rehabilitation program will be tailored to your needs. Depending on your injury, rehabilitation may help you regain movement and strength, relearn skills or learn new ones. It can also help you to recover mentally and emotionally from the trauma you have experienced.

Rehabilitation may include:

• help for emotional and mental health difficulties
• help to increase movement, strength and endurance
• help to learn how to look after yourself with an injury or disability
• help in moving around, using aids or wheelchairs
• pain management
• help to return to work, leisure and family activities
• help with home modifications or discharge to supported accommodation, if required
• help with arranging home care services, where applicable.

The healthcare professionals who make up your rehabilitation team may include:

• nurses
• doctors
• physiotherapists
• occupational therapists
• podiatrists
• psychologists
• speech pathologists

• prosthetics and orthotics specialists

• pharmacists

Depending on your injury (or age), specific rehabilitation services may address:

• orthopaedic (musculoskeletal) rehabilitation
• post-amputation rehabilitation
• neurological (nervous system) rehabilitation
• cardiac (heart and lungs) rehabilitation
• hand therapy
• paediatric rehabilitation
• burns rehabilitation.

Choosing a rehabilitation service

If you are in a position to be able to choose your rehabilitation service, it can be helpful to ask questions about:

• the range of rehabilitation services available to you
• any costs that may be involved, such as fees for equipment
• the estimated length of stay, noting that this may not be able to be accurately predicted
• the types of activities and care that you can expect, and the duration of services such as physiotherapy (for example, one hour, twice a day for three weeks)
• the aims and expected outcomes of the rehabilitation (for example, return to full or partial movement, improvement in cognitive function, learning new skills to cope with limb loss or ongoing brain injury)
• taking someone along with you such as a family member or friend to ensure that you fully understand your options
• dietary, language or religious needs, if required, and how these will be managed.

At the rehabilitation service

When you arrive, the rehabilitation service team will look at your capacity as a result of your injuries and design a rehabilitation program that suits your particular needs. They will develop the program in consultation with you and your family.

Rehabilitation costs

To find out what costs you may need to pay (including standard charges and out-of-pocket expenses), talk to the rehabilitation service provider. Costs will vary depending on your needs and whether you are a public patient (with or without a Medicare card), a private patient, or eligible for funding from the TAC, WorkSafe Victoria or Department of Veterans’ Affairs.

Public patients

If you have a Medicare card, you may be eligible for Medicare rebates.

Private patients (with private health insurance cover)

If you have private health insurance, contact your insurance provider to find out if your cover pays for rehabilitation services. (Your hospital team may do this and arrange your move to a private service for you. Speak to your healthcare team about this.)

Be aware that even top cover may only provide two weeks of inpatient rehabilitation. In such a situation, you would likely become a public patient after those two weeks. Alternatively, you could choose to pay for ongoing rehabilitation as a private patient yourself, if you are in a position to do so.

Patients with TAC and rehabilitation cover

If you had a transport accident, contact your claim manager and visit the TAC website for more information about what rehabilitation services the TAC may pay for.

Patients with WorkSafe cover

If you had a workplace incident, your WorkSafe agent may approve various rehabilitation services to help you return to work. Talk to your WorkSafe agent about:

• which rehabilitation services you need, and which service providers you wish to access
• which of these need to be approved in advance by Work Safe
• which of these require you to have a medical referral (in order to be covered by WorkSafe).

Find more information at WorkSafe treatment expenses.

Discharge from rehabilitation services

The process of discharge from rehabilitation services includes addressing your ongoing care needs, and is planned and coordinated in partnership with yourself, your carer and family. Discharge planning commences on admission to the rehabilitation service and is regularly reviewed. Eligibility for the National Disability Insurance Scheme will be considered as part of this process.

More information

Rehabilitation and complex care - health.vic website

Admitted Rehabilitation

Specialist Rehabilitation

Maintenance Care

National Disability Insurance Scheme (NDIS)