The report is available in English with a French summary - KCE

172 Musculoskeletal & Neurological Rehabilitation KCE reports 57
Patients older than 70 years are less eligible to these models and are referred to
geriatric rehabilitation. Geriatric rehabilitation is a special category of rehabilitation in
Germany offering less intense rehabilitation compared to the other models. 169
Figure 8.1: The 'Phasenmodell' in neurorehabilitation (BAR, Die
Bundesarbeitsgemeinschaft für Rehabilitation, 1999)
Specifically, for neurorehabilitation a conceptual ‘Phasenmodell’ was developed to
streamline the thinking about rehabilitation services. The model distinguishes 6 phases
(see Figure 8.1). The patient may not go through all phases neither pass them in
chronological order. In Phase A, the acute treatment is the major priority. As soon as
the patient is medically stable, the first rehabilitation interventions can take place. Phase
B is a phase in which the patient still may need intensive care support and has not
reached a sustained phase of full consciousness. If the patient evolves to a condition
enabling active participation in the rehabilitation process and where significant
improvement for his functional independency can be expected, the patient will move to
Phase C: a period of intensive rehabilitation where supervision of nurses and medical
staff is still needed. If no improvement is expected, it will be decided to transfer him to
a long-term nursing care setting (Phase F).
If no further nursing support is needed but improvement is still expected, the patient
will then continue to Phase D.
Phase A trough phase D is organised in different types of intramural settings. Acute
hospitals have the necessary technical equipment and expertise to support the patient in