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The Merck Manual--Second Home Edition logo
 
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Chapter 40. Pulmonary Rehabilitation
Topics: Introduction | Enrollment and Goal Setting | Exercise Training | Psychosocial Counseling | Nutritional Evaluation and Counseling | Drug Use and Education | Oxygen Therapy | Chest Physical Therapy | Postural Drainage | Suctioning | Breathing Exercises
 
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Enrollment and Goal Setting

The first step for the team members is to determine the person's short-term and long-term goals. For example, an older person may desire to travel by air to visit a grandchild. If the person can walk only 300 feet because of shortness of breath but must be able to walk 1,000 feet to board the airplane, the initial short-term goal may be to increase the walking distance by small increments. Team members must encourage the person while also setting realistic goals. Periodic reevaluation (weekly) is important to ensure that these goals are being met.

It is also important for the team members to identify factors that may limit the program's effectiveness for a particular person; these factors may include problems with financial resources, transportation to the rehabilitation center, cognition, and family dynamics. An example of a problem with cognition would be when a person who has lung problems also has dementia. Such a person may need a specific approach to enhance comprehension. An example of a problem with family dynamics would be when a person who is enrolled in a program is dependent on a caretaker who is mentally or physically abusive. It is important for team members to recognize such problems and plan ways to help the person.

Long-term goals are also established, and team members teach people to recognize changes in their lung condition, so that they will contact their doctor promptly. Treatment may need to be modified in response to changes in symptoms.

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