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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 (about 90 meters) because of shortness of breath but must be able to walk 1,000 feet (300 meters) to board the airplane, the initial short-term goal may be to increase the walking distance by small increments. Team members must be encouraging while also setting realistic goals. Periodic reevaluation (weekly) is important to ensure that these goals are being met.
It is also important for 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 caregiver who is not able to help the person with rehabilitation at home. 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.
Last full review/revision May 2007 by Bartolome R. Celli, MD
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