Increased numbers of older people, many more people living with chronic conditions together with and falling lengths of hospital stay have necessitated a need in many countries for more home-based rehabilitation. There is as yet no full or widely used definition of rehabilitation, but a model of the process has been proposed rehabilitation is an educational, problem-solving process that focuses on activity limitation and aims to optimize patient social participation and well-being, thus reducing stress on the carer/family. Emphasis is placed on the users’ own goals in the rehabilitation process and on them being given help to formulate a different understanding of their situation within a new framework. User participation is vital.
Home-based rehabilitation makes it possible to base the rehabilitation process on daily activities in home surroundings, and to make use of local services in the rehabilitation process which makes it easier for the patient to resume earlier activities, possibly adapted to a new situation. For older patients, home-based rehabilitation appears to be as effective as rehabilitation in a care home, in hospital or in a day hospital. Home-based rehabilitation seems better than usual home care, and intensive home-based rehabilitation is better than non-intensive. Coordinated services are necessary and working in teams is to be preferred.