Rehabilitation Evaluation—Some Social and Clinical Problems

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Abstract
This study reports one problem area in an attempt to determine the rehabilitation potential of an aged indigent population living in nursing homes. The device for testing potential is the application of a comprehensive rehabilitation program to a stratified random sample of the impaired members of this group, with evaluation of the before and after status of disability in regard to specified activities of daily living for a treated and a non-treated sample. This test depends on replicable and valid measures of disability. Some of the problems in achieving measuring tools are described. Differences ace reported between results of 2 different evaluation approaches at 2 different sites suggesting the influence of social situation as well as of the nature of the examiner and type of examination on test results. Reports of day-to-day function differ from test results. It is hypothesized that differences between a clinical and a research orientation on the part of observers may affect test results. In relation to disability, it is emphasized that evaluation can be most productive if performed in terms of capacity to carry our specific activities rather than in terms of full or partial loss of body parts or their functions. The general principle is offered that, given knowledge of a potential treatment outcome, the quality of any medical care services offered may, in part, be measured in terms of treatment results actually achieved.

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