HEART ATTACK AND COMPREHENSIVE FOLLOW-UP CARE: ARGUMENTS IN FAVOR OF CLINICAL EARLY REHABILITATION (IN EUROPE)

The ambitious goals described may be met at home under the supervision of the personal physician if no complications arise from the heart attack and the patient and physician are able to cooperate. But how often are the conditions so favorable? May we suggest that home care be preceded by a structured program of rehabilitation in a special center or clinic for rehabilitation? We are discussing, of course, the present situation in Germany for patients after a myocardial infarction, a situation which may sound almost Utopian to the American reader.

The difficult process of becoming accustomed to a new life-style is made easier in a place where group therapy is possible. In such a center, the patient can be informed and encouraged to adopt the life-style appropriate for the rest of his life. As a participant in a controlled group, the patient is motivated more easily. In discussion groups, the patient is made aware of his personal risk factors and can then reduce them, for example, by attending non-smoking sessions.

What are the important goals of a rehabilitation program after the discharge from the hospital?

controlling the individual risk factors

practicing the self-discipline necessary to comply with long-term drug therapy (see p. 86);

maintaining the individualized exercise therapy.

The success of this program is of course also dependent on the cooperation of the family, in particular of the spouse.

In a later chapter we shall discuss the particular problems which the return of heart attack patients may pose for their marriages. They must avoid the two extremes of behavior, playing the role of a spoiled child as well as the totally helpless approach.

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Cardio & Blood/Cholesterol