Imprisonment of patients in the course of rehabilitation

The patient carries the major responsibility and plays the most significant role in the rehabilitation process. It is appropriate to continuously examine rehabilitation management techniques to determine the degree to which they facilitate or inhibit patient participation. Of 213 consecutive inpatients on the rehabilitation service of an urban municipal hospital serving a black community, 53 requested discharge before the team considered it advisable. Thus, one patient in four differed with the staff on the decisive issues of functional ability within the environment and readiness for discharge. These "imprisoned patients" were confined against their wills. Improved communication between patients and staff, patient education and mutual goal-setting would yield greater patient participation on the decision-making process.