Every home health clinician working in the field practices rehabilitation nursing, which is a specialty unto itself. Ultimately, the purposes of home health are to prevent hospitalization and to enable people to remain in their homes despite illness or injury. To accomplish these purposes, home health clinicians teach clients and their support systems how to practice self-care management, adapt to disability or chronic illness, and optimize independence. We are in the culture of doing "with" the client, not "to" or "for" the client. The concepts of self-care management, adaptability, independence, and the assistance or facilitation of care are fundamental rehabilitation concepts. Home health clinicians, however, are not always cognizant of the impact of the rehabilitation approach on the care they provide. There are specific methods by which rehabilitation principles can be implemented to improve client outcomes.

This issue of HHN provides a few practical examples of the application of rehabilitation principles to complex client cases. The articles illustrate how instrumental and vital the interdisciplinary team is to home care and to rehabilitation. The authors of these articles come from a variety of backgrounds, and each brought valuable contributions from vast clinical experience to the discussion of these cases. Rehabilitation and home care are inherently interdisciplinary.

"The Role of the Home Healthcare Nurse in Smoking Cessation: Guidelines for Successful Intervention" identifies the problem and provides methods for successful cessation. Another article, "The Rehabilitation Nurse Specialist in Home Care" (a part of the "So You Aspire To Be" series), describes the history of this specialty, as well as what the role looks like from a practical perspective. The other articles discuss specific patient cases and how they might be approached as part of a comprehensive rehabilitation program. The case each author addresses is common in home care, but the authors have used unique and interesting approaches to work through each complex case. Another article, "Using a Rehabilitation Approach to Wound Care in the Home Setting: A Case Study," presents the case of a patient with myriad problems who was discharged from the hospital with complex care needs. In addition, an interesting study involves elders using pedometers as a way to increase ambulation that could be a model for agencies as we seek to decrease or prevent parameters causing illness and subsequent hospitalizations--see "Using Pedometers as a Strategy to Increase the Daily Steps of Older Adults With Chronic Illness: From Research to Practice." Combined, the authors have backgrounds in community and home health, rehabilitation nursing, critical care, quality of life, and recreational therapy.

We hope that you will find this issue a valuable and practical resource. We have strived to make the articles directly applicable to your practice. It is imperative that clinicians integrate rehabilitation principles into practice even more now than ever as those who decide how and whether to reimburse our work are looking for clients to be discharged quickly from home health. The sooner the client and family become independent with care, the sooner they will be ready for discharge. As responsible and caring clinicians, we take comfort in knowing that our clients really are prepared for discharge and have adapted to the changes in lifestyle required by their disability or illness. You are the key to patients achieving this important goal.