Young rehabilitation patients: Between homesickness and hope for improvement

"I cried a lot at first," says Cornelius Jankowski. He was eleven years old when he went to rehabilitation, or rehab for short, alone for the first time. "That was really difficult for me," recalls the now 18-year-old. This is now his seventh rehabilitation treatment. He suffers from asthma and severe atopic dermatitis. He repeatedly travels to the Alpenklinik Santa Maria in Allgäu for treatment. He last visited the clinic at the end of 2024. "It helped a lot this time too," says Cornelius.

According to the annual report of the German Pension Insurance, almost one million rehabilitation treatments were carried out in 2023 alone. The majority of patients are over 60 years old, and the number of chronically ill patients increases with age.

But there are also people like Cornelius who need rehabilitation as teenagers or young adults up to the age of 35: in 2023, a good three percent of treatments were for children and adolescents.

The reasons for rehab are varied. In Cornelius's hometown of Duisburg, the air quality is often very poor, putting a lot of strain on his lungs. This is particularly problematic for asthmatics. During his time in the Alps, Cornelius can benefit from the fresh air there. Furthermore, he says, "the hospital staff has sunshine in their hearts." However, not all patients have the same positive experience. Besides him, three other patients his age were there. Cornelius recalls: "One of them didn't say anything, didn't eat anything, and left after just three days."

Very young patients in particular often suffer from homesickness when they arrive at the clinic, just as he did during his first rehab. The nurses and doctors are aware of this and take it into account. However, the homesickness subsides week by week. Cornelius remembers this, too. For the initial period, there is also a mentoring system. This means that patients who have been at the clinic for a longer time look after the new arrivals and explain everyday life there to them. For minors, this also means that they have to attend the clinic school during the day – just like in "normal" everyday life.

At the age of 18, Cornelius Jankowksi had already been to rehab seven times.

Source: private

According to the Federal Health Report for 2020, children and adolescents are most frequently admitted to rehabilitation for mental health problems and behavioral disorders, closely followed by asthma and obesity.

Some of the young patients have had chronic illnesses for years, some have just undergone major operations, and others want to lose weight.

Laura Kühn also wants to lose weight. At 18, she is one of the youngest patients at the Median Clinic in Bad Gottleuba in Saxon Switzerland. She chose to undergo rehab voluntarily. "But I'm also aware that at 18, I'm an exception," she says. "There are hardly any people my age here, which bothered me. But if you can handle the age difference, I can really recommend the treatment."

Her daily routine at the clinic consists of three meals, lots of group exercise, lectures, massages, and nutritional advice. It starts at 7 a.m., and dinner is often served before 6 p.m. And then there are those awkward situations Laura experiences. "During water aerobics, I had the impression that some of the older men were flirting with me," says the 18-year-old. "Then I would hear comments like, 'I like you better with your hair down.'" Such situations can be challenging, especially for very young women. Nevertheless, the rehab helped her health; she was able to lose three kilos during the time.

There are different, independent medical rehabilitation facilities for each diagnosis. Yet, the cause of the symptoms cannot always be determined and remedied.

This is the case with Marie-Luise Rieck, for example: The 31-year-old has been suffering from stomach pain for several years, but the cause has not been conclusively determined. "They now describe me as chronic gastritis. I actually have stomach pain every day, which is why I decided to go to rehab." Pain therapy was supposed to provide relief. She, too, underwent various measures: water aerobics, yoga, nutritional counseling, and gymnastics. Marie-Luise Rieck spent five weeks in the rehabilitation clinic in Bad Gottleuba.

"Unfortunately, it didn't change my stomach pain much," says the kindergarten teacher from Berlin, looking back. She, too, struggled with the age difference that separated her from most of her patients: "'You're way too young for that,' I was told." Nevertheless, she also had some positive experiences. For example, she met other people who also had to cope with chronic gastrointestinal problems. U And the rehabilitation treatment still had a positive effect, says Marie-Luise Rieck: "I've definitely become fitter."

For many younger people who have to attend a rehabilitation clinic, the main question is whether they will ever be the same again, says Dr. Saskia Meves. She is the chief physician of neurology at the Rhein-Ruhr Fachklinik in Essen-Kettwig and has long been familiar with the needs of patients. Although 18- to 30-year-olds only make up about three percent of all patients, younger patients in particular need to be treated differently.

"The illness usually takes them out of their lives suddenly, and many don't know what to do next," says the doctor. Rehab is a "black box . " Many don't know what to expect and are afraid because they had just begun a new phase of their lives.

Dr. Saskia Meves is a specialist in neurology and chief physician of the neurology clinic at the MEDICLIN Rhein/Ruhr specialist clinic in Essen.

Source: Dr. Saskia Meves

Patients come to Meves' clinic in Essen-Kettwig for a variety of reasons. The majority have suffered a stroke and must now learn to live with the consequences. Strokes can have a variety of causes: drug use, vasculitis (inflammation of blood vessels), or HIV infection. "Younger patients may have more resources to cope with a stroke, but some of them suffer very severe strokes," says Meves. Some strokes are so severe that patients must stay in rehab for up to six months. "People who are paraplegic often have to relearn techniques that are completely normal for healthy people," explains the doctor.

Although almost all rehabilitation clinics are geared more toward older people than younger patients, Meves is nevertheless certain that the facilities can help young people effectively. However, the question of the extent to which the "rehab system" is geared toward young people is a different one, she says.

And then there's the issue of expectations: Many patients assume that they'll be completely healthy again at the end of rehab. "But for some, that may not be the outcome," Meves emphasizes. "It really depends on the severity of the illness. Sometimes the goal is simply to be able to manage everyday life independently again or to work." Laura Kühn, Cornelius Jankowski, and Marie-Luise Rieck also have this expectation. Whether it will be fulfilled, however, will only become clear after rehab.