December 4, 2009
Choosing the Right Rehab Service for Your Family
By Dr. Pamela Salazar, Medical Director
Walton Rehabilitation Health System
Augusta, GA—If you or a loved one has suffered a stroke, brain injury, spinal cord injury or other musculoskeletal orthopedic injury, it’s important to know that not all rehabilitation services are created equal.
Depending on the level of your injury, and any coexisting medical conditions, different types of facilities or services may be right for you.
Rehabilitation services may be provided by the following:
- Home Health. Patients who are home bound can receive therapy through home visits by aides, who guide them through exercises, activities of daily living and other therapy as needed, up to three times a week.
- Outpatient Therapy Facility. Patients have individual, or group, sessions on a scheduled basis with a therapist at their office. Patients are mobile and have a safe level of independence.
- Outpatient Rehabilitation Facility. Patients come in for scheduled sessions with a therapist(s), nurse and case manager but also benefit from physician services. Again, patients are typically mobile and have a safe level of independence.
- Skilled Nursing Facility. Patients require a higher level of care and are typically chronically ill, or elderly. They receive long-term in-house nursing and therapy care.
- Inpatient Rehabilitation Hospital. Patients are more complex and require in-house therapy, nursing and the supervision of a rehabilitation and internal medicine physician.
- Long-Term Care Hospital. These care for the most medically complex patients, who are more stable than patients in an ICU, but who may still have unresolved complex medical conditions and require long-term care.
The Difference Between Inpatient Rehabilitation and Skilled Nursing Facilities
Perhaps one of the more confusing to understand is the difference between an inpatient rehabilitation hospital and a skilled nursing facility, since both provide care and therapy on an inpatient basis for patients who require a higher level of care than outpatient or home health care.
An inpatient rehabilitation hospital typically cares for patients with active medical problems, including cardiac issues, diabetes or infection, along with a disorder or injury requiring rehabilitation. Physicians who specialize in rehabilitation are available 24 hours a day and consult patients daily. Nurses may also be certified as rehabilitation specialists.
Patients receive a minimum of three hours of individually tailored therapy a day, five days a week. They benefit from a team approach, which combines the expertise of the physician, nurse, physical therapy, occupational therapy, speech therapy, respiratory therapy, psychology and neuropsychology, a dietitian, case manager and pharmacist.
The goal of an inpatient rehabilitation hospital is for patients to achieve maximum independence upon discharge and return home to their community.
In contrast, a skilled nursing facility cares for patients who are medically complex but who do not require the daily attention of a physician. On-staff or on-call physicians are not required to be rehabilitation specialists and are available for emergencies 24 hours a day and round regularly.
Patients typically receive one and a half hours of therapy a day, five days a week. Services may include physical therapy, occupational therapy, speech therapy, social services, medications, supplies, equipment and other services to support the health of the patient.
The goal of a skilled nursing facility is to provide ongoing care and support of a patient’s changing condition.
Questions to Ask
As you make the decision on where your loved one should go for rehabilitation after a temporary illness or life-changing disability, your physician can provide good input and guidance. But it’s also important that you ask the right questions, including:
- Is the rehabilitation service accredited? Accreditations demonstrate that the facility has met certain quality standards.
- What other quality indicators does the service meet? Facilities may also have their own internal quality standards, typically compared against national averages.
- What services/therapies are available that will help achieve our family’s goals? Depending on your family’s goals, certain services or therapies may be important. For example, does the facility offer a full schedule of rehabilitation? Are there community supports available after discharge?
- How is the family involved in developing a treatment plan? Family plays an integral role in a patient’s treatment plan, so make sure the facility welcomes family involvement.
- Are physicians fellowship trained or do they have other specialized training? How often do they round and are they on-site or on call? Just like accreditations, fellowship or other specialized training is an indicator of physician expertise and experience. And, depending on a family member’s needs, physician availability may be an important factor in your decision.
- What is the nurse/therapist to patient ratio? Nurses and therapists are vital in the daily care of your loved one.
- Does the rehabilitation service offer a tour or more information to help families determine if it is the right fit? There is often nothing more enlightening than being able to see in person what a facility and its staff are like. That way, you can judge for yourself if a facility would be the right choice to care for your family member.
Remember, your insurance coverage is your paid benefit and you do have a choice about where to go. By knowing your options, you can choose the right service that will provide the best results for you and your loved one.
Media Contact: Danielle Wong Moores, Public Relations Specialist, 706-434-0150.
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