What Can Acute Rehab Do For Me

What Can Acute Rehab Do For Me?

“Why acute rehab?” This is one of the most common questions that I get asked by patients or their family members/caregivers when they are trying to determine what the next step is for them after a hospitalization. Acute rehabilitation programs are unique in that they provide a comprehensive outlet for patients experiencing a decline in his or her prior level of functioning through intensive skilled therapy services, 24 hour rehab-centered nursing care, and daily medical monitoring by a rehabilitation physician. The primary goal of acute rehabilitation is to increase a patient’s level of independence and safety with activities that we all need to complete in our daily life. These activities include basic tasks such as mobility within the house and community, self care skills such as bathing, dressing, self-feeding, communication with others, social cognition, and bowel and bladder management to name a few. Increasing a person’s independence with everyday daily tasks typically increases a person’s feelings of self-worth, confidence, quality of life, mental well-being, and often times reduces the burden of care that family members or caregivers might experience when caring for someone who has had a functional decline. Acute rehabilitation offers an opportunity for patients and caregivers to work closely with an interdisciplinary team of rehab-focused healthcare professionals including the rehabilitation physicians, social workers, physical therapists, occupational therapists, speech therapists, psychologists, dieticians, recreational therapists, and chaplains. The rehab team works together to develop an individualized program to reach a specific, desired goal for most patients—returning home with the least amount of assistance! It certainly takes a team approach to accomplish this goal, most importantly keeping in mind that the patient is an integral part of the team.
“How can I qualify for acute rehab?” This question typically follows after explaining what some of the benefits of acute rehab are to patients and family members. There is a specific set of guidelines that must be followed to determine if an acute inpatient rehabilitation facility is the ideal setting after a discharge from the hospital or healthcare facility. First, the patient must be medically stable and have recovered from the acute phase of his or her illness or injury, but still be in need of 24 hour nursing care and supervision. Common diagnoses admitted to acute rehab include (but are not limited to): stroke, brain injury, other neurological disorders such as Guillain-Barre Syndrome or exacerbation of MS, limb amputation, complicated orthopedic problems from trauma, and other complex illness that occur after respiratory or cardiac failure. Second, the patient must be in need of 2 or more skilled therapy services (physical therapy, occupational therapy, and speech therapy). Just as importantly, the patient must be able and willing to tolerate at least 3 hours of therapy per day, 5 days per week. Some people might get intimidated by hearing 3 hours a day and feel a bit overwhelmed by the thought of engaging in that much activity after an illness or injury. However, the therapy sessions are typically divided up into 30-45 minute treatment sessions throughout the day. Often, working on bathing and dressing and other self care skills is incorporated into therapy sessions as it is considered an important part of rehab and sometimes counts as part of the required 3 hours of therapy. Third, there needs to be a realistic plan in place after discharge from inpatient rehab that includes a support system that will participate in hands on care, depending on the needs of the patient. Having a clearly defined plan in place for anticipated needs helps the patient, the treatment team, and the family members know what their expectations are in working towards the return to home. Often times, therapy session will incorporate family member/caregiver teaching and training to build on the progress made thus far and allow for family members to carry over the techniques needed for continued success in the rehabilitation process. Finally, the patient must show the need and ability to participate in the program based on his or her current level of functioning, previous level of functioning, and an anticipated ability to demonstrate therapeutic improvement over a clearly defined period of time. The patient must meet measurable and attainable treatment goals and be able to demonstrate consistent, steady progress towards the specific goals that the treatment team establishes. The amount of time that someone stays in inpatient rehab varies from case to case based on functional and medical needs, as well as progress towards the goals. Typically, patients stay for an average of 2 to 4 weeks before discharge home.
“Who do I contact to start the process of getting me to rehab?” All hospitals have discharge planners or case managers who can contact the admission nurses at the inpatient rehabilitation facilities. It might be necessary for the patient or family member to request being considered for inpatient rehab. The admission nurses will complete a pre-admission assessment and case review to determine if the patient meets the criteria and if acute rehabilitation would be the ideal fit for his or her medical/healthcare needs. A physician must also order rehabilitation services and agree to manage a patient’s case while in rehab. Referrals to acute rehabilitation admission nurses can also be made from other healthcare facilities, community resources, and family members or friends.
If you feel that acute inpatient rehabilitation might be the ideal setting for you, friend, or family who has had a recent decline in physical and/or cognitive functioning, contact the discharge planner or case manager assigned to you or the patient to get the preadmission screening started.

"Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome." --Booker T. Washington

Elizabeth Robinson, OTR/L
Occupational therapist
Baptist Hospital East
Acute Rehabilitation Program
(502) 896-7467