All the efforts are directed toward the needs of the patient, the most important member of the team. Patients and family caregivers help set rehabilitation goals. Participation in planning and therapy sessions is critical to the outcome of the rehabilitation program.
The primary source of support is usually family members. The family provides important information that is helpful in planning the rehabilitation program. In the beginning, the patient may not be able to communicate his or her wishes, which is when other members of the team will look to the family for guidance. Family is asked to attend therapy sessions, keep in regular contact with the social worker, and, at times, meet with the physician. These meetings will help prepare the family for the days and weeks to come, enabling them to provide the support and care the patient will need after hospitalization.
While in the hospital, the patient will be under the care of a rehabilitation physician (called a physiatrist). The physician is a member of the Mary Free Bed Rehabilitation Hospital’s medical staff. The physician will see the patient at regular and appropriate intervals and oversee the efforts of the rehabilitation team. The physician may also seek the expertise of other medical specialists, depending on the needs of the patient. After hospitalization, the physician, along with members of the outpatient rehabilitation staff, monitor any ongoing rehabilitation that occurs.
Nursing provides care to the patients at Mary Free Bed Rehabilitation Hospital 24-hours a day. A registered nurse assesses, plans, implements, and evaluates the patient's care on a daily basis. When a patient is admitted, a primary nurse is assigned to each patient for the length of stay. This nurse will coordinate the treatment plan with the other team members to ensure care needs are met. During each 8-hour shift, a caregiver (who may be either a nursing assistant or a LPN), along with an RN is assigned to the patient. A registered nurse does the initial patient and family education and caregivers reinforce teaching so that a successful discharge is accomplished. Patient and family education begins on the first day of admission and continues throughout the hospital stay.
An occupational therapist assists the patient with regaining independence during daily routine tasks such as eating, dressing, home management, community reintegration, and prevocational activities, when appropriate. A treatment program is developed to improve or compensate for deficits that interfere with the performance of these tasks. Adaptive equipment will be recommended and ordered for the patient, if indicated. The occupational therapist evaluates and treats arm strength, coordination, sensation, visual perception, and cognition.
A physical therapist is responsible for evaluating and treating abnormalities in range of motion, muscle tone, strength, sensation, balance, and functional activities. Functional activities include the ability to move in bed, transfer from one surface to another, use a wheelchair, and walk. The therapist will assess orientation and safety in the hospital and community. The focus of treatment is on helping the patient regain independence in areas of difficulty. The physical therapist educates the patient and family and assists with equipment ordering.
A psychologist provides specialized testing to assess the patient’s memory, emotional status, intelligence, vocational, and educational potential. The psychologist caring for the patient may also provide individual psychotherapy, family therapy, and family support. The psychologist may suggest treatments for improving cognitive skills such as memory, attention, concentration, visual perception, and eye-hand coordination.
Therapeutic Recreation Specialist
Therapeutic recreation specialists help patients resume social and leisure skills by designing an activity programs. New leisure activities are encouraged, depending on the level of cognitive and physical functioning. A therapeutic recreation specialist plans both hospital activities and community outings for patients.
Social workers meet with patients and family members to provide services such as individual and family counseling, sexual counseling, family education, discharge planning assistance, and information about community services. Social workers are also helpful when it comes to communicating information between the patient, rehabilitation team members, family members, and insurance company representatives.
A speech-language pathologist is responsible for the diagnosis and treatment of problems in the areas of communication, cognition, and swallowing. The speech-language pathologist assesses and treats cognitive deficits such as memory, attention, problem solving, and reasoning. Possible problems of communication include difficulties with comprehension, expression of language, the mechanics of speaking, as well as processing and retaining information. The therapist can assist the family in learning the best ways to communicate with the patient. A speech-language pathologist also diagnoses and treats swallowing and feeding problems, which may include weakness in chewing, aspiration of certain liquids, or difficulty attending to the feeding process.
Other professionals involved in the rehabilitation process:
Because we believe the spiritual needs of patients are as important as their physical and emotional needs, a chaplain is available to meet with patients and families. The chaplain is available for pastoral counseling, and on request, the chaplain also assists in arranging for the services of a clergy person from a particular denomination.
A nutritionist works with each patient to plan a diet that contains the right amount of calories and nutrients and accommodates individual food preferences.
Driver Rehabilitation Therapist
When appropriate, a member of the Driver Rehabilitation Program is available to assess the patient’s ability to return to driving. Driver rehabilitation will provide on-the-road driving instruction and recommend vehicle modifications, if needed. The Driver Rehabilitation Program also provides information on licensing and handicap parking permits.
Insurance Rehabilitation Case Manager
Some insurance companies assign a rehabilitation nurse or case manager to monitor and ensure that reasonable and appropriate services designed to return the patient to independent living – to the extent possible –are being provided. While this person is not an employee of Mary Free Bed Rehabilitation Hospital, the case manager will work closely with the rehabilitation team to provide support and education and help plan the patient’s discharge from the hospital.
Children and teenagers who are missing school as a result of hospitalization at Mary Free Bed receive educational services through the Grand Rapids Public School system. The teacher, experienced in working with both physically and cognitively impaired students, provides cognitive and academic instruction and serves as a communication link between the student’s home school and Mary Free Bed Rehabilitation Hospital.
Vocational Rehabilitation Counselor
A vocational counselor is available to help explore plans for education, training, and employment after hospitalization. Services may include assessment, referral to other community resources, and job placement. Often, vocational counselors continue to work with patients after discharge from Mary Free Bed Rehabilitation Hospital. The vocational counselor is an employee of the State of Michigan.