Rehabilitation and the Interdisciplinary Team Working for Your Successful Recovery
Skilled nursing facilities provide both sub-acute rehabilitation and long-term rehabilitation for their residents. Residents may stay for their recovery period or an extended length of time. Therapists that work in a skilled nursing facility can provide treatment for, or assistance with, many illnesses and conditions affecting daily life.
Nursing facilities have evolved over the years to serve an aging population that has become increasingly more clinically complex and requires intensive rehabilitation. Recent studies show that over half of all Medicare beneficiaries are now requiring additional skilled care following a hospitalization. Individualized treatment plans devised by therapy professionals are an important part of this care. Therapy services enable patients to regain speech and motor function, as well as master key daily activities, such as bathing and dressing.
Therapy services share a common goal of helping residents achieve and maintain their highest practical level of function. In this way, therapy plays an important role in meeting the Omnibus Budget Reform Act, or OBRA, of 1987 requirements. These guidelines establish a minimum standard of care including an expectation that nursing facility resident’s ability to perform activities of daily living and functional mobility would be improved or maintained, absent of medical challenges.
Therapy services in conjunction with skilled nursing care establish expert clinical programs tailored to enable better outcomes and improvement. These programs invest clinical resources to meet the needs of residents. This includes residents recuperating from joint surgery, strokes, cardiac illness, or other conditions requiring an interdisciplinary nursing and rehabilitation regimen. Such regimens include physical, occupational, and/or speech therapy to restore physical and mental functions necessary for independent living.
With the application of specialized clinical programs to meet the unique needs of each resident, therapy services are driving very specific and measurable improvements that are important to recognize in the discussion of the role of skilled nursing facilities within the post-acute continuum of care. Combining cutting edge technology with proven therapeutic programs improves outcomes, decreases length of stay, and provides each resident the opportunity to reach their highest level of function and discharge home whenever possible.
People tend to think that a rehabilitation program is all about a grueling regimen of therapeutic exercise. That is the cliché – lots of movie montages have shown it that way. But, that is rarely how it happens.
Each skilled nursing facility is equipped with a therapy department that typically utilizes a strong physical therapy program, which focuses on the identification, prevention, and rehabilitation of individuals with physical impairment and pain. Following an evaluation, the physical therapist develops an individualized treatment program for you that will address lower extremity and trunk strength, range of motion, balance, coordination, functional movement, ambulation, endurance, and pain reduction.
In addition to physical therapy, you may be working with a member of the occupational therapy team. Occupational therapy programs address activities of daily living skills, including eating, dressing, hygiene, and home management tasks. They also provide treatment interventions for upper extremity function, cognition, perception, and community reintegration.
Depending on your condition, you may need speech therapy services provided by a licensed and skilled speech language pathologist. Speech therapy provides a continuum of services, including assessment, education, and treatment of patients with communication, cognitive, and swallowing problems. Treatment programs are directed towards improving communication skills in the areas of comprehension and expression. Patients admitted to a skilled nursing facility who are receiving nutrition partially or exclusively from an artificial feeding source via a tube are evaluated for their potential to return to solid foods as appropriate.
Throughout your stay in a skilled nursing facility, your progress will be monitored by an interdisciplinary team, which consists of doctors, nurses, therapists, and dietitians. This team ensures that you are making progress towards your goals, and, if necessary, can reevaluate those goals with you. You will have care conferences that include members from the nursing department, social services, and the therapy department to give updates on the progress that you have made. This is also a great time for you, or your family, to ask questions or voice concerns that you have pertaining to your stay. These care conferences typically occur at the beginning of your stay, at approximately half way through your stay, and just prior to discharging.
It takes a team to care for people. Teamwork across all disciplines and staffing units, including clinical, nursing, environmental services, and dietary work together for the benefit of the resident. Great facilities prohibit the “it’s not my job” attitude creating a positive and supportive work and healing environment. Since a skilled nursing facility is a home for its residents, it is important that the facility feels warm and friendly. It is important that a facility provides support to meet productivity expectations. Most facilities help therapists be as efficient as possible, just by their layout. Transporting residents between their rooms and the gym hinders the process. One solution is having sub-acute resident’s live in a designated rehabilitation wing, which provides therapists with easy access to meet residents and get them to the gym. Nursing staff can also help therapists improve efficiency by ensuring a timely delivery of the medications that are necessary for the rehabilitative process to take place.
Rehabilitation after illness or injury is a slow step-by-step process that aims to help you recover. Rehabilitation might help you get moving again, regain your strength, relearn skills, or find new ways of doing things. The aim of rehabilitation is to help you lead as good a life as possible. That may be the same life you had before you got sick or injured, or it may be different. You can speak to your doctor about what you would like rehabilitation to do for you. With your doctor, and a therapy team, you will set therapy goals. Then, you and your team will work out how to achieve those goals. You will play a very important part in your rehabilitation. You will need to be patient – it takes time – but, rehabilitation can help.
by Dustin Blewett, AIT: Director of Admissions EmpRes – Royal Plaza Health and Rehabilitation
Dustin Blewett is the Director of Admissions and an AIT student for Royal Plaza Health and Rehabilitation. Dustin has been a long time Clarkston resident, born and raised here in the valley. With two decades of healthcare experience, he boasts a vast set of skills, including long term care and aging, long term care pharmacy, hospital pharmacy, and health policy administration. Dustin earned his Bachelors of Science from Washington State University and is working on completing his masters in Health Policy Administration from Western Governors University, as well as his masters in Physician Assistant Studies from Yale School of Medicine.