Division of Physical Medicine and Rehabilitation
Patients Return to Community Life with Help from Acute Rehabilitation Unit

As most of her neighbors and friends spent the hot summer months having fun at the shore and enjoying barbecue dinners, 51 year old South Philadelphia resident Geraldine Schoffler faced new challenges in her life after having a second leg amputated.

Following her surgery, Geraldine, known to her friends as Gerry, learned new ways to stay independent and gain function right in her own neighborhood at the comprehensive acute rehabilitation unit at Methodist Hospital, where the attentive staff helped her adjust to the physical and emotional demands of her situation.

The acute rehabilitation unit offers specialized inpatient rehabilitation programs for adults with neurologic, orthopedic, oncologic, medical or surgical impairments, and disabilities. The unit provides patients with state-of-the-art medical care, as well as emotional, social, vocational and psychological support that will help each attain optimal independence. Previously, patients such as Gerry had to travel farther away from their families and communities to get such care.

Adults diagnosed with a wide range of illnesses or who have suffered from injuries can be considered for admission. The unit's staff is capable of helping people with stroke, arthritis, multiple sclerosis, amputations, Parkinson's disease, Lupus, cerebral hemorrhages, joint replacements, orthopedic fractures, and more. Patients are usually referred to the unit by their primary care physician.

While in the unit, patients work with specialists from a variety of disciplines to reach their goals and achieve maximum independence and function. While patients stay in private rooms, a supportive environment is fostered by group activities. For instance, the unit has a dining room where all patients meet daily for each meal. The rehabilitation gym, where therapy is administered, also promotes a sense of community among patients.

"Our interdisciplinary treatment team is at the heart of this program," said Donna Collins, RN, MSN, who coordinates the unit. Patients may work with physiatrists, rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, social workers, and psychologists, depending on their specific needs, according to Collins. Patients in the acute rehabilitation unit usually undergo approximately three to four hours of therapy each day.

The physiatrist, or rehabilitation doctor, determines an appropriate treatment plan for each patient, including what therapy, medications or counseling are necessary. He or she will also evaluate the patients' ability to carry out daily activities.

Complementing the physiatrist are:

• Rehabilitation nurses who teach patients the skills needed to take care of themselves

• Physical therapists who evaluate mobility skills and design programs that focus on flexibility, strength, endurance, coordination, walking and/or wheelchair management, and more

• Occupational therapists who determine for patients how to best perform activities of daily living, such as dressing, using a phone, or cooking;

• Speech-language pathologists who will help if a speech or swallowing problem is indicated

• Social workers and psychologists who deal with the emotional aspects of such disabilities.

"Families and friends need to understand the challenges and goals of the patient, and to help make decisions when necessary," said Collins. "That emotional support helps patients make considerable progress," she said.

While staying at the Comprehensive Acute Rehabilitation Unit, patients have a daily regimen of physical, occupational and other therapies, and meet weekly with their treatment team to discuss their goals, concerns, progress and discharge plans. In addition, patients may be asked to participate in a community skills therapy session with the physical and occupational staffs outside the hospital. And if they are medically able, patients may leave the unit for up to six hours with a doctor's approval.

Gerry has taken the skills she learned in treatment home with her. She says that she preferred her stay at Methodist to the large rehab hospital she went to when she had her first amputation. "The Methodist Rehab Unit is smaller so the patients could get to know and support one another," she said.