questions to consider when choosing

a rehabilitation facility

 

Choosing a rehabilitation center is very important. Not all rehabilitation centers have a spinal cord injury program. Do as much research as possible, and don't be afraid to ask questions.

 

Some general questions to help you find a rehab that best fits your specific needs:

  • Are the beds for people with SCI in the same area of the facility?

  • Are there people in the SCI program of the same age and sex as the person considering admission?

  • Do the people in the SCI program have similar levels and kinds of spinal cord injury e.g., quadriplegia, paraplegia, incomplete and complete?

  • What is the average number of people admitted annually to the SCI program? (program staff should treat people with SCI on a regular basis to acquire and maintain expertise.)

  • Is the SCI program accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)? Has it been designated as a Model Spinal Cord Injury Center by the National Institute of Disability Research and Rehabilitation (NIDRR)?

  • Is the SCI program part of a SCI rehabilitation system operated by the state?

  • Are there treatment specialists in the SCI program who speak the primary language of the individual seeking treatment?

  • Will the treatment team develop a rehabilitation plan with both short and long term goals?

  • Will an experienced case manager be assigned to help family members obtain medical payments and other benefits from public and private insurance? Will a team member be assigned to coordinate treatment and act as a contact for staff and family members?

Staffing/Rehabilitation Program Elements

  • Is the physician in charge a Physiatrist? If not, what credentials does he/she have? How long has the physician in charge been directing programs specializing in SCI? Is there physician coverage seven days a week? Twenty-four hours a day?

  • Do the regular nursing staff and other specialists responsible for providing treatment in the SCI program have specific training in treating SCI? Is the nursing staff employed by the hospital or employed through an outside agency?

  • Does the program ensure the availability of rehabilitation nursing and respiratory care on a twenty-four hour basis?

  • Are there consultants available at the facility or nearby medical centers? These should include neurosurgery, neurology, urology, orthopedics, plastic surgery, neuropsychology, internal medicine, gynecology, speech pathology, pulmonary medicine, general surgery and psychiatry.

  • How often and for how long each day will participants get treatment by specialists such as occupational and physical therapists? Treatment should be no less then three hours per day.

  • Are other specialties such as driver education, rehabilitation engineering, chaplaincy, and therapeutic recreation available if needed?

  • Are activities planned for SCI program participants on weekends and evenings?

  • How much time is spent teaching SCI program participants and their families about sexuality, bowel and bladder care, skin care and other essential self-care activities?

  • Does the SCI program offer training in the management and hiring of personal care assistants? If so, how much time is spent by staff on this topic?

SPECIAL PROGRAMS

 

Pediatric Programs

 

Because incidence rates of SCI among children are relatively low, rehabilitation hospitals and programs usually do not maintain a separate program or unit exclusively for children with SCI. As an alternative, caregivers may consider facilities/programs which place children with SCI in rehabilitation units with other children with chronic disabilities. Hopefully, this will provide families and children with opportunities to share common experiences and information with each other, and may lead to the development of support networks in the community.

 

It is possible that children may be placed in units with other children who are too ill for rehabilitation. Children generally derive greater benefit if they undergo rehabilitation with other children who are actively involved in the rehabilitation process.

  • Are the beds for children with spinal cord injuries in one area or in the same location as children with similar disabilities?

  • Are children of the same sex and similar age currently in the program/facility?

  • Is the physician in charge an individual with experience in rehabilitation? Does this physician have experience with children? If not, what are his/her qualifications? Do the other staff members specialize in pediatrics?

  • How many children with SCI does the program/facility admit on an annual basis?

  • Does the program/facility offer educational programs for children and young adults undergoing treatment? If not, does the facility coordinate tutoring programs with local schools? If so, who is responsible for payment?

  • Are there child life or therapeutic recreation specialists on staff? (Child life specialists develop programs for children and families which strive to maintain normal living patterns and minimize the clinical environment. Therapeutic recreation specialists focus on teaching persons with disabilities new leisure and sports skills to maximize their independence).

  • Are young siblings and friends allowed to visit the unit?

  • Does the program/facility offer adaptive technology to help children communicate and learn?

  • Is counseling available for siblings and families members?

  • Is the equipment used by therapists, appropriate for children?

  • Does the facility/program provide patient education materials for children and family members?

Ventilator Programs

  • Is the physician who directs the program a board certified Pulmonologist or a Physiatrist? Does he/she have experience with SCI? Are ventilator users treated on the same unit?

  • How long has the facility been providing treatment for ventilator users?

  • If the treatment team determines that an individual cannot breathe independently, what kind of services are offered to assist them in living as independently as possible?

  • Are people in the unit similar in age to the person considering admission?

  • Will they have the opportunity to meet ventilator users who have returned to the community and maximized their independence?

SPECIAL CONSIDERATIONS

 

Psychosocial/Counseling Services

  • What types and how many hours of psychosocial services are available? These should include peer support, individual and group psychotherapy, couples, vocational and substance abuse counseling? Does the facility offer sexuality and fertility counseling?

Facility Policies/Family Members

  • Do facility policies encourage family members including siblings regardless of age, to participate in rehabilitation programs? Are there living arrangements for family members participating in training? What other services, parking, meals and etc. are provided? Are counseling and other social services available to family members?

Discharge Planning

  • Are SCI program participants given educational self-care manuals when they are discharged?

  • Will staff members develop a formal discharge plan with program participants and their families?

  • Does the facility and discharge planner work with local Independent Living Centers? Do they incorporate referrals to these centers into their discharge planning? Is there an independent living unit available for program participants and families to practice self-care skills? Can family members stay there also?

  • If the facility does not have an independent living unit do they encourage overnight therapeutic leave prior to discharge?

  • Will someone be assigned as a liaison to provide follow-up services? Will a staff member visit or make arrangements for someone locally to evaluate the home for modifications?

  • Will the follow-up plan include:

  • Referral to an appropriate physician and other medical specialists in the community?

  • Regular follow-up visits with this physician or a spinal cord injury unit physician?

  • Regular urological evaluations?

  • Scheduled equipment evaluations?

  • If appropriate, a thorough vocational evaluation and referrals to a vocational rehabilitation program?

 

SCI-Info-Pages maintains a list of available rehabilitation centers in the United States. To go to the list please click here. Close the window to return to this page.

 

 

Source: Spinal Cord Injury Resource Center