Barrow Neurorehabilitative Services' interdisciplinary team of specialists is led by physicians who specialize in physical medicine and rehabilitation and consists of rehabilitation nurses; social workers; case management professionals; physical, occupational, speech, and recreational therapists; and neuropsychologists. Spiritual services also are available as part of the rehabilitation process. An interdisciplinary team of licensed professionals guides patients and their families through a comprehensive treatment program. From admission through discharge, patients are closely monitored and assigned a case manager or social worker who acts as a liaison to patients, families, support groups, and funding sources.
Team members work closely with other experts and with support professionals to help patients to achieve successful outcomes.
Social work service/Nurse case management
Social workers and nurse case managers provide the rehabilitation team with psychosocial information about patients and their families to assist with treatment and discharge planning. They help patients and their families to accept and adjust to the effects of their illness or injury through education and emotional support.
Social workers and nurse case managers are the link among patient, attending physician, and rehabilitation team. They help the patient and the rehabilitation team to understand each other's opinions, needs, and concerns. They also help plan the patient's care, treatment, and continued rehabilitation after discharge from Barrow. In this process it is often necessary to confer and negotiate with insurance carriers regarding posthospital rehabilitation treatment, equipment, and programs that patients may need. They also advise patients of community resources to help them further improve or maintain the level of functioning that they achieved while at Barrow.
Clinical neuropsychologists are knowledgeable about how brain injury affects psychological functioning, including both cognitive function and patients' emotional state and personality. After an injury to the brain, many changes occur that influence thinking, memory, emotions, and behavior. If these changes are not addressed, patients will have difficulty in regaining a normal lifestyle, perhaps even more so than with a physical difficulty. These cognitive, emotional, and personality problems are complex and difficult to understand and measure. They are even more difficult to treat or manage appropriately.
Clinical neuropsychologists evaluate patients' cognitive and behavioral changes related to their brain injuries, help patients and families understand and cope with these changes, and work with other team members in management and discharge planning.
The physical therapist's primary goal is to help patients increase their ability to move about purposefully in their environment. To achieve that goal, they evaluate the patients' needs and help design a program along with other team members to meet those needs. The goal of the program is to help patients become more independent in activities such as getting in and out of bed, operating a wheelchair, and walking. Physical therapists assist patients with exercises that focus on improving patients' body mechanics, flexibility, balance, coordination, strength and endurance. They help patients with training in walking and mobility in the community, wheelchair training, home-exercise programs, and injury-prevention education. They also direct activities such as exercise and casting to keep joints flexible and sensorimotor stimulation to provide patients with normal sensations and normal movements. This stimulation enables the brain to receive information and interpret it so that patients are able to redevelop muscle tone, strength, balance, and coordination.
Occupational therapists assist patients in restoring their ability to participate in the activities of daily living such as hygiene, grooming, dressing, eating, and bathing. They evaluate and help develop the many skills patients need to function in their daily life.
Occupational therapists are also specifically concerned with patients' ability to use their arms and hands. Patients are taught exercises to increase muscle tone, strength, and coordination to improve the function of their arms and hands.
Occupational therapists work with patients while they perform self-care tasks so that the therapists can help patients apply what they are learning to practical, everyday activities and to gauge their progress toward independence.
Speech pathologists help patients improve their communication skills, cognitive functioning, and swallowing abilities. They help patients work on their ability to speak, to understand speech, and to read and write. Material may be used to develop patients' attention, concentration, memory, ability to plan and to organize thoughts, and their ability to improve problem solving, reasoning, and judgment skills.
On admission to the rehabilitation program, patients may be evaluated by a speech-language pathologist to determine whether they have communication, cognitive, or swallowing problems. Patients' hearing may be screened to see whether they need further evaluation by an audiologist.
After the evaluation, the speech pathologist develops an individual treatment program to address the specific needs of patients. A program may consist of individual or group therapy sessions, or both. The length and number of sessions vary according to each patient's needs. Family members are encouraged to attend these sessions so that they may receive information and counseling to help them assist with the patient's communication, cognitive, and swallowing needs.
By guiding patients' awareness of the benefits of leisure pursuits, recreational therapists play an important role in helping to ensure a high quality of life for patients after they leave the hospital. They also help patients to learn how to take advantage of the many personal and community opportunities available.
During therapeutic community outings, recreation therapists introduce patients to their first contact with the "outside world." This process allows patients to apply the skills that they have learned from physical, occupational, and speech therapies to real-world situations before they are discharged. Going to a restaurant or a movie theater is a fun break from the hard work involved in the rehabilitation program. However, it also gives patients a chance to practice mobility skills and creative problem solving, to mingle in public, and to develop healthy attitudes so that they have fewer problems later.
Dietitians evaluate the nutritional needs of patients, provide optimal nutritional support during their stay, and instruct patients and their families on their dietary needs before discharge.
While patients are in the hospital, dietitians evaluate and monitor their nutritional progress including tolerance of tube feeding, oral intake, weekly weights, and pertinent laboratory values. Dietitians routinely communicate with patients, their families, and team members regarding nutritional management. If patients have special dietary needs after returning home, continuing dietetic services may be provided through a home-health agency, an outpatient facility, or other community resources.
For more information, please call 1-800-BARROW1 (227-7691) or 602-406-6281.