Comprehensive Rehabilitation

Comprehensive rehabilitation programs help people with disabilities, injuries or complex medical conditions achieve an improved quality of life. These programs take a holistic approach to recovery and are designed to improve physical function, increase independence, and promote mental, emotional and social well-being.

Many of those who benefit from comprehensive rehabilitation programs suffer from chronic illnesses, such as COPD or diabetes, or have recently spent time in the intensive care unit following a traumatic injury or major brain, heart, or lung condition.

Sometimes, when patients are medically stable and physically able to begin a rehabilitation program, they are transferred to a rehabilitation hospital where they receive intensive rehab therapy for several hours in a day. However, those who require continued acute care in addition to specialized rehabilitation, benefit from the more comprehensive programs provided in long-term acute care hospitals (LTACHs). In this environment, rehabilitation services are integrated with specialized acute care to help patients with medically complex conditions achieve the fullest and most complete recovery.

Traumatic events like a heart attack, stroke, or respiratory failure, or chronic issues like serious wounds can result in nerve, muscle, and tissue damage that makes it harder for patients to do things they used to do. They may need to relearn how to do seemingly simple things like swallowing, sitting up, talking, walking, and using the bathroom. Brain injury patients in particular may struggle to remember or understand things and may have difficulty processing emotions. Therapy can help increase exercise tolerance, decrease shortness of breath, enhance communication, and improve independence.  

Post-Intensive Care Syndrome (PICS) refers to a number of health disorders that occur after a patient has spent time in a critical care or intensive care facility. The most common physical impairment PICS patients experience is called ICU-acquired weakness (ICUAW). Patients who have been sedated for a long period of time are most likely to develop ICUAW. Other possible physical impairments include joint issues, nutritional complications, and airway or breathing problems, which may necessitate mechanical ventilation. ICU patients may also experience a number of cognitive issues, including difficulty with memory, attention span, mental processing, and problem solving. Mental health disorders are also considered a symptom of PICS. Anxiety, depression, delirium, post-traumatic stress disorder (PTSD), and delusional behavior are some of the most common examples. 

Patients with respiratory conditions will receive specialized therapy designed to help them breathe more easily and independently. Respiratory therapists manage ventilators, conduct breathing exercises, and help liberate patients from the ventilator when they are ready. 

After suffering from a serious illness, patients may need help moving and completing everyday activities. Physical therapists help patients regain mobility, which can look very different depending on the patient’s stage of recovery. Physical therapy might start with range-of-motion exercises or sitting at the edge of the bed and progress to walking down the hallway with little to no support. Occupational therapists work closely with physical therapists to help patients with daily tasks such as brushing hair, shaving, bathing, or putting on clothes. 

This rehabilitation helps patients with communicating, swallowing, and cognition after a traumatic event

When a patient is unable to speak, the speech-language pathologist (SLP) helps the patient with adaptive communication, including mouthing words, using yes/no questions, writing or using a communication board. When someone is able to start speaking, they help the patient make sounds again. SLPs, in coordination with respiratory therapists, are also in charge of placing a speaking valve when a tracheostomy tube is in use.

If a patient has a speaking valve in place, SLPs will run swallow tests with the patient, including water, ice, and food trials. If the patient does not have a speaking valve, they may help stimulate swallowing by placing cold instruments in the mouth. They will also coach the patient in swallowing exercises.

Finally, SLPS also help with cognition retraining, focusing on attention, memory, problem solving and executive function.