Pleasant Hope, MO
The physiatrist is the main medical doctor in rehabilitation. He/she is an M.D. (Medical Doctor) or D.O. (Doctor of Osteopathic Medicine) with a specialty in physical medicine and rehabilitation. The physiatrist will assess the patient at admission, treat medical problems, and maintain stable medical status. The physiatrist will direct the rehabilitation team, establish goals, and monitor the course of rehabilitation towards functional goals for discharge. He/she stays in contact with your other physician consultants to address special issues and keep them updated on rehabilitation progress. The physiatrist makes contact with all patients daily and meets with families, as needed, during the rehabilitation stay.
Neuropsychologists are clinical psychologists who specialize in studying brain behavior relationships.
The role of the neuropsychologist on the brain injury team includes three aspects, generally:
The neuropsychologist leads the team in addressing psychological changes following brain injury, and provides neuropsychological and other assessment services, which may include:
These services contribute to the process of informed clinical decision-making.
Nursing staff provide comprehensive rehabilitation care 24 hours a day. Nursing staff work with the physician to provide medical care. Patients learn techniques in therapy and in the nursing unit. Nursing staff encourage the patient to use techniques learned in therapy. They also will encourage patients to do as much of their own care as functionally possible, since the goal is to teach independence and challenge each patient to achieve their maximum potential.
The speech-language pathologist is concerned with the brain injured patient’s speech, language, cognitive, pragmatic and swallowing abilities. The speech process may be affected due to weakness/ paralysis and/or in coordination of the speech musculature. The brain injured patient may show difficulty in many areas of expressive language (talking, naming, and writing) and receptive language (understanding and reading). Closely related to communication is cognitive functioning. This has to do with an individual’s ability to attend to their surroundings, use memory skills, organize their thoughts, reason/problem-solve through situations, and show good judgment. It is also the role of the speech-language pathologist to assess the function of the patient’s swallowing to ensure the patient is eating/drinking the appropriate diet consistency safely. Speech-language pathologists provide swallowing therapy, as needed.
The role of the occupational therapist with the brain injured patient is to help them regain the skills needed to perform everyday functional activities. During the early stages of the patient’s therapy program, the therapist may provide daily orientation and sensory stimulation to facilitate appropriate responses. Physical limitations such as decreased head control and imbalanced muscle tone may require the fabrication of adaptive equipment (such as splints and head control bands) designed to improve such deficits that inhibit a person’s performance in tasks. As the patient’s responsiveness increases, follow-through with functional tasks (such as, car/toilet/tub transfers with equipment assessment), plus participation in self-care (such as, feeding, bathing, dressing), will become the treatment emphasis. Often the building blocks of these tasks, such as visual perceptual abilities, problem-solving, orientation, memory and motor planning must be addressed. Activities related to independent functioning such as cooking, household, and job-related tasks also are emphasized.
The role of the physical therapist in the treatment of a person with brain injury is to address overall mobility. Specific areas that are important for mobility are muscle strength, muscle tone, balance and range of motion, all combined with cognition. The types of mobility range from movement within the bed, to moving/transferring from one surface to another, to walking. The physical therapist assesses the areas mentioned above on each individual patient and works with them to establish individualized goals. The physical therapist then uses various treatments such as vestibular rehab, electrical stimulation and body weight supported gait training to maximize functional mobility.
The role of the dietitian is integral to the care of brain injury patients and relies heavily on the coordination with all team members. Because brain injury patients are often dependent upon the total provision of nutrients through tube feedings, the patient is nutritionally assessed to determine caloric needs and method of feeding. Constant monitoring is performed to evaluate tolerance, and recommendations are made for any necessary progression or changes. As the patient’s awareness level and physical ability increases, oral intake usually progresses and is monitored until the patient is safe and independent in self feeding. The rate of progress each patient makes is individual. A great deal of stimulation and encouragement is provided. Communication between all team members is essential in assuring the nutritional adequacy and the rate of progress made.
The case manager serves as a primary contact for the patient and family. He/she is a professional whose role on the team is to direct the patient’s rehabilitation and coordinate with everyone involved in the patient’s care. In addition, the case manager communicates updates to insurance companies, and identifies available resources for post discharge care. The case manager coordinates communication between the team and the family regarding patient goals, progress, expected length of stay, and discharge plans.
Respiratory therapy may be a service provided, depending on the needs of the patient. A respiratory therapist specializes in airway care and breathing and is involved when the individual has the need for oxygen, has a tracheostomy, or has other breathing problems that necessitate specific respiratory treatments. Different methods of treatment can deliver medicine or humidity to the lungs to restore a patient’s cough and keep their airway clear of secretions. It is important to maintain adequate breathing to prevent pneumonia and keep the lungs strong to maintain sufficient oxygen supply to the body.