The care a patient receives in Madonna's Rehabilitation Day Program (RDP) is individualized and follows an interdisciplinary care plan.
Pre-Admission: Most patients come to RDP from within Madonna's system. In that case, the OP Nurse visits with the patient and family while on inpatient to explain what to expect and answer any questions. About 35% of RDP patients come from an acute care hospital or other provider. In that case, typically the case manager or social worker from the acute care hospital contactsthe OP Nurse to make the referral. Patients are then scheduled for the first day, which is made up of comprehensive assessments.
First Day: The first day in RDP is focused on assessment and treatment planning. A family member is required to be present this first day so they may meet the team and have input into the goals, needs, and scheduling preferences. The day starts with OP Admissions, where all of the necessary registration materials are verified and signed. Depending upon each patient’s specific needs and physician orders, he/she will meet with a registered nurse, physical therapist, occupational therapist, speech-language pathologist, therapeutic recreation specialist, neuropsychologist, and social worker. These professionals will take physical tests and measurements and solicit input regarding those things that are most important to the patient and family member. Each session is 30-60 minutes long. In between, if necessary, a rest break may be scheduled as well as a lunch break. Before the patient leaves, they will receive a schedule of appointments for the remainder of the week, have an idea of the main goals that will be worked on, and will know approximate length of stay in RDP.
Subsequent Days: Once the evaluations are completed, a schedule is determined based upon the individual patient's needs, insurance benefits, and preferences of the patient and family. Lockers are provided for personal items. Throughout the day, patients are involved in both individual and group therapies as necessary. Therapies generally occur in the gym area, Independence Square, Therapeutic Pool, ADL Suite/Kitchen, Vision Clinic or out in the community depending upon specific needs. Our school and college-aged patients may spend a few hours in the Therapeutic Learning Center. Recliner chairs are provided in the RDP lounge, should a rest period be necessary. Lunch break happens over the noon hour. Patients can buy lunch in the cafeteria or bring something from home. A refrigerator and microwave are available in the RDP lounge area. After lunch, therapy resumes. The OP Nurse is available to perform skilled procedures such as intermittent catheterization, wound care, monitoring of blood pressure or lab work as ordered by a physician. The nurse is available to answer questions or provide education and will facilitate an appointment with one of Madonna's rehabiltition physicians if necessary during the patient's stay.
Activities/Groups: Weekly there are other activities or groups that patients may be involved in, as appropriate. These include:
Opportunities to participate in Adaptive Sports & Recreation outings such as golf, tennis, bowling, billiards, or fishing.
Several group sessions are available on various topics of interest, such as support groups, adjustment, self-advocacy, leisure education, and holistic approaches including massage, aroma therapy, and other topics.
Independent Living Skills group, which involves hands-on community based activities aimed toward regaining skills necessary for living independently such as grocery shopping, meal preparation, path finding, money management and accessing community transportation.
Vocation Rehabilitation, where a Rehabilitation Counselor from the Nebraska Department of Vocational Rehabilitation comes to Madonna to begin the process of transitioning back to work or school. (There are also opportunities to simulate work activities within Madonna's Work Re-entry program for those with goals to return to work.)
End of the Day: It is not unusual for the therapists in RDP to ask patients to practice specific things at home during the evenings. This "homework" is very important for reinforcing new techniques learned in therapy. Feedback to the therapists regarding how the task went at home will also help guide future treatment.
Communication: Each week the RDP treatment team meets to discuss each patient's progress, plans and goals. One team member, assigned as the patient's Primary Therapist, will meet with the patient before the team meeting to solicit input. Care plans are updated every other week and then after the meeting the social worker will relay what was discussed. Additionally, a family conference will be held prior to discharge from RDP.