The care a patient receives on Madonna's ARU is very individualized, following an interdisciplinary care plan. However, there are some basic things a person might expect during their stay.
The Nurse Therapist and Physiatrist visit the patient each day to see how he or she is feeling, discuss the progress being made, any concerns the patient has, and any adjustments to medical or rehabilitation interventions necessary. Physicians and other clinicians from various specialties, such as pulmonary, wound, or internal medicine areas, may also visit the patient to make their assessments and recommendations.
7 am - wake up time! Patients are encouraged to do as much of their own self-care as possible, as this is one way to gain the necessary skills and strength to return home. Occupational therapists teach different ways to do things, using adaptive equipment and then the nursing staff reinforces. Patients may wear their own clothing or use Madonna sweatpants and shirts provided at no cost. The morning is a busy time, filled with bathing, dressing, nursing care and eating breakfast.
9 am to 12 noon - Patients are encouraged to get dressed and actively engage in therapies, as well as other activities outside their rooms as much as possible. Whenever possible, patients are transported to the large treatment space on the main level. Here, they have individual and group sessions with physical, occupational, and/or speech therapy scheduled in half-hour segments. Other sessions might involve the neuropsychologist, recreation therapist, nutrition therapist, or other members of the rehabilitation team. Family members are always welcome to participate. Skilled nursing procedures, such as dressing changes, bowel and/or bladder training, and medication management will occur in between therapy sessions as necessary. Sometimes,a patient will have a scheduled rest break, depending upon their stamina and other medical needs.
12 to 1 pm - Lunch time. Some patients like to eat their lunch in a group setting, while others prefer the quiet of their room. A special therapy group is also available for those patients who have difficulty with swallowing. In this group, a speech therapist and occupational therapist teach adaptive techniques for swallowing and feeding. As patients gain more independence, they may graduate to "Independent Dining," which means they may go to the Madonna cafe and select from a wide menu of food.
1 to 4 pm - In addition to individual and group therapies described above, patients may be involved in group education classes. Whether it is learning about the signs and symptoms of autonomic dysreflexia in the SCI education group or how to develop and maintain a portable health profile in the Stroke education group, patients and their family members are provided with a multitude of opportunities to learn about their condition and how to manage life in the future. The groups also provide valuable opportunities to interact with peers (people with similar types of conditions) to both give and receive support and encouragement, as well as to have social interaction. Therapy might also include a community outing, adaptive sports activity such as golf or tennis, or work in Madonna's training kitchen.
4 to 7 pm - Late afternoons are times for patients to visit with family and friends, rest, and eat dinner. Group recreational activities, such as a movie or cook-out are available on some evenings.
7 pm - The evening is a time for the nursing staff to reinforce many of the things that were taught during the day. Some patients prefer to have their bath in the evening and are encouraged to do as much for themselves as possible, using the adaptive techniques and equipment taught by the therapists. Others may use this time to catch up with family and friends via internet, videophone, telephone or in person. It is an important time for patients and those who support them to both share their successes and to discuss what's next.
Children and adolescents who receive inpatient rehabilitation at Madonna have a little different type of day, integrating those things that are important to their normal development.