The care a patient receives on Madonna's LTACH unit is very individualized, according to an interdisciplinary care plan. However, there are some basic things a person might expect during their stay.
Physician Visits: The morning is a busy time with visits from one of the three Internal Medicine physicians who provide primary care for patients on the unit as well as any number of other physicians who specialize in pulmonary, wound, physiatry, or other clinical areas.
Personal Care: Performing as much of one's own self-care (bathing, dressing, grooming) as possible is one way our patients gain the necessary skills and strength to return home. An Occupational Therapist will teach adaptive way of doing these tasks, often using special equipment, which are then reinforced by the nursing staff. Patients are encouraged to get dressed and actively engage in therapies as well as meals outside their room if able.
Clinical Procedures: Throughout the day, registered nurses and other specialized clinical staff, such as respiratory therapists, will provide highly technical clinical care such as changing wound dressings, monitoring of vital body functions, managing oxygen needs, providing technical support for patients on ventilators or who have tracheostomy tubes, developing and teaching bowel and bladder programs, and delivering necessary medications and nutrition supplements.
Rehabilitation: Most patients on LTACH will receive some combination of physical therapy, occupational therapy, speech-language pathology, and/or neuropsychology services. Many patients may begin by receiving therapy in their room, but eventually most will get out of bed and travel to a small therapy area on the unit to use specialized equipment, or to the larger gym on the first floor. Therapy is scheduled in half-hour increments, and focuses on strengthening, mobility, communication, and functional skills. A person can expect to receive 1-2 hours of therapy each weekday, depending upon their individual needs.
Education & Training: A very important part of rehabilitation involves the patient and/or their family members or other caregivers learning about the person's condition and care needs. This is done throughout the day in a variety of ways. CARES (Cardiac) patients attend a group education class that is lead by various clinicians each day and covers a variety of topics. Therapists teach adaptive techniques and how to use different pieces of equipment to help with self-care or other functional tasks. Nursing staff teach patients and their family members about their medications and management of other health conditions. A Nutrition Therapist may teach a special diet, a Neuropsychologist may teach some techniques for coping, or a Respiratory Therapist might teach how to manage oxygen.
Case Management: Each patient has an assigned case manager and social worker, who coordinate the treatment plan, help drive discharge planning, and provide education regarding community resources. Each day the team meets to discuss patient's individual progress, adjusting the plan as needed. The case manager or social worker shares information discussed at the meetings with each patient and/or family member, and solicits their feedback.
Meals: Patients may choose to eat in their rooms or out in the common area, where they may interact with others.