Traumatic Injury and Illness
By Andrew Morpurgo, MD
If you are recovering from
hip replacement surgery, stroke, or a traumatic injury or illness, your doctor
may prescribe rehabilitative therapy. There are four settings in which rehabilitation
happens: at the physical therapist’s office; in your home, through visiting
nurse services; in a nursing home; and in the hospital. Of the four options,
the inpatient hospital rehabilitation setting is the most intensive.
does admission to inpatient rehabilitation work?
There are guidelines
governing who can be admitted to an inpatient rehabilitation unit. These rules
are in place to identify patients who are physically able to work at intensive
rehabilitative therapy following a life-changing event such as a motor vehicle
accident, hip fracture, or stroke. These guidelines have been codified by the
health insurance industry because health insurance providers cover the cost of
happens in the inpatient setting?
The goal of therapy is to
return people to their homes as quickly as possible. In order to accomplish
this goal, the inpatient physical medical rehabilitation unit (PMRU) has a team
of specialized care providers. The team is led by a physiatrist, which is a doctor
who specializes in rehabilitation (also known as physical medicine). The team
includes physical therapists, occupational therapists, speech and language
pathologists, recreational therapists, social workers, and other specialists as
we need them. Registered nurses in PMRU are attuned to the problems that arise
with life-changing events relating to mobility, pain control, skin care, and
bowel and bladder function.
The PMRU team meets weekly
to set goals for each patient, to discuss their progress, and to determine when
they are ready to go home. Patients on the PMR unit dress in
street clothes and work intensively with a therapist in each of the
The physical therapist
helps the patient with mobility issues: walking, getting around in a
wheelchair, getting in and out of bed, and assessing the proper equipment to
accomplish these goals. The occupational therapist deals with self-care, such
as bathing, teeth brushing, toileting, and eating. Patients with a neurological
deficit from stroke or trauma will work with a speech-language pathologist to
recover language and speech capabilities and to learn how to swallow safely if
that has been impaired. A recreational therapist helps patients discover
avocational interests, new ways to spend their time now that their lives are
changed. Social workers coordinate discharge planning and counsel patients
about difficult life adjustments.
is the effectiveness of inpatient rehabilitation measured?
rehabilitation units must submit data on every patient to a national
organization that monitors how patients function at the time of admission and
the time of discharge. This database also takes into consideration the impact
of co-morbidities, which are medical conditions a patient may have that are
unrelated to their admission for rehabilitation.
does Cayuga Medical Center measure up?
For three years running
Cayuga Medical Center has ranked above the 90th percentile and has
received the Top Performer Award for Medical Rehabilitation from the Uniform
Data System. Our PMRU is evaluated along with 800 other facilities that are
included in this national database.
I am initially hospitalized elsewhere, can I be transferred to Cayuga Medical
Center for inpatient rehabilitation?
Yes, you can request to be
transferred to Cayuga Medical Center. Many patients choose to recover here, so
we have made the transfer process into our facility as easy as possible. Having
local family and friends nearby to help you and cheer you on through recovery
can make a big difference.
Morpurgo is board certified in physical medicine and rehabilitation. He has
been the medical director of the PMRU at Cayuga Medical Center since 1996.