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more articles by Morpurgo, Andrew , MD  |  author's bio

Recovering from Traumatic Injury and Illness

Recovering from 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.


How 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 inpatient care.


What 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 rehabilitative disciplines.


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.


How is the effectiveness of inpatient rehabilitation measured?


All inpatient 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.


How 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.


If 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.


Dr. Morpurgo is board certified in physical medicine and rehabilitation. He has been the medical director of the PMRU at Cayuga Medical Center since 1996.



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