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Acute and Subacute Rehabilitation

By NED HAGGARD
SENIOR LIVING

Acute and Subacute Rehabilitation

Her hand was recycling a motion of reaching for the arm of her chair without gripping it. That was how I found my mother the day she suffered her stroke. She died two weeks later. I don’t know whether a watchful, medically aware retirement residence or nursing home would have prevented mom's stroke via pre-emptive medical intervention or not. I never will know but I do know that both, along with acute and/or sub-acute rehabilitation, have helped many an older person to live longer and better lives. Mom’s unexpected stroke had been too severe for survival but it is possible, with a different environment and monitoring, that she might have avoided her fate or postponed it.
  
In the Chicagoland metropolitan community, as elsewhere, there are a number of exceptional living environments—permanent and temporary—with health care options available. They run a gamut of services, and cover a range of fees, some at least partially covered by medical and long-term care insurances, of various stripes and character including Medicare that benefit seniors, affording them greater independence with enhanced health security.
   
Acute rehabilitation is an intensive physical therapy intervention that serves the purpose of improving more commonplace  age-related restrictions like, but not limited, to sitting up easily or overcoming pain that is not, in itself, the product of exceptional trauma. In the case of a stroke, rehabilitation usually starts a day or two after the stroke, using carefully-directed repetive movements, usually aided by a therapist. By practicing repetitive movements, the patient can learn skills, eventually performing progressive and complex tasks.
   
According to the NIH, stroke rehabilitation, including using a body-weight-supported treadmill with a physical therapist can result in a significant improvement in walking and quality of life, even after a year. In fact, in a recent study, 52 percent of patients improved after rehabilitation, even after a year. It is important to have access to a skilled therapist or nursing facility that has full-time physician supervision, devoting 3 hours of active therapy 5 or 6 days a week to optimally benefit from rehabilitation from a stroke. Acute physical therapy is also sometimes used simply to improve stamina.
   
Under some conditions, the acute and subacute are combined to further the development of abilities; for example, a patient who has undergone the more rigorous acute therapy may begin the less rigorous subacute rehabilitation to further finesse their rehabilitation once the greater issue has been substantially addressed. Sometimes rehabilitation can be an ongoing process that requires working with specialists for months or even years after the stroke.

Rehabilitation is often required if a senior breaks a hip or another weight-bearing bone. The rehabilitation team’s priority following surgery is to get the patient moving within 24 hours. Therapy usually consists of strengthening exercises, focusing on techniques for everyday living such as bathing, cooking and dressing..The fracture can be strengthened by bisphosphonates—medications that can prevent the occurance of a second hip fracture. Physical therapists sometimes recommend use of a walker or wheelchair.
  
While the specifics vary from senior facility to facility, terms like “assisted” and “skilled” often incorporate physical therapy services that help patients improve, continue or regain function. Subacute rehabilitation is less demanding physical therapy than acute physical therapy which is often employed with patients following a serious illness or event like a stroke. The purpose, of course, being greater improvement in their recovery than they would likely realize otherwise.
 
Among the most popular facilities covering the suburban outer ring to downtown Chicago is Presbyterian Homes (presbyterianhomes.org). All of their retirement communities have earned accreditation by CARF; four of their fourteen continuing care retirement communities are accredited in  the state of Illinois. Taking a holistic approach that respects and encourages the independence of residents, three in Evanston, one in Arlington Heights and the fifth in Lake Forest, offer a varying array of services covering Independent Living,  Assisted Living, Skilled Nursing Care and Specialized Memory Care.
   
Located in Evanston and servicing the North Shore, the McGaw Care Center (seniorcareanswerteam.org) has a notable short-term and long-term rehabilitation center, Westminster Place. Affiliated with Presbyterian Homes, independence is their ongoing goal. Among the services they provide, is temporary care for patients who have opted for joint replacement and do follow-up rehab at the McGaw Care Center two days following their surgery, returning home within a couple of weeks. Their Kimble Fitness and Therapeutic Center also offers a range of interventions.

One of the most extensive rehabilitation health systems is the Marionjoy Rehabilitation Hospital located in Wheaton (marianjoy.org). Their extensive services cover hospital inpatient, subacute, day rehabilitation, outpatient services and physician clinics. Their programs are offered at the hospital and satellite centers located throughout the Chicagoland suburbs.
   
Emeritus Senior Living’s Illinois assisted living and retirement communities (emeritus.com) provide a range of services located in Burr Ridge, Hoffman Estates, Joliet, Orland Park and Prospect Heights. Those services embrace senior rehabilitation services, including physical therapy,  occupational therapy and speech therapy. The services provided vary from location to location.
    
Lutheran Social Services of Illinois’ St. Matthew Center for Health in Park Ridge (matthewcenter.org) provides orthopedic and stroke/cardiovascular rehabilitation. Clinical teams work with patients and families for the speediest recovery feasible. Staff therapists often provide safety recommendations, services and equipment before a patient's discharge.
   
Chicagoland Methodist Senior Services (cmsschicago.org) is one of Chicago's oldest nonprofits.  An accredited service,  it offers rehabilitative and subacute care, skilled memory support, memory support assisted living, supportive living, home care, home maintenance, computer services and low-income housing services for seniors. Their Wesley Place Rehab is dedicated to providing goal-oriented therapy and nursing care. Their expertise includes orthopedic, neurologic and general medical rehab. Their programs were created` in collaboration with well-known surgeons, setting a high standard of superior care.
   
Belmont Village (belmontvillage.com)  offers a wide range of services in its four Chicago-area senior homes in Glenview, Buffalo Grove, Oak Park and Geneva. They have Parkinson’s exercise classes and congestive heart failure exercise groups. Therapy services are available onsite, and licensed nurses communicate with doctors to manage rehabilitation and recovery after a health crisis.
   
Mather Lifeways (matherpavilion. com) in Evanston provides a wide range of senior services in a beautiful setting. If functional independence becomes a concern or has been decreased due to illness or surgery, they provide one-on-one physical, occupational, and speech therapy to help residents attain their individual goals. Individualized care is provided by attentive professional therapists.

The Admiral at the Lake (admiral. kendal.org), is a Kendal affiliate. The Harbors at the Admiral has a dedicated team of physical, occupational and speech therapists who work with patients and their medical teams to create short-term rehabilitation programs geared toward regaining skills and independence as quickly as possible. The Harbors is Medicare-certified for residents who need short-term rehabilitation.
   
Lexington Square senior residences in Elmhurst (lexingtonsquares.com) offers cardiac, pulmonary, orthopedic rehabilitation as well as wound care. They offer licensed physical and occupational therapists and offer post-acute care including an on-staff board of nephrologists, cardiologists, physicians, nurse practitioners, and psychologists. Their goal is to help their seniors recover from surgery or illness as quickly as possible, offering the latest rehabilitation equipment and state-of-the-art therapy gyms.

Published: December 07, 2013
Issue: 2013 Philanthropy Guide