West Florida Hospital

The Rehabilitation Institute
(850) 494-6100

OUR SPECIALIZED PROGRAMS

Brain Injury Program:

Each year 500,000 individuals sustain head injuries which require extended hospitalization. Of this group, approximately 50,000 to 90,000 experience residual cognitive and physical deficits that prevent the patient from returning to a normal lifestyle. The Brain Injury Program at The Rehabilitation Institute provides a comprehensive plan of services for these patients and their families.

The Brain Injury Program is designed to administer treatment to head injured patients at levels three and higher as measured by the Ranchos Los Amigos Cognitive Functioning Scale. A team of rehabilitation experts works with each patient throughout evaluation and treatment. Brain injured patients reside in a separate wing on the rehabilitation nursing unit. Each day begins with a feeding and dressing skills program. Team members also work with each patient in various therapies and activities including ambulation, visual perception training, cognitive retraining, and recreational activities. Most activities take place in the treatment area which enables the team to work with each patient in a quiet, non-distracting atmosphere. Brain injury rehabilitation programs include physical therapy, occupational therapy, speech-language pathology, social work/case management, rehabilitation nursing, therapeutic recreation, adaptive aquatics, pulmonary rehabilitation, neuropsychological assessment, psychological counseling, and vocational rehabilitation.

COMPONENTS OF BRAIN INJURY PROGRAM:

Community Reorientation Therapy
Home visits are part of the overall program to assist in the gradual transition from The Rehabilitation Institute to home and community. In addition, supervised outings are planned on a weekly basis for brain injured patients to further assist reorientation to the community.
Education/Support Groups
Recognizing the impact of a brain injury on the entire family, monthly educational/support groups for families are provided to increase the family's level of understanding about the long-term impact of a brain injury and to teach appropriate management skills. These groups also provide an opportunity for individuals to share experiences, concerns, and coping methods.
Cognitive Retraining
Cognitive deficits resulting from brain injuries are what really make a separate program necessary. An individualized, systematic, goal-oriented treatment plan is designed with primary emphasis placed on evaluation and remediation of cognitive deficits. Evaluation and treatment is an ongoing process, updated weekly to ensure appropriate focus on skills such as attention, memory, sequencing, reasoning and problem solving. The cognitive retraining program incorporates techniques compiled from several different brain injury programs and individually modified to meet the special needs of each patient.
Neuropsychological/Psychological Services
A neuropsychologist is a psychologist (doctoral level) with specialized training in how the brain functions to produce thought (cognition), emotions and behavior. The neuropsychologist provides an assessment of the changes that occur in these areas after traumatic injury or illness to the brain. Information regarding these changes is provided to the patient, the family, the rehabilitation team, and the physicians. The neuropsychologist also provides cognitive and behavioral retraining for the patients, as well as psychological support for the patient and family. Psychologists and pediatric specialists are available to provide supportive counseling for all patients who experience difficulties adjusting to the life changes associated with the rehabilitative process.
Vocational Rehabilitation
When indicated, vocational evaluation, counseling and retraining are provided in conjunction with the Brain Injury Program through contractual agreements with area services. When one recognizes that fewer than nine percent of severely head injured persons return to gainful employment, it is clear that returning brain injured patients to productivity is a significant undertaking with dramatic economic and social impact. The role of vocational services is to act in concert with the entire rehabilitation team in order to promote functional independence.
Educational Services
Tutoring and/or homebound instruction is arranged through the local school system for school-age patients at the elementary and secondary levels. The Rehabilitation Institute provides follow-up care and outpatient services.

Stroke Program:

An early program of rehabilitation enhances the stroke patient's quality of life. The Rehabilitation Institute has a comprehensive rehabilitation program designed to maximize the patient and family's recovery from the stroke.

The purpose of rehabilitation is to assist each individual to achieve a maximum level of independence. An individualized rehabilitation plan is developed by a multidisciplinary team and, most importantly, the patient and the family. There is a strong educational component to the program so that individuals and families learn not only "how to," but also "why."

For both the stroke patient and family, rehabilitation is a process of learning and relearning what is needed to adjust to new limitations. The period of rehabilitation will vary with each individual, but the goal is to help each person make the greatest possible recovery. The rehabilitation process is carried out by a team of professionals who will work closely with the patient and family to make the social, psychological and physical adjustments to a stroke.

Because the degree of disabling complications following stroke varies widely, the stroke rehabilitation program is flexible and individualized to meet the special needs of each patient. Physicians and therapists evaluate the patient, and together with the patient's family, individualized goals and a plan of treatment are established.

Program components may include:

Physical Therapy
Social Work/Case Management
Occupational Therapy
Pulmonary Rehabilitation
Rehabilitation Nursing
Vocational Rehabilitation
Psychological Counseling
Neuropsychological Assessment
Speech-Language Pathology

As the patient progresses in these areas, the ability to apply these skills in the community will be practiced. Regular team conferences assure that a coordinated approach is taken with the patient's program. Recovering from a stroke often means learning how to do things in a new way, both for the patient and the family. Education is therefore an important aspect of our program. Families and patients participate in both group and individual training sessions with various members of the rehabilitation team. Therapy is provided to increase independence in mobility, hygiene, dressing, grooming, bowel and bladder management, skin care, homemaking, driving, language and communication skills, and problem solving and coping skills. Vocational counseling and evaluations are also available for those considering returning to work.

COMPONENTS OF STROKE PROGRAM:

Dysphagia Evaluation and Treatment
For patients with dysphagia (difficulty swallowing), our physicians, speech therapists, nurses and nutritional support team work closely with the patient to improve swallowing ability while monitoring nutritional needs. Videofluoroscopy may be used as indicated to assess the extent of the swallowing disorder and to monitor progress as indicated. In addition, if a stroke patient needs more intensive nursing care, a special program provides therapies on a shorter-time, more-frequent schedule.

Community Reintegration
Outings and home visits by the patient care planned to assist in the gradual transition from the hospital to the home and community.

Education
Covers a wide range of topics and is provided to increase the level of understanding about the consequences of stroke.

Psychological Counseling
The Psychology Department provids comprehensive services to assist in the recovery of both patient and family. Services may include individual, group, and family counseling.

Support Groups
Recognizing the impact of a stroke on an individual and the family, support groups are provided to assist with coping mechanisms. These services also provide an opportunity for individuals to share experiences with common concerns.

Follow-Up Care
The Rehabilitation Institute provides follow-up care and outpatient services as needed.

Spinal Cord Injury Program:

Spinal cord injury is a catastrophic event with physical, emotional, and financial consequences for not only the patient but family members as well. One of the first state-designated Spinal Cord Injury Rehabilitation Centers, The Rehabilitation Institute provides comprehensive services for the spinal cord injured individual and family.

The purpose of spinal cord injury rehabilitation is to help each patient achieve the maximum level of independence. Functional goals that may be addressed include mobility, daily living activities (dressing, eating, hygiene), bowel/bladder management, home management, etc. An individualized rehabilitation plan is developed by an interdisciplinary team for both patient and family. There is a strong educational component to the program so that individuals and families learn not only "how to," but also "why." Some of the program components assisting in the progress of the patient include:

Indoor pool - Heated and equipped with a hydraulic chair lift, the pool is available for adaptive aquatics and therapeutic recreation activities.

Fully Equipped Exercise Clinic - Individual activities are provided based on the patient's needs.

Driving Program - A major goal for many spinal cord injured individuals is to achieve independence in transportation. Driver training and consultations for car or van adaption are available.

Pulmonary Rehabilitation - A comprehensive pulmonary therapy program is provided which includes an extensive pulmonary evaluation and ongoing therapy in the fully-equipped Pulmonary Lab. Special techniques are used to help strengthen the muscles necessary for optimal breathing capacity and prevention of complications related to the respiratory system.

Sexual Counseling - Sexuality is dealt with individually and in group session programs available to both patients and their partners.

Educational Services - Tutoring and/or homebound instruction is arranged through the local school system for school-age patients at the elementary and secondary levels. The Rehabilitation Institute provides follow-up care and outpatient services.

Community Reintegration - Outings and home visits by the patient are planned to assist in the gradual transition from the hospital to the home and community.

Patient and Family Education - Covers a wide range of topics and is provided to increase the level of understanding about the consequences of spinal cord injury.

Vocational Rehabilitation - A counselor is available to provide work evaluations, vocational counseling, and job placement services.

Psychological Counseling - The Psychology Department provides comprehensive services to assist in the recovery of both patient and family. Services include individual, group, and family counseling.

Peer Counseling/Support Groups - Recognizing the impact of a spinal cord injury on an individual, peer counseling and support groups are provided to assist with coping mechanisms. These services also provide an opportunity for individuals to share experiences and common concerns.

Follow-Up Care - The Rehabilitation Institute provides follow-up care and outpatient services as needed.