Oh gosh, this is such a major problem! And if I knew how to fix it, I would be a wealthy woman! I experience this both as a clinician and as an advocate. A few strategies that are absolutely not fixes:
1. bundle needs as much as possible so there are fewer calls on the call light. I know it's not always possible! If possible, build ADL routines so they're more anticipated/scheduled and more efficient.
2. let the staff know they're appreciated, with words and maybe snacks. Let managers know who is excellent.
3. escalate as needed if/when there are safety concerns
4. aim for non-profit care centers whenever possible
Well, that's a few thoughts to start the conversation.
Ditto all of the above! Coming from a neuro rehab background, though w/ adults, I'll piggyback on Melina's comment «a setting that can support brain injury recovery and that there is a clear plan for reassessment if/when her level of responsiveness evolves.» Ensure that the receiving facility has a strong system in place for promoting normalized circadian rhythm, progression to up-time (can start with cardiac chair or even just the bed in «beach chair» position, progressing to a wheelchair with a good seating system when she's ready), pressure sore and contracture prevention (a great way for dad to feel involved and helpful), ongoing assessment by the therapy team, and of course reconsults along the way by PM+R regarding readiness for ARU. One angle that resonates with some families is something along these lines: ARU time is a precious and limited commodity. We want to ensure she uses that resource when she can most optimally benefit.
It's such a bummer that ARU time is now measured in weeks rather than months. :o(
I think you're in Cle Elum? I believe I've given your name to some folks who have contacted me from that side of the mountains. Yes, please reach out so we can be in more direct contact.
Hi everyone! I'm the founder of Seattle Patient Advocates. My practice centers on clinical navigation with a focus on facilitating more productive and satisfying out-patient care, and assisting clients through ER and hospital/SNF/rehab stays and discharges. I offer, and really enjoy, in-person advocacy in clinical settings. I am a physical therapist with a clinical background in neuro, trauma, geriatrics, and critical care.
1. bundle needs as much as possible so there are fewer calls on the call light. I know it's not always possible! If possible, build ADL routines so they're more anticipated/scheduled and more efficient.
2. let the staff know they're appreciated, with words and maybe snacks. Let managers know who is excellent.
3. escalate as needed if/when there are safety concerns
4. aim for non-profit care centers whenever possible
Well, that's a few thoughts to start the conversation.
Cheryl Kauffman, PT, BCPA
Seattle Patient Advocates
It's such a bummer that ARU time is now measured in weeks rather than months. :o(
Happy to answer additional questions!
Cheryl Kauffman, PT, BCPA
Seattle Patient Advocates