Younker Rehabilitation

Full Kitchen

Our kitchen was designed to include all of the things found in a typical kitchen to allow our patients to practice homemaking in a real-world environment. The full kitchen has an oven, refrigerator, microwave, toaster, coffee pot and dishwasher.

• Occupational therapists will work with patients in the kitchen, practicing reaching into cupboards, maneuvering a walking device while transporting food, learning the use of one-handed techniques and working on safety while using a stove, oven or while cutting.  

• A patient may practice heating up a microwave meal to improve their ability to read and follow instructions. A patient may also plan a meal, make a shopping list, and prepare this meal to work on sequencing, problem-solving and other higher level thinking skills.  

• Speech therapy may use the kitchen to identify common items and how they are used.

• Physical therapy may lay out an outline of the barriers that may exist in a patient's own kitchen at home so that the patient can practice maneuvering around them during a functional task. They may also work with a patient to retrieve items from various heights to work on balance.

Laundry Room

There is a laundry room set up in the unit to work on the physical and cognitive skills required for this daily living task. The therapists may work together on the goals of:

• Balance and strength to stand while using the washer or transferring clothing to the dryer.
• Problem-solving skills to decide what needs to be washed and what settings to use.
• Memory and recall to remember to return to move laundry to the dryer or to retrieve laundry after finished.
• Use of adaptive equipment to assist if a patient is unable to stand or reach to access all items needed in the laundry room.

This apartment-like room allows patients and caregivers to practice the skills learned in therapies and with nursing in an environment similar to at home. While the patient and caregiver are encouraged to manage bathroom tasks, take him/herself to therapies, and practice medication management by calling staff when it is time for medications, the staff is always available to assist, if needed. This allows for a safe trial before going home to determine any possible situations which may occur when a patient is trying things on their own and/or allowing family members to practice being the caregiver before leaving the hospital.

Discharge can be a stressful time for patients and families, and the use of either the transition room or modified transition in the patient's hospital room can help to alleviate many of the worries that can occur.

The transition room features:

• Queen size bed
• Fridge for simple meal prep
• Table and chairs for family style meals
• Pull-out futon couch for family members or caregivers

In the therapy gym, we have a dedicated room set up like an apartment. It has a full size 'normal' bed, dresser, closet, functioning storm door, front door, window, couch, recliner chair and vacuum. These items allow therapy to practice in more standard environments tasks such as:

• Getting up from a fall
• Getting on and off a regular bed
• Making a regular bed
• Putting clothes away in a dresser or closet
• Vacuuming the floor
• Opening the front door
• Practicing entering over doorways
• Getting on and off a couch

After an injury or illness, families and patients may need to look at their home to determine if changes are required to make the space more accessible or safe. At Younker Rehabilitation, we know this can be a daunting task for a family who may not know where to start.

Our therapists work with patients and families to determine discharge plans, including adaptations required to allow the patient to return home. The therapist will ask families for pictures or descriptions of their home (number of floors, how many steps, etc.). A questionnaire has been put together by our therapists that helps families know what areas should be measured in the home. The family member then returns the questionnaire to therapy so that this information can be incorporated into the treatment plan. For example, therapists can set up a simulation of the patient's bathroom at home using the measurements provided in the questionnaire, allowing a patient to practice transfers as they would be done at home.

Additionally, this allows therapists and families to identify any changes or equipment that may make the patient's return to home more successful. Some modifications may include: grab bars, ramped entry, and shower chair/bench.

Our occupational therapy programs focus on techniques to become more independent with daily living tasks. This includes commercially available adaptive equipment or equipment fabricated for a specific person's needs.

Occupation therapists specialize in helping patients regain use of their arms and hands.

• Using equipment like the Deltoid Aide or the SaeboMAS allows the patient to work on strengthening and control of the arm even if they are not yet able to lift against gravity.
• Electrical stimulation may be used to strengthen a muscle contraction during neuromuscular training.
• We may fit patients with a lightly compressive glove, position the arm on an elevating arm rest or perform massage to reduce swelling in the hand.

After an injury to the brain or a stroke, an occupational therapist may screen the patient for visual and perceptual changes.

• We involve both the patient and their family in our visual assessments to help educate everyone about how to make the home environment easiest to navigate for the patient.
• We'll help to maximize vision, train the patient in methods to reduce the effect of a visual field cut or neglect or inattention to one side, and work toward restoration or compensation for visual/perceptual changes.
• We use a variety of assessments to look at your visual skills, like the Dynavision D2™. The Dynavision helps with visual skills, weight shifting, use of one or both arms and improving attention and concentration.

Sometimes simple changes to the home environment can improve a patient's vision. We make suggestions to improve lighting so our patients can avoid harsh glares, see books and magazines more clearly and walk feeling safe and independent when they return home. Our occupational therapists work with patients, families and staff to see what types of aides they might need. We call these, "environmental controls and assistive technology." Sometimes these aides are high-tech, like a voice-activated controller for lights, TVs and phones. Other devices are very simple, such as a pointer for people who have trouble bending or using their hands and arms.

 

Speech therapists, speech-language pathologists, evaluate and treat communication and swallowing disorders.

• The speech therapist will sometimes do a test called a videofluoroscopy with a radiologist present. This records a person swallowing, which allows the speech therapist and radiologist to see if the patient is swallowing safely. Based on the test's findings, speech therapists recommend food and liquid with the safest consistency for the patient's differing needs. Mealtime observations give us the chance to monitor patients and teach or help them work toward feeding themselves.

Much of a speech therapist's time is spent assessing cognition.

• Cognition, or thinking skills, can be affected by an injury to the brain such as anoxia, seizures or stroke. Cognition can also be affected by dementia, alcohol or drug use/abuse, medications and metabolic imbalances.
• Speech therapists plan an individualized program to focus on improving thinking skills so patients can quickly return to caring for necessary things like managing medication or paying bills.

A stroke or brain injury sometimes changes how people talk, sound or receive information from others. It may be hard to understand them when they speak or read aloud.

• Speech therapists train and educate patients in the use of techniques and exercises that help them maximize or regain their ability to communicate. iPad programs may be used to work on certain cognitive skills or to compensate for cognitive losses.

 Our experienced speech language pathologists have worked more than 30 years in their field and bring their knowledge to the treatment of their patients.

Amount of Rehabilitation Therapy Provided

• Customized therapy for patients based on need.
• Care delivered in the patient's home and is focused on creating safety and independence.
• Therapy visits vary in length and each discipline visits 1-3 times per week based on patient need.
• Therapy often focuses on fall reduction and home safety measures.
• Services are provided in the patient's home.

Nursing Care

• Nursing visits 1-7 times per week based on patient need.
• Skilled nursing services including IV therapy, wound care, catheter care and ostomy care.
• Teaching patients with new diagnoses or other changes in health status.
• Observation and assessment of chronic conditions.

Physician Care

• Home health Plan of Care is developed in partnership with the patient's primary care provider.

Likely Candidates

• Patient's basic needs are met at home through self or other caregiver.
• Patient requires nursing or therapy to recover to prior level of function or to help manage a chronic condition.
• Patient is unable to travel to outpatient therapy.

Amount of Rehabilitation Therapy Provided

• One to three hours per day, therapies dependent upon patient need.
• Two to three days per week.

Nursing Care

• None

Physician Care

• Routine office visits with primary care provider, and specialists such as orthopaedic surgeon, physical medicine and rehabilitation, neurologist and other providers that direct your care.

Likely Candidates

• Patients whose physical disabilities and medical problems are stable enough to live in their own homes and can travel to get their treatment.
• Many patients who have been treated in their provider's office, the hospital, inpatient rehabilitation or skilled nursing may transition their recovery plan to this level of care setting.