A hospital is a hospital is a hospital, right? Afraid not. Health care terminology doesn't help matters: acute care, subacute, skilled nursing, continuums, inpatient, outpatient. What do you do when the doctor says you need rehabilitation?

You're Not Alone

Most people don't think about rehabilitation until they need it. Even then, it's often a physician or other health care professional who recommends rehab to continue the person's recovery after a disabling illness or injury.

It's the goal of a rehabilitation facility to help people resume the ordinary activities of daily life that they enjoyed before: earning a living, raising a family, running a home, pursuing a hobby, playing sports. A good rehabilitation program offers therapy and education to avoid further injury.

It is important to know the difference among facilities. There is a difference, for example, between a retirement home that has rehabilitation professionals on staff and a dedicated rehabilitation hospital. Facilities that have rehabilitation as their sole objective, such as rehabilitation hospital or center, are likely to have the most highly trained therapists, medical supervision by physiatrists (doctors who specialize in physical medicine and rehabilitation), nurses and psychologists. These centers usually offer innovative therapeutic programs, state-of-the-art technology and facilities, and education programs for patients and health care professionals.

The type of rehabilitation facility you choose depends on the kind of illness or injury experienced and its severity. There are two main types of rehabilitation facilities:

• Outpatient facilities where patients come and go for treatment on a daily or weekly basis
• Inpatient (or acute care) facilities where patients stay for days, weeks or months, depending on their condition.

Outpatient Care

Outpatient activities may stand on their own or be part of a comprehensive rehabilitation hospital. Common programs cover therapy for:

• sports injuries
• hand rehabilitation
• stroke and other neurological injuries
• speech-language or cognitive deficits
• orthopedic rehabilitation (including osteoporosis or arthritis)
• industrial rehabilitation and return-to-work services

While most outpatient facilities offer some or all of these services, you can tell the difference between an excellent facility and an ordinary or inadequate one by asking the following questions:

1. Does the center offer a comprehensive range of services? Look for trained staff in physical therapy, occupational therapy, speech and cognitive therapy, industrial rehabilitation and vocational counseling. Also ask about counseling and support services that can be crucial in the rehab process.

2. Does the facility emphasize prevention of injury? Many common injuries, such as carpal tunnel syndrome, will recur without a change in the way people use their hands.

3. Is the facility well-respected and well-connected in the medical community? Does it have a medical director who specializes in rehabilitation? Does it have a strong network of consulting physicians and other health care professionals to call upon if necessary?

4. Is the site easily accessible by car or public transportation? Are the buildings easily accessible for people with disabilities?

5. Does the facility accept the insurance or managed care plan you use? A good facility will have an adviser who can help you make financial and insurance arrangements for your therapy.

Inpatient or Acute Care Facilities

Most people who are admitted to an inpatient rehabilitation facility are recovering from injuries or illnesses that severely impair their physical functioning or understanding. These include:

• strokes
• spinal cord injuries
• traumatic brain injuries
• chronic pulmonary problems
• neurological disorders
• other debilitating conditions

Consider the following factors in selecting an inpatient rehabilitation facility:

1. Does it have a physical entity or "campus" equipped with the best in medical care, technology and facilities?

2. Does the facility provide 24-hour nursing care?

3. Are its services well integrated and provided by multi-disciplinary teams?

4. Is it accessible to your family and friends? Is it located near highways?

5. Does it have a caring and restful atmosphere?

6. Does it offer more than the basics in terms of facilities and services? For example: Does it have a pool for aquatic therapy or a sports program for people with disabilities?

Other Guidelines

• Certain services should be available daily or twice daily: occupational, physical and speech/language/hearing therapies as well as social work and psychological counseling. Other important services are recreational therapy, vocational training and special education services.
  
  
• Look past the time of discharge. Does the discharge staff help plan your home care and the support services needed once you return home? Are there vocational, psychological, social work professionals available to help patients adjust to life outside of the facility? Does the facility offer practical assistance, such as programs to help patients drive again after their illness or injury? Ideally, an inpatient rehabilitation hospital will also offer outpatient rehabilitation services that provide continuity of care after discharge.
  
  
• Look for a continuum of care from the time of your admission past the time of discharge. Anyone who is disabled will face a long period of adjustment and will need services that are not anticipated. Find a facility that will help you prepare for and fulfill those needs.

These guidelines were adapted from a publication by the American Hospital Association. Gaylord Hospital endorses these standards. For more information about our rehabilitation programs, see programs and Services or call us toll-free at 800-64-REHAB, extension 2828 or e-mail Public Relations.