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What's expected before leaving rehab?

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  • What's expected before leaving rehab?

    Hey all --

    I'm working on a project to point out the decline in some states as far as spinal cord rehabilitation goes currently, as opposed to 20+ years ago when I, and many here, did rehab.

    For example, when I was in rehab in 1987, before I was released I had to be capable of the following:

    basic care, including, in/out of bed, chair, shower
    dressing/undressing - shoes on/off
    personal hygiene
    bowel/bladder management
    skin care
    preparing meals
    cleaning up
    wheeling - including up/down steep ramps/inclines - popping up/down curbs
    emergency - bumping down staircase in chair
    falling out of chair/getting back into chair
    transferring in/out of vehicle - and for my rehab, driving as well

    I do peer support, and have noticed a trend that people are being sent home earlier and as a result, needing more help than may otherwise be necessary.

    If you're a para or a quad, can you please share with me what you had to do before leaving rehab? Can you also share your level and approx. rehab date?

    Thanks so much in advance.

  • #2
    basic care, including, in/out of bed, chair, shower
    dressing/undressing - shoes on/off
    rolling over
    personal hygiene
    bowel/bladder management (learned premise, couldn't practice until c-collar came off)
    skin care
    preparing meals-well, 1 meal
    transferring in/out of vehicle

    No chair skills. No driving.

    C5-6 inc., Aug. 2000, approx 8 weeks at TIRR
    Does This Wheelchair Make My Ass Look Fat?


    • #3
      My son, c6/7, spent approx. 2 1/2 months in rehab (2004). When he came home, he could cath himself, shave, brush his teeth, wash his face, hold eating utensils, and that's about it! Could not transfer himself, could not wheel up our ramp, etc. It's been 6 years and he is now living on his own (he has caregiver in morning only), but does bed time stuff by himself. He's come a long way and whatever he has accomplished, it's been his own doing.


      • #4
        T12 complete, i had to stay on bed more than usual because of ribcage trauma.
        I learnt more or less the following: dressing up and undressing, shoes, B/B management, sitting back to my wheelchair (in a ridiculous non-practical way that i've already changed), personal hygiene and negotiating curbs.
        I prefered to learn on my way at home and in the real life so i quit one week after i was released to sleep at home. No better place to learn and no better nurses than the people who love me.
        Don't ask what clinical trials can do for you, ask what you can do for clinical trials.

        Fenexy: Proyecto Volver a Caminar (soon in english too)


        • #5
          Originally posted by ThinkerGirl View Post

          1978, before I was released I had to be capable of the following:
          same as your list, except swimming, they had a pool, i just never did it.
          We must reject the idea that every time a law's broken, society is guilty rather than the lawbreaker. It is time to restore the American precept that each individual is accountable for his actions.
          Ronald Reagan


          • #6
            In 1956, my list was the same except for swimming and driving. Kessler did not have a pool. Automatic transmissions just started to become popular and handcontrols were still pretty primitive then.
            You will find a guide to preserving shoulder function @

            See my personal webpage @


            • #7
              In 1966 when I left Spain Rehab in Birmingham, AL, they must have had a similar check-list, but it was a bit of a joke.

              I could push my chair, transfer into and out of bed. But, I was given only one opportunity to undress and dress.

              Basically, I wanted to get back into high school with my class, and they must have thought that was my best option, so they cut me loose in time for summer school.

              I learned almost everything I know after I left rehab. I was there about 4 months.


              • #8
                2005, T 7-8 para,

                basic care, including, in/out of bed, chair, shower
                dressing/undressing - shoes on/off
                personal hygiene
                bowel/bladder management
                skin care
                wheeling - including up/down steep ramps/inclines, opening doors, no curbs
                transferring in/out of vehicle ... with help, just enough to get me home basically

                No housekeeping skills, a little cooking although this was treated as a fun activity to kill time on Weds afternoons.

                My family was taught how to get me back in the chair after a fall, and what needed to be done to my home to make it accessible.

                Some things, including floor to chair transfer weren;t attempted due to a broken shoulder.

                Using the shower was put on hold for a while due to a pressure sore. This appeared to be a key item to allow my rehab stay to be extended twice. I wasn;t going to be sent home until I was able to do this.
                T7-8 since Feb 2005


                • #9
                  I am really appreciative of the input so far! Thank you all. Please keep it coming. This is very helpful.


                  • #10
                    I did rehab at one of the Model SCI Centers here in CA. My stay kept getting extended due to fun stuff like MRSA I got thru my trach since they wouldn't take it out...they did the day before I left since I threatened to pull it and leave it in the parking lot Anyway since my total stay was 4 months I learned most things and was quite independent, except as a C7-T1 I needed helpt to cath but could get dressed, transfer, never learned cooking but wasn't interested, was put in the driving program while still in rehab, and since the average stay was 4-6 weeks I spent tons of time in the gym which helped me gain strength and it helped I was and still am an athlete. I live on my own now and it seems I just got hurt, although I just hit the 6 year mark yesterday since my rollover accident was 3/4/ how time flies!


                    • #11
                      I got out of rehab September of last year (2009). T8 complete. I was released because my insurance thought I was fine and wouldn't pay anymore. I still had to wear a TLSO so could not do bowel care (couldn't reach my pooper). I had some wheelchair skills but because of the brace it was hard to balance. I could cath, kinda put on my clothes (not being able to reach my feet hampered my ability to put on socks and shoes. Could transfer with a board fairly well. It was a struggle when I got my brace off 3 weeks after I left rehab, had to relearn my balance, wheelchair skills and how to transfer. I am a little bitter considering I pay 1300 bucks a month for insurance.

                      But good news is next friday I am getting on a plane for the first time since my accident and will be staying hotels for two weeks. It was a fun journey to get this far.


                      • #12
                        C6/7, Got out in 1991 after 5 months at Mt Sinai in NYC...

                        in/out of bed, chair, shower chair.
                        personal hygiene - washing face, brushing teeth, shower.
                        skin care - check my butt w/ adapted mirror.
                        feed myself.
                        wheeling - including up/down steep ramps/inclines, able to instruct others how to pop me up/down curbs.
                        falling out of chair throw legs to side, instruct others how to get me back into chair.
                        transferring in/out of vehicle, instruct others on chair breakdown & storage.

                        We tried some dressing, shoes, etc - but I had more tone back, then making it very difficult. It wasn't till a year after when I significantly improved in ADL.
                        "If ya don't have it in the hips, ya better have it in the lips..." ~ Charlie - Villa Dulce


                        • #13
                          Re: What's expected before leaving rehab?

                          Dear ThinkerGirl,

                          The biggest surprise I ran into was the lack of follow up from Inpatient to outpatient. I was assured 60 ways to Sunday and until some therapists were blue in the face that "care" would continue. A doctor and some of the therapists were acutely aware that a bulk of the patients would be discharged and then stop or quit Physical Therapy, Occupational Therapy, and Vocational Therapy.

                          I had one therapist to tell me some grim statistics regarding fatality rates post discharge and in short it was beyond repugnant. I have run into several people here in the threads who were also injured on the job and were (and still are) pissed off at how the system lies to them (to the worker) to "compensate" them.

                          Five years post injury I feel like I am still wondering what things I missed out because of the apathy that care providers and patients disjunction while communicating. I agree about peer support and the critical need for advocacy in and among the SCI Community. There are some things that we the disabled have run into that other able bodied people just do not understand.

                          The things I have become frustrated with on a big scale is the terminology that are commonly used but rarely understood. Some of those acronyms and terminology jumble are: PT, OT, PCA, ADL, DM Need, DME, Adaptive Equipment, PD, TD, SSI, SSDI, FICA, CIL, ICF, CMS, SSA, Aquatic Therapy, Vocational Rehabilitation, Equal Opportunity, HIPPA, TTW&WI, Medicare, Medicaid, Medicare Set-A-Side, Life Care Plan, Volunteer, Donation, Gift, Resources, Service Provider, Co-Pay, Health Insurance, Payment Premium, Qualifying Period, Medical Expense, Schedule R, W-2, 1099, Atrophy, Osteoporosis, ASIA Classification.

                          If you can Private Message me I could go on further because if we the disabled cannot help ourselves then even fewer people are going to go that extra mile on our behalf.

                          From to ,


                          • #14
                            Here is a brief list of what I had to do
                            First of all Be as Grumpy as you can this makes everything easier in the long run
                            Did I mention hydrate ?

                            Me Jarhead Gypsylady 2000..95/ 60 160-6'tall or so
                            Wait thats my Vin for a vehicle lol
                            1) Push my manual wheelchair with 2 Grey concrete blocks hooked to my earlobes
                            2) Brush hair and try gluing the ones that I pulled out back in with crazy glue
                            3) Change the Rehab bus tire
                            4) learn 40 different languages
                            5) Eat lots of spinach and pick grapes for the vinyards
                            6) Be a weeblewooble clown toy model for hasbrooo
                            7) Dress myself while hanging upside down with my legs strapped to a bar
                            8) Hydrate
                            9) evacuate
                            10 ) shovel Dirt into a hill to wheel up with a 60 degree gradient
                            11) Rehydrate
                            12) Poop
                            13 ) Shower
                            14) mudwrestle
                            15) write a 200 page report on how to brush my teeth
                            16 ) Hydrate
                            17) Feed the Goldfish
                            18) Do Soduku puzzles
                            19) confuse myself
                            20) just get my ass home and enjoy life
                            Get home and workout in a real Gymn
                            soon i'll try learning water therapy for some reason the rehab place didnt help me with this none of us
                            Whaz up with playdo and oooh I loved the Breakfasts all sausage paatties and oatmeal
                            I never liked playdough or picking red beans out of a bowl of rice
                            Years back I taught myself how to Catheterize myself which is just something that was a fluke of nature I dont know how I managed but I did .
                            Oddly I even monthly would totally change my own indwelling catheter because I felt more comfortable Sorry but no male nurses gonna go look at my privates lol .. I never trusted anyone to change my catheters so it is fairly easy for me ...
                            This blew their minds .. They asked me how do I know how to do this I said look A girl just knows her body .....
                            All of my life i've done thing's my way so I really dont think Rehab was much any good for me they knew I was very strong willed and I had my style of life .

                            Therapy wise I actually didnt have much because I worked out on my own most everyday in rehab and I focused on getting dressed and important things of that nature pertaining to real life

                            I just didnt understand the whole Rehab thing !!! Waste my time pulling on rubber and junk



                            • #15
                              Originally posted by ThinkerGirl View Post
                              I am really appreciative of the input so far! Thank you all. Please keep it coming. This is very helpful.
                              Here in the UK rehab included the following:

                              B/B management
                              Bed/Chair transfers
                              Bath & Toilet Transfers
                              Car transfers
                              Dressing Practise - In Bed and In Chair
                              Kitchen Skills
                              Hydro/Water Therapy
                              Traditional Physiotherapy
                              Seating clinic (finding the best seat for you)
                              Wheelchair skills - ramps, kerbs, wheelies etc
                              Wheelchair sports (basketball, tennis, field hockey, rugby etc etc)
                              Educational lectures regarding disability benefits, driving, sexuality, fitness, bowels, bladder, pressure sores, drugs, returning to work, depression etc etc

                              I think that is about it.

                              Fly Pelican Fly