I attended the annual AANLCP conference last month in Denver and was fortunate to receive a tour of Craig Hospital that was arranged as part of the conference. I was very impressed with Craig Hospital and would highly recommend it for inpatient spinal cord or traumatic brain injury rehabilitation.
Craig has treated more than 27, 000 patients with spinal cord and traumatic brain injury since 1956. They have treated more spinal cord injury patients than any other single facility in the world. Adding to their credits, they have ranked every year in the Top Ten Rehab Hospitals by US News and World Report for 20 consecutive years.
In 2008 patients came to Craig from 47 states; 54% of inpatients with SCI from outside of Colorado, 35% of inpatients with TBI from outside of Colorado.
Craig hospital offers a slew of sub specialty programs:
Car transfer and airline travel training labs
What makes Craig Hospital special in my opinion, is their focus on the family as a whole, and their outstanding therapeutic recreation program.
FAMILY
In addition to encouraging family involvement throughout the rehab process, the families of Craig patients are offered 30 days of free housing in their on-campus family housing building. Families stay together (including the injured person) in a 1 bedroom apartment to get accustomed to daily life together again, before being discharged from the rehab program. They also offer family education classes and family counseling. The support of other families who are dealing with similar life changes is another benefit of this model of care.
Family housing units
THERAPEUTIC RECREATION
The Therapeutic Recreation program at Craig is serious business. They have 9 staff members with 225 years of combined service at Craig. The longevity of the staff overall at Craig is very good. They obviously love what they do. With regards to therapeutic recreation, some of the activities or adventures that the patients and families go on with the staff are far too adventuresome for the average person. Their philosophy seems to be that anything is possible. Check out the photos below.
OUTPATIENT FOLLOW-UP
Craig hospital performs 550 re-evaluations per year for SCI and TBI patients. The re-evaluations are extensive and I’m told that many of the out of town graduates from Craig will coordinate their re-evaluations to coincide with the re-evaluations of their fellow graduates, many of whom have become lifelong friends.
Craig also have a website dedicated to Craig Alumni. Alumni can reconnect with former roommates and friends and ask questions or share information. 11:09 PM GMT | Read comments(4)May 31Twenty Questions for Long Distance Caregivers
The National Institute on Aging has created a booklet called “So Far Away: Twenty Questions for Long Distance Caregivers”. On that webpage you can click on the question (on the left hand side of the page) that interests you and it will bring you directly to the answer. You can also order copies of the booklet or download the entire PDF. This is a good resource for long distance caregivers.
The booklet answers such questions as:
The booklet also has a resource page with some useful links to different eldercare resources.
It is a common misconception among many patients that the man or woman wearing the scrubs, checking blood pressure, giving an injection or dressing a wound is a nurse. In actual fact, most of the time those people in scrubs you see in the hospital or at your doctor’s office are not nurses at all.
I frequently hear my patients using the word “nurse” to describe the medical assistant at their doctor’s office or the aid at that comes to their home to help them bathe. Most of the time this error goes uncorrected, as it is often not worth the hassle to explain the difference and it doesn’t matter to many patients as long they are receiving good care. Sometimes, however, it is important to know who you are dealing with.
A medical assistant, for instance, should not be giving medical advice and a registered nurse should not be prescribing medication. While there is quite a degree of overlap in the skills and responsibilities of MAs, CNAs, LPNs and RNs, their training is quite different. The title doesn’t necessary make one professional better than the other either. You can have a very experienced LPN who functions better than an RN with little experience or integrity. Character also plays a huge role in one’s professionalism as well. Further complicating the matter are the rules and regulations set by different states and places of work, sometimes severely limiting what MAs and LPNs can do.
Here’s what you need to know about the differences between the various titles:
* Nursing diagnoses are statements about a patient's health that are formulated based on data obtained during the nursing assessment. North American Nursing Diagnosis Association (NANDA) defines nursing diagnosis as "a clinical judgment about individual, family, or community responses to actual or potential health problems/life processes. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable." Some examples of some nursing diagnoses are:
Check on U is a great new service available for seniors requiring telephonic reassurance and medication reminders. At a low cost of only $14.50 per month, 9 different messages can be sent each day to remind the person to take their medication, remind them of upcoming doctor's appointment, or simply remind them to eat a meal.
A sample reassurance call might sounds like this; "Hi! This is your daily checkup call! If everything is ok, press 1. If you need help, press 3." This is an automated calling service that uses a computer phone system to place calls. The senior is instructed to acknowledge the call using the "Press 1" option on the phone keypad. If the call is not answered or the senior does not acknowledge the call, an alert sequence is initiated that calls or emails family and friends of the senior.
This is a great, affordable service for seniors or someone with memory problems. It could to be very useful for someone with a brain injury.
Another great thing is that is doesn't require any special equipment and there is no cancellation fee. It is available nationally.
Compared to a service like Lifeline, Check on U is much more affordable. Lifeline costs $35/month in Oregon. What Lifeline has that this service does not have though, is the help button on a pendant or wrist band that can be pushed when help is needed. This is great for someone who will remember to use it, but if the user has memory problems, they may not remember to push the button. It also doesn’t help if the person is unconscious and unable to press the button to summon help. Lifeline does have a feature where you can add up to 6 reminders per day for things like medications, but no one verifies that the message was received.
What I like about Check on U is that it checks in on the user and will alert family or friends if the user does not respond appropriately. This takes the responsibility away from the user, who may not be reliable.
The New York Times published an interesting article about how care coordination can help to reduce costs for patients and health plans such as Medicare. It references a JAMA study that highlights the features of the most effective programs and suggests that consumers should look for the following characteristics when choosing a program for themselves or their loved ones:
From my experience I can understand why this is true. Face to face interactions in the home reveal so much more about how a patient or caregiver are managing. It also allows the care coordinator or care manager to talk with the family and get a broader picture of what’s going on than what can be achieved by a phone call or a 15 minute office visit. Conversations with the doctor are also key and something I try to do whenever I get a new client or there is a change in condition or confusion about a treatment plan. Often times I hear from the patient or caregiver that the doctor was in a rush during their office visit and they didn’t get to discuss in detail what they needed to. Sometimes the doctor gets a totally different story from the caregivers than what I’m witnessing in the home. It helps to just check in now and then to make sure we’re all on the same page. Unfortunately some doctors won’t spare the time to do this and I truly feel that they are doing a disservice to their patients and creating more aggravation for themselves in the long run. When I can’t get to the doctor directly, I’ll go through his or her nurse or assistant, but it’s not the same as talking directly to the physician. It can turn into a game of broken telephone which only adds to the frustration for all parties.
If you want to read the NYT article you can find it here. 10:16 PM GMT | Read comments(0)