By Lori Lovely
Known for their “Back on Track” Rehab to Home program that enables patients to return to normal routines as quickly as possible, Farmington Country Manor Nursing and Rehabilitation Center has expanded their services to include outpatient therapy rehabilitation. Knowing that some situations require ongoing rehab, this program was established as an extension of their inpatient program. It received certification in July 2013.
The on-site service is open to anyone in need of therapy. This means that patients who have recovered enough to go home can now come back for outpatient therapy, with the same therapists they’ve been seeing. Also, people with sports injuries or other impairments can receive outpatient treatment close to home.
Located in a rural area where the closest outpatient physical therapy services were 20-30 miles away gives Farmington Country Manor an advantage, says Jennifer Baker, administrator. “People don’t have to drive so far for therapy anymore.”
Speaking of Therapy
People who have suffered a stroke or are afflicted with Parkinson’s or other neurological issues, or even Alzheimer’s or dementia, may need speech therapy. To help them, Sarah House, speech and language pathologist at Farmington Country Manor, targets cognitive therapy, working on memory, orientation, attention, concentration, problem solving, identifying mistakes, and executive functions. She targets these skills in tasks and activities of daily living (ADLs), like medicine sorting and writing checks.
Another aspect of the therapy she provides, focuses on the expressive and receptive portions of speech and language with patients who have difficulty pronouncing certain sounds, who have a hard time being understood or finding words, and who have difficulty with communicating verbally and in writing. Patients may have trouble understanding and interpreting verbal and written language. In addition to working on both expressive and receptive skills, House may also address voice disorders by targeting the development of a vocal hygiene program and assisting patients with adequate breath support and modifications in voicing.
House also helps patients with dysphagia or swallowing disorders. Patients may have difficulty chewing, moving food within the mouth, sensory difficulties, or swallowing. “There are exercises to improve strength, coordination and range [in order to help people swallow],” House explains. She also provides safety training, and implements techniques to promote safety while eating and drinking. “I try to educate the patient on thickening liquids, promoting proper oral hygiene and on the use of strategies to ease chewing and enhance safety.”
Rehab the Wright Way
Rollen Wright, a city administrator, is recovering from an aneurism he suffered on Halloween night while making cotton candy for trick-or-treaters. When he went to light a propane heater in his garage, he felt a “pop” in his head that dropped him to his knees. Experiencing nausea, vomiting, sweating and trembling legs, he waited for his family to return and call 9-1-1. That was his last memory for about 17-18 days.
Shuffled back and forth between two hospitals, he underwent a CT scan, a brain bore surgery, and minimal initial therapy. For four days he was packed in ice because his temperature hit 104 degrees and he stopped breathing.
One thing Wright does remember is a rather bleak prognosis. “They told me I wouldn’t be able to talk, would have no mobility, and couldn’t learn to speak — basically, I’d be a vegetable.”
After his release from the hospital, Wright spent two weeks as an inpatient at Farmington Country Manor, where he worked with their physical, occupational, and speech therapists. “His speech was filled with jargon,” House recalls. “He made a lot of word substitution errors.” Focusing on word finding, writing skills, and error recognition three times a week for 45 minutes to an hour, Wright is about halfway through the program. “Now he can hold a conversation.”
In fact, he is progressing so much faster than usual, Wright says he’s ready to go back to work. “I need to do the budget for the municipality,” he explains. That won’t happen until he’s been cleared to drive, but he has resumed some activities closer to home. Having painted the living room, he’s now working on a fishing boat while he waits to return to his job.
“I appreciate what I can do now,” Wright says. “I’m very fortunate.” Before therapy, he says he didn’t notice mistakes. “I had a ‘guy’ mentality and thought I was doing well. It took a while to understand when I messed up. Then it drove me nuts.”
He still sometimes struggles to come up with the correct word, leaving his speech peppered with pauses. But his progress is remarkable. “I had no expectations when I started therapy,” he recalls, “but Sarah is getting me through this. She gave me education. If you break a leg, you’re in a cast for 8-10 weeks. Then you’re good to go. The brain has more activity. Injuries cause more severe catastrophe. It takes a long rest to heal.”
Choking up as he describes the staff at Farmington Country Manor as the most compassionate and professional group he’s been involved with, Wright says, “I would recommend them to anyone.”
Physical therapy is another of the services offered by Farmington Country Manor. Marianne Severine, physical therapist, helps orthopedic patients, patients with neurological issues (stroke, dementia and/or Alzheimers), patients with debility, cardiac and pulmonary patients, amputees, and patients with head injuries. As part of the treatment she provides, she targets areas such as sitting and standing, balance, safety awareness, bed mobility, transfer training (moving to and from one surface to another while changing position), ambulation, gait training (walking with an assistive device such as a cane or a walker on all surfaces including steps or outside surfaces), pain management, range of motion, strength and coordination. She also designs individualized restorative home exercise programs so that therapy can continue outside office sessions.
Former patient Iona Grgurich is still doing her exercises — now at home. The 96-year-old suffered a broken shoulder and arm in a fall at her home in 2011. The hospital transferred her to Farmington Country Manor, where she recuperated for three months, and where she returned for physical and occupational therapy as an outpatient.
Grgurich considers herself very fortunate; she even made a friend while she was an inpatient. “It was a good experience. Everyone was very kind.”
It was also beneficial for her mobility. “I wasn’t walking as good as I could, and I wanted to use my shoulder and arm better,” Grgurich recalls. The staff designed a program that included weights, exercise equipment, and mobility training. “I thought it was funny that they had me tossing a ball and putting things into little holes, but I know it was to get me to use my hands.”
Her hard work helped, she says. Back at home now, she makes her own meals and does her laundry. “I could hardly move at first. The exercises help. You’ve got to do them to keep going. You’ve got to keep moving.”
The Ins and Outs of Patient Therapy
Doing laundry is one of the life skills certified occupational therapy assistant Emily Austin works on with patients. Others include cooking, light housekeeping, and hobbies valued by the patient. She also works with patients on ADLs such as bathing, dressing, self-feeding, and grooming, all designed to enable patients to live a more independent and full life. “We help them be as functional as possible by working on valued tasks,” she explains.
Therapy also includes upper body strengthening with weights or special therapy bands, fine motor control tasks, and activities to increase hand dexterity. “Some women want to continue crocheting, while others need to be able to button their shirts, zip their pants, and hold a fork,” Austin adds. All of these therapy interventions are crucial to increasing successful completion of functional tasks.
Use it or lose it, as the saying goes. There’s a lot of truth to that, Austin says. It’s important to strengthen the muscles for the integrity of the joints; otherwise, you’ll lose flexibility. She mentions a patient who is a former motorcycle racer with severe arthritis, for whom they designed range-of-motion exercises in order to work his joints.
Often, more than one type of therapy is used to get the patient to a functioning level. “We work in tandem,” Austin says. “We are like an extra pair of hands for each other. Marianne works on stability — standing balance and transfer training — while I work on functional tasks such as lower body dressing, brushing teeth or washing and grooming at the sink.” She might work on the movement of hand to mouth and gripping a utensil, while the speech therapist addresses swallowing with the same patient.
Things That Matter
That spirit of teamwork helps patients improve quickly. It’s just one of the details the staff at Farmington Country Manor focuses on. They will even perform home evaluations to investigate how well the patient functions at home. This helps to ensure safety and an easier transition back home. Recommendations may include checking on the need for items such as ramps, grab bars, and other adaptive equipment.
A home evaluation may also include recommendations for changing the environment that may include the removal of rugs or the arrangement of furniture. The therapists may make recommendations in terms of how to organize the kitchen or other layouts in the home to make things more accessible for the patient.
Severine has worked there almost 10 years. “It’s a nice, clean facility,” she says. “Those things matter.” Another thing that matters is consistency in the staff. “It helps with the patients’ progress,” she says. Returning outpatients continue to work with the therapists they saw as inpatients. “It saves time with the patient because we’re familiar with their progress and it makes them more comfortable.”
She believes that former inpatients, and members of the community, are more comfortable seeing a therapist who lives in the community and/or has previously worked with them. “I evaluate the patients and do the treatments so there is a greater continuity of care in progressing them to their highest functional level.”
When people feel comfortable, they’ll stick with the program. Keeping patients involved in their therapy program contributes to getting them back to their routines and living full, active lives.
For more information on Farmington Country Manor, visit www.farmingtoncountrymanor.com, email Jennifer Baker at J.email@example.com, or call 309-245-2407. Farmington Country Manor is located at 701 South Main Street, Farmington, IL, 61531.