December 4, 2012 started off like any other day for 17-year-old Darby McGee, an Arkansas high school junior and devoted member of her school’s Color Guard. But it quickly became the first day of what would become the most challenging few months of her young life, and she doesn’t even remember the day or anything that happened in the month after it.
Darby was driving to school by herself when she lost control of her car and ran off the road, into a tree and then into a creek. She suffered a traumatic brain injury and was in and out of consciousness for the next three weeks. Her family didn’t know what to expect.
Said mom April McGee, “Our first thought, of course, was is she going to live? After that, we wondered whether she would be able to speak, would she ever be herself again?”
Darby, who had been very active, outgoing, studious and extremely committed to her Color Guard routines, spent two weeks at Arkansas Children’s Hospital, where her rehabilitation began. Immediately, her family noticed that one part of the old Darby was shining through: her commitment and work ethic.
“They had her sitting up on the side of bed, and had her brush her teeth, and it was such a moment for us, to see them put her in the wheelchair and wheel her down the hall, and she was interacting with people,” said her dad, Robert.
After discharge, the real work began. Darby worked tirelessly with her RehabCare therapists at National Park Medical Center in Hot Springs, Ark. over the course of the next five months, with the goal of getting back to doing the things that mattered most to her.
“I wanted to get better, get back to Color Guard and get my life back,” Darby said, with no trace of any lasting speech impairments. “I wanted to stop having people see me as this broken person lying in bed, because I’m not broken.”
Robyn Smith, M.S., CCC-SLP, was Darby’s speech language pathologist.
“From day number one, she was willing to do whatever she needed to do to recover back to a functional level,” Robyn said.
Robyn noticed that Darby was progressing very quickly in a short amount of time. Through cognitive-linguistic therapy, Robyn worked with Darby on memory and attention exercises, showing her how to keep a journal detailing things like what she did during the day and what she ate to help her recall those details later. Attention-to-task and multi-tasking were challenging as well, so Robyn would work with Darby to devise scenarios that were applicable to her life as a teenage girl.
“We used Facebook and Google and other real-life things that Darby would be doing in her day-to-day life,” said Robyn.
Monica Scott, M.S., CCC-SLP, Program Director of Rehabilitation at National Park Medical Center, said the team approach to Darby’s recovery was crucial to her progress.
“We met with the principal at her school and gave her educators some information about what a traumatic brain injury is, and by working with them, we were able to reduce her school day to a manageable three periods with therapy in the afternoons,” Monica said. “I think it was the buy-in from everyone involved – the parents, the teachers, therapists and of course, Darby herself, that really helped to make this a true success story.”
Robyn was so impressed with Darby’s progress and her committed role in her own rehab that she nominated Darby for the state poster ambassador program, for which she was selected. Darby and her rehab team were able to meet the governor of Arkansas on the day he signed a proclamation declaring the month of May as Better Hearing and Speech Month in Arkansas.
Darby will resume a full course load as a high school senior and is set to graduate with honors. She is also back to being a full participating member of the Color Guard, her greatest passion. Despite all that she has achieved, the road has not always been smooth.
“There were days I would get frustrated,” Darby said. “Before the wreck I had a really good memory, and studying for tests and remembering Color Guard routines were really difficult for me afterwards. I would come home some days and cry but then I would get right back into it.”
She says she wouldn’t have made it through this challenge without the support of her friends, her parents and her two siblings.
“I feel like I’m almost back to where I was,” she said. “My friends and my family have been really supportive.”
Happy National Rehabilitation Awareness Week! From the inception of occupational therapy to rehabilitation job prospects, we bring you nine things you might not know about rehabilitation:
- Occupational therapy began in 1917. Therapists were recruited by the Surgeon General and worked as “reconstruction aides” during World War I. These reconstruction aides attended to roughly 150,000 wounded infantry men. The treatments gained recognition, and the American Occupational Therapy Association was formed.
- According to the U.S. Bureau of Labor Statistics, employment of physical therapists is expected to increase 39% between 2010 and 2020, a rate that is “much faster than average.” Many baby boomers are remaining active, more so than past generations, and rely on PT services to stay involved in their activities.
- Older patients with chronic heart failure benefit as least as much from a multi-week cardiac/exercise rehabilitation program as younger patients, according to a recent study of 243 patients at a rehabilitation center in Belgium.
- “Few jobs are so rewarding as physical therapy,” says CNNMoney, which consistently ranks physical therapy as one of the best jobs in America. Though the job can be emotionally and physically straining, “the workday is filled with small triumphs.”
- The American Stroke Association and American Heart Association recently declared that all stroke patients should have access to rehabilitation. Most stroke patients require some degree of rehabilitation. The sooner one begins stroke rehabilitation, the better the chance of regaining lost abilities.
- Speech, language and hearing disorders account for 20.1% of children in Special Education programs in the U.S., according to the Department of Education. According to the American Speech-Language-Hearing Association, more than a million children are treated each year for communication impairments.
- Late talking children who are otherwise developing normally do not always “catch up” to their peers. If in doubt, parents should seek advice and a prognosis from a speech language pathologist sooner rather than later. Speech-language pathologists may specialize, but they are trained to treat all ages.
- Physical therapists, occupational therapists and speech therapists can choose from a wide variety of work settings. They may work with different patient populations in hospitals, skilled nursing facilities, outpatient facilities and schools, to name a few.
- Physical therapy can alleviate the fear of falling. Patients may be more willing to participate in group activities like church if they feel more confident about navigating pews, for example.
- Patrick King: Exactly how occupational therapy started. Yahoo. Accessed on September 12, 2013 from http://voices.yahoo.com/exactly-occupational-therapy-started-10201709.html
- Occupational Outlook Handbook, U.S. Bureau of Labor Statistics. Accessed on September 12, 2013 from http://www.bls.gov/ooh/Healthcare/Physical-therapists.htm.
- Mitchel L. Zoler: Cardiac rehabilitation benefits elderly heart failure patients. Internal Medicine News. Accessed on September 12, 2013 from http://www.internalmedicinenews.com/cme/click-for-credit-articles/single-article/cardiac-rehabilitation-benefits-elderly-heart-failure-patients/44c62e5b8d0614f169c1a04d8422cb66.html.
- Best Jobs in America. CNNMoney. Accessed on September 13, 2013 from http://money.cnn.com/pf/best-jobs/2012/snapshots/8.html.
- Tim Mullaney: All stroke patients should have access to rehabilitation. McKnight’s Long Term Care News. Accessed on September 12, 2013 from http://www.mcknights.com/all-stroke-patients-should-have-access-to-rehabilitation-skilled-nursing-care-american-heart-association/article/309651/.
- Department of Education. “Twenty-fourth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act”. 2001. Washington D.C.. Table 11-5, p. 11-22.
- Lauren Lowry: Fact or Fiction? The Top 10 Assumptions about Early Speech and Language Development. The Hanen Centre. Accessed on September 12, 2013 from http://www.hanen.org/helpful-info/articles/fact-or-fiction–the-top-10-assumptions-about-earl.aspx.
- Katharine Gammon: Physical therapists may ease fear of falling in the elderly. Medscape. Accessed on September 12, 2013 from http://www.medscape.com/viewarticle/781175.
The House Ways and Means Committee recently released legislative language reflecting several elements included in the Administration’s budget proposal – including reducing market basket updates, equalizing payments for certain conditions commonly treated in IRFs starting in 2014, reinstating the 75% rule and other changes aimed at providers. Specifically, the proposal would reduce market basket updates by an additional 1.1% each year through 2023 for all post acute care providers creating an estimated $79 billion in budgetary savings over ten years.
It is perceived that the release of this language by the Committee was largely a political maneuver. However, it is concerning that such cuts to post acute care and the provision of rehabilitative services continue to be discussed, particularly in light of the pursuits of post acute care reform and a repeal of the SGR. No Congressional activity is planned at this point, but it may be included in the greater policy discussion in the near future.
RehabCare’s government relations team will continue to engage with Committee Members and their staffs to illustrate the value proposition of rehab therapies and to protect critical funding. As developments occur, we will provide timely updates.
RehabCare is a platinum sponsor for McKnight’s Long Term Care News first Fall Online Expo, where participants can gain access to industry white papers, giveaways and product information for free. Part of tomorrow’s expo will focus on how to build relationships with case managers. The expo includes three webinars, and attendees can earn a CE credit for each webinar they attend.
Register for the expo at http://engage.vevent.com/index.jsp?eid=521&seid=3718&code=1. Participants will be able to log in tomorrow morning at 10:30 AM Eastern Daylight Time.
RehabCare recently hosted a webinar in conjunction with McKnight’s Long Term Care News to discuss how long-term care providers can reduce rehospitalizations. Why are patients readmitted to the hospital, and where does therapy come in? RehabCare’s Glenda Mack, PT, MSPT, MBA, CLT, CWS, division vice president of clinical operations, shared strategies for involving therapists in the care of medically complex patients.
To learn more about rehabilitation’s role in reducing returns to acute care, access RehabCare’s presentation by registering here at: https://event.webcasts.com/starthere.jsp?ei=1020450.
As we shared earlier this year, Members of Congress have been working on a framework for a permanent repeal of the sustainable growth rate (SGR) for the physician fee schedule. Efforts to repeal the SGR are of importance to therapy for two critical reasons; first because Medicare Part B reimbursement rates for therapists are determined by the same schedule, and second because any efforts to repeal the SGR would likely be funded – all or in part – by reductions in payments to other providers most like in the post-acute space.
While discussion persists on Capitol Hill, the details of possible SGR repeal – including pay-fors – have yet to be released.
In related efforts, earlier this summer, the Senate Finance and House Ways and Means Committees requested that stakeholders provide real workable solutions to the post-acute care payment and delivery systems. In response to the request, Kindred and RehabCare will be submitting our “Blueprint for Post-Acute Care Reform” to the committees in which we will highlight our strategy to develop a patient-centered, integrated, post-acute care delivery and payment system model. Our government relations team will use the opportunity for continued advocacy to protect critical Medicare funding and promote common sense measures that preserve appropriate access to rehabilitative care across the continuum.
As Congressional interest in addressing post-acute care reforms moves forward, RehabCare will be sure to provide timely updates and analysis.
Dr. Kristine Yaffe, a professor at the University of California, San Francisco, and her colleagues followed more than 2,500 individuals between the ages of 70 and 79 over an 11 year period. At baseline, none of the participants had dementia, but 15 percent had anemia. Participants were cognitively assessed in the course of the study, and researchers found a correlation between anemia and the development of dementia.
“During the investigation period, 18 percent of all study participants developed dementia. Those who had anemia at the start of the study had a 41 percent higher risk of developing dementia than those who were not anemic,” said Lois Bowers of Long-Term Living Magazine.
Dr. Yaffe points to low oxygen levels in anemic patients as a possible reason for compromised brain health.
The researchers say that further investigation is warranted in this area and that anemia may one day be treated as a means of improving cognition.