Rehabilitation services at Silvercrest include both short and long-term in-patient programs, as well as out-patient services. The therapy provided our patients and residents is second to none, and is driven by our belief that the goal of therapy must be progress, and not just maintenance. We know that true quality of life is achieved for our residents when we obtain the highest level of independence for each among them.
At the core of the inpatient rehabilitation program is a 40 bed, sub-acute unit that is home to a variety of patient groups. Post-operative orthopedic patients (e.g. joint replacements), stroke recovery patients, people needing cardiac rehab and individuals with exacerbations of multiple sclerosis are among those whom we regularly treat. The unit also serves as a bridge to home for previously hospitalized medical patients whose state of de-conditioning requires therapy for a return to independence.
Rehabilitation team members also see and help long
term care residents, each of whom is evaluated at admission, at regular intervals thereafter, and whenever nursing staff most familiar with that resident develop any concern about changes in his/her capacities. Timely interventions can have major impact upon the daily lives of even those with the greatest limitations.
For example, if the physical therapist can forestall the need for a
(used to take a patient from bed) by maintaining the resident's ability to assist with bed to chair transfer, it can make an enormous difference to quality of life. Similarly, when the occupational therapist helps another resident to maintain the skills and mobility needed to feed himself, this provides important support to his sense of independence.
Each week the Director of Physical Therapy makes orthopedic rounds with New
York Hospital Queens' Chairman of Orthopedic Surgery (or his assistant).
Carried out at the bedside and in the rehabilitation unit, these rounds
also incorporate the individual therapist who is working with each patient.
Not infrequently, these rounds are a follow up on plans made by Silvercrest's
Director of Admissions prior to hospitalization
for the original surgery . That Director meets many patients in the NYHQ
pre-admission area and on the 6 South Neurology unit to acquaint them with Silvercrest, and
to lay the groundwork for post-hospital rehabilitative care.
This program of coordination has reaped great benefits for
the Silvercrest population. Protocols
have been developed to address the specific rehabilitative needs of a variety
of surgical patients, including those with total knee and
These protocols, and the equipment used to carry them out, are available
to all rehabilitation residents, regardless of the hospital or center from
which they arrive.
Occupational Therapy is devoted to the provision of "functionality"
for the patient, being focused on what each individual needs in order to
perform the tasks required for independence.
This comes first from a concentration on "Activities
of Daily Living" (ADLs), wherein the resident is coached back to
the ability to do for herself those many and essential things we all do
in our daily lives without thinking.
Patients with higher levels of disability may arrive at Silvercrest with limited mobility and even with chronic pressure sores. As essential
members of the multi-disciplinary team performing "Wound Rounds,"
occupational therapists provide insight into the contribution of body
positioning and ambulation methods to poor healing, and help to design
"work-arounds" that keep the resident moving forward on a plan
of ambulation while contributing to progress with healing. These insights and interventions of our "wound care" team have also contributed to a system wide strategy of prevention that is keeping rates of new sore development at very low levels. Although Silvercrest receives and cares for medically complex individuals with high risk for pressure ulceration, new sores only rarely originate here.
Our OTs also work with our speech/communications team to develop successful
strategies for the most severely impaired, designing orthotics and finger
positioning tools that allow quadriplegic patients to activate infra-red
switches for communication and computer interaction.
Speech Pathology staff are involved with a large percentage of Silvercrest's
most challenged residents. And, it has been ground-breaking work
at Silvercrest that has promulgated a
better understanding of the importance of speech and swallowing therapy
to the treatment community at large. Communications maintenance is critical
to quality of life and essential to the existence of even the most rudimentary
independence. Integrating speech evaluation and treatment planning into the early rehabilitation process has been proven by Silvercrest staff to have significant impact upon the trajectory of the patient's progress curve.
Among the groups regularly treated for speech concerns are:
- Post-CVA (stroke) patients (dysarthria and aphasia)
- Ventilator dependent patients
- Patients with tracheostomies
- Cognitive impairment patients ( e.g. those with brain tumors and neuro-trauma)
- Non-verbal, neurologically impaired individuals, (e.g. ALS patients)
Combining years of experience with the latest in technology, Silvercrest's Speech/Communications
team has had extraordinary success and has educated other groups from around
the country and the world.
Stroke and Language