HIGH-INTENSITY REHABILITATION IN THE HOME

High-intensity rehabilitation is one of Rehab Without Walls NeuroSolutions’ greatest strengths. Our care model is ideally suited for high-intensity cases, offering significant benefits including lower costs, faster recovery and more durable outcomes.

Perhaps the confusion arises with people who associate home and community rehab with home health care. But there is an enormous difference. We provide interdisciplinary, functional, goal-oriented rehabilitation in the home and community setting. Where the home health care patient by definition is homebound, Rehab Without Walls NeuroSolutions patients are focused on maximum independence and returning to their lives as quickly and as actively as possible.

In fact, the approach and tools used by Rehab Without Walls NeuroSolutions are more akin to what is offered in an acute, inpatient rehabilitation setting. First and foremost we offer the clinical expertise – highly trained rehabilitation professionals in all disciplines. And second, we can provide the patient as many as 18 to 30 hours a week of therapy, with longer treatment days and possible weekend availability.

“The key here is the intensity of treatment,” says Janet Ayers, Ph.D., one-time director of clinical management, home and community, Phoenix. “We are able to offer more of everything that is available in inpatient rehabilitation, whether at a hospital or a long-term care facility – more treatment hours, more variety of experts, more coordination of services, more treatment environments, more family contact, more emphasis on the patient’s real-life needs, and so on. This helps us maximize limited insurance benefits and help patients attain long-term goals faster.”

The home field advantage

The fact that this level of clinical care can be provided in the patient’s home results in a huge advantage in treatment gains. Not only is it more convenient for the patient and the family, but goals and barriers are addressed in real life settings. Often patients who need high-intensity rehabilitation have impaired strength, endurance, attention and memory. If treated in their own home, they can take breaks between sessions so that they can remain refreshed and rested. In addition, transport to off-site facilities can be exhausting and time-consuming, and affect the duration and intensity of the rehabilitation. Doing high-intensity rehabilitation in the home allows patients to focus on the rehabilitation process and participate more fully in treatment. In the majority of cases, this results in a swifter recovery and a successful return to work. “This is important because the odds of an injured worker returning to work significantly decrease after six months,” explains Dr. Ayers.

Clinical coordination

“One key to our approach is that in addition to having the services and expertise to provide the diversity and intensity of care, we also have the clinical coordination and collaboration among the clinical treatment team members,” says Dr. Ayers. “This maximizes the benefit to the patient, saves costs and ensures smooth implementation of the treatment plan. You absolutely need an effective manager to coordinate treatment at that level. I hate to use the phrase one-stop-shopping because what we offer is so much more than that, but the same principle holds. We not only provide the variety of services, but we coordinate them as well, which avoids gaps and overlaps that could be costly in terms of recovery time and dollars spent.”

This coordinated team approach has a number of associated benefits, including durability of outcomes. Team members have channels of communication with which to share results, motivational tips, family issues and problems as they arise. They can troubleshoot earlier and more easily keep the patient on track. This means that there are fewer opportunities for patients to settle into dysfunctional accommodations, the family gets the education they need to support their loved one and patients can more easily recognize gains. This, in turn, affects motivation and progress, which cuts down on depression and facilitates a return to work. Ultimately, this results in a shorter length of stay.

Shorter length of stays, lower costs

Rehab Without Walls NeuroSolutions promotes shorter length of stays in two ways. First, because we can provide high-intensity rehabilitation in the home, patients can have significantly shorter stays at hospitals or inpatient rehabilitation facilities. And second, because our interdisciplinary team approach accelerates recovery, patients use fewer health care resources in the long run and can return to work sooner. “Truly our approach to high- intensity rehabilitation is a win-win situation,” says Dr. Ayers. “Shorter length of stays, faster recovery and return to work, more durable results and significant cost savings…what more could you ask for?

Indicators for High-Intensity Rehabilitation

• Recent injury
• Impairments predominantly in the moderate to severe range
• Impairments across multiple areas of functioning
• Family requires significant education and safety training
• Typical diagnoses include TBI, spinal cord injury and stroke