SMH rehab center patients regain full lives by practicing everyday skills

Gaining your everyday life back after a brain injury, amputation, broken hip or something similar is usually difficult, and often requires intensive rehabilitation.

So what better way to regain the abilities needed for everyday life than by practicing the usual tasks that make up an average day?

That’s the main concept behind Sarasota Memorial Hospital’s 74,000-square foot Rehabilitation Pavilion. Opened in April 2017, the building has a 54-bed inpatient rehabilitation facility, where patients stay an average of about 10 to 14 days as they regain the skills they need to go about their lives once more. It also has a multidisciplinary outpatient clinic.

Perhaps the most important accomplishment of the Rehabilitation Pavilion is bringing all the care rehab patients need under one roof. Professionals from physical and occupational therapists to psychologists to nurses to speech pathologists work together to guide patients through the recovery process, according to Dr. Alexander Bajorek, the Medical Director of Rehabilitation Services.

“Every aspect of a patient's life, from when they wake up in the morning to when they go to bed, is specifically addressed from a medical standpoint [and] a psychosocial standpoint,” Bajorek said. “And through that team coordination, we get them to an independent level.”

Also, the facility is attached to the main hospital, so medically complex rehab patients who need access to their providers can get attention easily. And in the event that urgent medical help is required, it’s a very short commute.

Before the Rehabilitation Pavilion opened, SMH still had a similar rehab program to the one it runs today. However, the program was confined to the ninth and 10th floors of another hospital building. This meant smaller bedrooms that were not private, smaller hallways and less specialized/advanced equipment and machinery.

At the Rehabilitation Pavilion, each bedroom is its own private apartment, and there’s space in each room for patients to host a family member overnight. In fact, Bajorek said some guests say it’s like staying in a hotel.

Each apartment, like just about everything in the facility, is designed to help inpatient guests practice the skills they will need to rediscover their independence. For example, every unit has a full kitchen where patients can learn to cook for themselves again, and SMH staff can help with tasks as simple as putting on pants in the morning.

“The best neuro-recovery and neuroplasticity occurs when the movement or something that you're teaching a patient is meaningful and functional,” Bajorek said. “So I could tell you to do 100 bicep curls, and your brain will think it’s basically meaningless. But if I teach you to take a spoon and put it in your mouth and eat, one of the most functionally meaningful things to any patient, your neuro-recovery will be much quicker and much more meaningful.”

This strategy extends far outside the patients’ apartments. Where did you think they get the food with which they learn to cook? Patients can go to the grocery aisle and practice grabbing items from different shelves.

They can climb in and out of a miniature half-car that can be adjusted by height to simulate anything from a sedan to a pickup truck. There’s a set of stairs leading to a doorway so they can try entering and exiting their house. The stairs are higher than regulation, so patients who live in houses that were built before more recent codes went into effect are prepared. Outside in the mobility garden, there’s a mailbox, a hose for people who want to practice gardening and even a small putting green — because this is Florida, after all.

When it comes to therapy, Director of Rehabilitation Services Laura Magnusson said hundreds of hours of research were poured into making sure the facility had research-backed equipment that will improve patients’ outcomes. This includes the Bioness Vector, a track on the ceiling of a hallway that can reduce how much weight a patient feels as they are walking, complete with visual markers on the floor that show how far they’ve traveled.

There’s also the Hocoma Lokomat, which is a similar device that can also emphasize weight on one side or the other. Roland Serres has been using the Lokomat after suffering a stroke that has affected him on the left side. SMH uses the device to test his speed, range of motion and hip/knee extension. It also comes with a screen that the patient uses to play games with the objective of hitting specific speed or distance goals. Although he admitted to being tired quickly, Serres is able to walk at least 800 meters with the help of the Lokomat, as opposed to about five or 10 steps on his own.

Patients who stay at the Rehabilitation Pavilion have usually been robbed of some of the most basic skills that make us feel human. The facility itself and the SMH team that operates it gives patients access to a wide array of experts who create a plan to help them and a built-in support system of staff members and other patients. What better way is there for patients to regain their lives than by practicing everyday life?