rehab notbk part 1 - WakeMed Health & Hospitals · Alternate Menu Selections . . . . . . . . . . ....

[ T H E R O A D T O I N D E P E N D E N C E ]

Wa k e M e d R e h a b

2 | W A K E M E D R E H A B

Wa k e M e d R e h a b[ P A T I E N T / F A M I L Y E D U C A T I O N N O T E B O O K ]

WakeMed Rehab is a strong link inthe world-class WakeMed Hospitalsystem. All our rehabilitation services– including in-hospital medical care,inpatient rehab, day treatment,outpatient rehab and home care – areconnected, forming a smooth, well-defined path to your recovery.

We call this a “continuum of care.” Forour patients, this means we’ll be withyou every step of the way on yourjourney to maximum rehabilitation andindependence.

R E S T O R I N G Y O U R

S T R E N G T H A N D S P I R I T

Inpatient rehabilitation is an importantpart of the full range of rehabilitationservices provided by WakeMed Rehab.Once you enter our doors, we willwork to increase your independence, soyou can return to doing the things thatare important to you.

T A B L E O F C O N T E N T S

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Your Education Notebook . . . . . . . . . . . . . . . . . . 4

Important Phone Numbers . . . . . . . . . . . . . . . . . 5

Patient Complaint/Grievance ProceduresHospital Ethics Committee . . . . . . . . . . . . . . . 6

Patients Rights & Responsibilities . . . . . . . . . . . 7

Code of Ethical Conduct . . . . . . . . . . . . . . . . . 10

Patient Satisfaction Program . . . . . . . . . . . . . . . 11

General Hospital Information . . . . . . . . . . . . . . 13

Family Contact . . . . . . . . . . . . . . . . . . . . . . . . . 15

Family TrainingDay Passes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

The Team Approach to Treatment . . . . . . . . . . 18

Individualized Treatment Plan (ITP) . . . . . . . . 21

Discharge Planning . . . . . . . . . . . . . . . . . . . . . . 22

Alternate Menu Selections . . . . . . . . . . . . . . . . 23

Explanation of Words & Terms . . . . . . . . . . . . 25

Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

WakeMed Rehab Hospital is a 78-bed,state-of-the-art inpatient rehabilitationprogram that will help you if you haverecently had a stroke, brain injury, spinalcord injury, orthopaedic condition, or otherphysical trauma. Our goal is to help youbecome as independent as possible so thatyou can return to daily life. WakeMedRehab offers a team of experts (what we callan interdisciplinary team) to lead youthrough your rehabilitation program. Thisteam approach works to make sure you aregetting the best possible care.

WakeMed Rehab Hospital welcomes theinvolvement of your family members andencourages you to ask questions and to getto know the staff. We are eager to help youwith your concerns or needs. If you or yourfamily members have any questions orconcerns regarding your treatment program,please feel free to discuss them with yournurse, therapist or case manager.

We want to create a comfortable, homelikesetting for you and your family. Please let usknow what we can do to improve your stay.

W A K E M E D R E H A B A N D

H O W I T B E N E F I T S Y O U

As a patient in the rehab hospital, you willshare in designing a recovery program to helpyou return to as normal a life as possible. Youand your interdisciplinary team will planactivities and treatments that will best helpyou during your recovery period.

You will participate in a daily schedule oftherapy consisting of a minimum of threehours of physical, occupational, nursing, andspeech therapy services. You may also beinvolved in neuropsychology, therapeuticrecreation, community reentry activities,counseling and education programs. The staffmay coordinate community outings that mayinclude shopping, visiting a park, swimmingor bowling.

Your therapies are all offered on-site in thetwo-story WakeMed Rehab Hospital. Wehave comprehensive rehabilitation gymswhere you will go for occupational andphysical therapies. Our speech and languagetherapy program will help you with anyspeech, language, cognitive,eating/swallowing, or facial movementproblems you may have.

Most of our rooms are semi-private, so youwill more than likely have a roommate andyou will be invited to eat with other rehabpatients in one of our dining rooms. Yourfood will be prepared according to yourspecific dietary needs.

Your therapy program will begin on the dayafter admission. You will get a daily therapyschedule to carry with you to your treatmentsessions. The nursing staff and therapists willhelp you as needed to scheduledappointments.

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P A T I E N T / F A M I L Y E D U C A T I O N N O T E B O O K | 3

This education notebook is provided to helporganize written materials you may get fromvarious members of your treatment team.We are committed to meeting you and yourfamily’s educational needs so that you canactively participate in the overallrehabilitation plan.

We encourage you to share these materialswith your family to help them learn moreabout your rehabilitation. They may takethese materials home to read, but you willneed to keep the notebook with you in thehospital.

This notebook is for you to keep, so feel freeto add your own information. We hope thatit will be a resource for you and your familyduring and after your stay at WakeMedRehab.

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W A K E M E D R E H A B

Elaine Rohlik, Executive Director, WakeMed Rehab . . . . . . . . . . . . . (919) 350-8852

Ann Bené, Director, Rehab Nursing Services . . . . . . . . . . . . . . . . . . . (919) 350-7938

Beth Rudisill, Director, Rehabilitation Hospital Services . . . . . . . . . (919) 350-8864

Tannis Hillis, Manager, Rehab Therapy Services . . . . . . . . . . . . . . . . (919) 350-6344

Angela Jones, Manager, Rehab Nursing Services . . . . . . . . . . . . . . . . (919) 350-2879

Jeanne Dibbert, Manager, Rehab Case Management . . . . . . . . . . . . . (919) 350-2945

N U R S E S ’ S T A T I O N

2D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8787

2C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8850

6B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8818

WakeMed Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8109

Campus Police . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8805

Department of Spiritual Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8556

Cafe 3000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (919) 350-8047

W A K E M E D R E H A B I L I T A T I O N H O S P I T A L

3000 New Bern Avenue

Raleigh, NC 27610

[ I M P O R T A N T P H O N E N U M B E R S ]


At WakeMed Rehab, you can be sure ourprograms and staff adhere to the higheststandards of health care. WakeMed isaccredited with commendation by the JointCommission on the Accreditation ofHealthcare Organizations ( JCAHO).WakeMed Rehab Hospital is also accreditedby CARF, the Accreditation Commission forRehabilitation Facilities.

We employ a select group of therapists andstaff. Along with extensive experience, ourteam has solid credentials, specialized trainingand advanced certifications.

Specializing in rehab requires more thanclinical qualifications. It takes a uniqueperson with patience, the ability tocommunicate well, and the ability tomotivate. These are the people who help youreach success, one step at a time.

G R I E V A N C E P R O C E D U R E

WakeMed Rehab encourages you to askquestions and to get to know the staff. We areeager to help you with your concerns orneeds. If you or your family has any questionsor concerns regarding your treatmentprogram, please discuss them with yourclinical case manager (the staff memberassigned to work with you and your familyand act as a liaison between your family andyour treatment team). If you have acomplaint, please share your concern with anyteam member. If your complaint cannot bepromptly resolved, WakeMed Rehabmanagement will conduct an investigation

and respond to you in writing within 10business days. If you would like to file aformal grievance, you may call or write toElaine Rohlik, WakeMed Rehab,3000 New Bern Ave., Raleigh, NC 27610(919) 350-8852

Ms. Rohlik will respond through a scheduledappointment or in writing within 10 businessdays of receiving your grievance.

You may at any time contact the NorthCarolina Department of Health and HumanServices Division of Facility Services, Attn:Assistant Chief, Licensure and Certification,Acute/Home Care, 2712 Mail ServiceDelivery Center, Raleigh, NC 27699-27121 (800) 624-3004

E T H I C S C O M M I T T E E

There may be a time when you have to makea difficult health care decision for yourself ora loved one. WakeMed has an EthicsCommittee to help you. This group is madeup of physicians, nurses, a hospital chaplain,representatives from social work,administration and the community.Committee members are trained andprepared to listen to your case objectively.They will never come up with a final answeror tell you what to do. The Ethics Committeeexists to help everyone involved make thebest decision possible. For a more detailedbrochure, ask your nurse or clinical casemanager, or call the Department of SpiritualCare at (919) 350-8556.

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P A T I E N T S ’ R I G H T S

Access to Care and Communication –Patients are admitted to WakeMed facilitieswithout regard to race, religion, sex, nationalorigin, disability, or source of payment forcare. Patients have the right to accessprotective services (i.e., guardianship,advocacy service, child or adult protectiveservice) with support from the hospital. Thehospital shall not impose restrictions onvisitors, mail, telephone calls, or other formsof communication except for therapeuticreasons that are fully discussed with thepatient or their authorized representative.The patient has the right to have a familymember or representative of his/her choiceand his/her own physician notified promptlyof his/her admission to the hospital.

Respect and Dignity – All patients have theright to care that is respectful andconsiderate of personal values and beliefs,paying attention to psychosocial, spiritual,and cultural needs as they relate toindividualized patient care. Patients have theright to refuse to be observed or cared for byany person or group other than thosedirectly responsible for their care. Patientshave the right to expect treatments andprocedures to be explained to them usingthe language or method of communicationthey best understand. They have a right topastoral counseling. Patients have the rightto be free of restraints of any form that arenot medically or behaviorally necessary.

Information and Participation in DecisionMaking – Patients are encouraged tobecome involved in all aspects of their care.They have the right to be informed of theirdiagnosis and course of treatment. Patientshave the right to ask their doctor, nurse, orother health care professional forclarification. Patients have the right to refuseany prescribed course of treatment after theyhave been informed of the possibleconsequences of that decision, and theirrefusal will not affect access to care. Patientsand families are educated about their role inhelping to facilitate the safe delivery of care.Patients, and when appropriate, theirfamilies are informed about the outcomes ofcare, including unanticipated outcomes.Patients have the right to access informationin their medical record in a reasonable timeframe.

Informed Consent – Patients (legallycompetent adult, parent/guardian of minor)have a right to have proposed treatments orprocedures explained to them in a mannerthey can understand. Only after they givetheir voluntary consent will the procedure ortreatment for routine, non-emergent care beprovided. Patients asked to participate in aresearch project are given information onexpected benefits, risks, alternatives, theprocedure itself, and the right to refuse toparticipate without compromising theiraccess to services.

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Conflict Resolution and Ethical DecisionMaking – Patients have the right to voicecomplaints about their care, and to have thecomplaint reviewed, and when possible,resolved. Patients have a right to expectassistance in resolution of dilemmasregarding their care and treatment. Patientshaving a conflict or complaint shouldexpress their concern to the staff deliveringcare, the department manager, or the ChiefOperating Officer of WakeMed at 350-8104. Patients can expect a written responsefrom the hospital within 10 business daysfollowing the failure to resolve a complaint.They also have the right to lodge acomplaint with the North CarolinaDepartment of Health and Human Services,Division of Facility Services at 1-800-624-3004. The address for patients wishing tosend a written complaint to Division ofFacility Services is: Licensure andCertification Section, Acute/Home Care,2712 Mail Service Center, Raleigh, NC27699-2712. In addition, for grievancesrelated to quality of care or prematuredischarge, patients have the right to requestreview by the North Carolina Peer ReviewOrganization.

Security, Privacy and Confidentiality –Patients have the right to expect to be caredfor in a secure environment free from allforms of abuse and harassment. Personalprivacy will be respected in care delivery.Patients have the right to privacy andconfidentiality regarding their treatment,care and medical record.

Advanced Directives – Patients of legal agehave the right to express their wishesregarding treatment at any point in the careprovided. Advanced Directives can includeself-directed anatomical gift donations. Inthe absence of advanced directives, thehospital will offer information and educationand will offer assistance in completing awritten advanced directive.

Pain Management – Patients have the rightto have their pain recognized and addressedappropriately. This includes informationabout pain and pain relief measures, aconcerned staff committed to effective painprevention and management, health careprofessionals who believe and respondquickly to reports of pain, and state-of-the-art pain management.

P A T I E N T S ’ R E S P O N S I B I L I T I E S

Respect and Dignity – All patients have theresponsibility to follow all rules andregulations established by the hospitalsystem concerning patient care and conduct.If they have questions related to these rules,they should ask their care provider forclarification. All patients have theresponsibility to respect the rights of otherpatients as well as hospital staff in both theirconduct and the behavior of their visitors.

Information and Participation in DecisionMaking – All patients have theresponsibility to provide complete andaccurate information with respect to theirmedical history, present complaint, and any


other health-related issues that may have aneffect on their course of treatment. They areexpected to become partners in thedevelopment and implementation of theirplan of care.

Once their treatment plan has beendetermined and communicated by the healthcare providers, all patients have theresponsibility for following the plan oftreatment. They are responsible for reportingto the responsible practitioner unexpectedchanges in their condition and perceivedrisks in their care. They should notify thehealth care provider if they have concernsabout their ability to follow the treatmentplan so the hospital can make every effort toadapt to the patient’s specific needs andlimitations. Where such adaptations are notrecommended, the patient and family shouldunderstand the consequences of failing tofollow the recommended course oftreatment, or of using other treatment.

All patients have the responsibility to askquestions when they do not understandwhat they have been told or what they areexpected to do. If a patient or family refusestreatment or fails to follow instructions, theyare responsible for the consequences of thatdecision.

Pain Management – Patients have theresponsibility for participating in their painmanagement. This includes communicatingwith the health care professionals about painrelief options, a pain management plan ofcare, measuring the pain, and what to expectregarding pain and pain management. Theyshould ask for pain relief when pain firstbegins and tell the doctor or nurse if thepain is not relieved.


The staff of WakeMed Rehab havedeveloped and abide by a code of ethicalconduct. This code of conduct is intended toguide staff behavior and interactions with allcustomers of the rehabilitation hospital. Ithas as its primary goal, the welfare andprotection of the individuals and familieswith whom staff work. It is the individualresponsibility of each staff member to aspireto the highest possible standards of conduct.The rehabilitation staff respect and protecthuman and civil rights, and do notknowingly participate in or condone unfairdiscriminatory practices.

C O M P E T E N C E

All staff strive to maintain high standards ofcompetence in their work. They recognizethe boundaries of their particular abilitiesand the limitations of their expertise. Theyprovide only those services and use onlythose techniques for which they are qualifiedby education, training or experience.

I N T E G R I T Y

Staff is honest, fair and respectful of others.In describing or reporting theirqualifications, services, products or fees, theydo not make statements that are false,misleading or deceptive. Staff strive to beaware of their own belief systems, values,needs and limitations and the effect of theseon their work.

P R O F E S S I O N A L

R E S P O N S I B I L I T Y

Staff uphold professional standards ofconduct, clarify their professional roles andobligations, accept appropriate responsibilityfor their behavior and adapt their methodsto the needs of different populations. Staffconsult with, refer to or cooperate with otherprofessionals and institutions to serve thebest interests of their patients.

R E S P E C T F O R P E O P L E ’ S

R I G H T S A N D D I G N I T Y

Staff respect the fundamental rights, dignityand worth of all people. They respect therights of individuals to privacy,confidentiality, self-determination andautonomy. Staff are aware of cultural,individual and role differences, includingthose due to age, gender, race, ethnicity,national origin, religion, sexual orientation,disability, language and socioeconomicstatus.

M A I N T A I N I N G E X P E R T I S E

Staff who engage in assessment, therapy,teaching or other professional activitiesmaintain a reasonable level of awareness ofcurrent scientific and professionalinformation in their fields and undertakeongoing efforts to maintain competence inthe skills they use.

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D O C U M E N T A T I O N , R E C O R D S

A N D D A T A

Staff appropriately document theirprofessional work in order to facilitateprovision of services later by them or byother professionals, to ensure accountabilityand to meet other requirements of thefacility or the law. Staff create, maintain,disseminate, store, retain and dispose ofrecords and data relating to their practice inaccordance with hospital policy andapplicable law.

F E E S A N D B I L L I N G

Staff do not exploit recipients of services orpayers with respect to fees. Charges are setand authorized by the department ofreimbursement and budget.

C O N F L I C T S B E T W E E N E T H I C S

A N D O R G A N I Z A T I O N A L

D E M A N D S

If the demands of the organization conflictswith this Code of Ethics, staff clarify thenature of the conflict, make known theircommitment to the Code of Ethics and tothe extent feasible seek to resolve theconflict in a way that permits the fullestadherence to the Code of Ethics.

R E P O R T I N G A N D R E S O L U T I O N

O F E T H I C A L V I O L A T I O N S

When staff believe that there may have beenan ethical violation by another staff member,they attempt to resolve the issue by bringingit to the attention of that individual if aninformal resolution appears appropriate andthe intervention does not violate anyconfidentiality rights. Staff exerciseprofessional judgement in notifyingmanagement of their perceptions. If anapparent ethical violation is not appropriatefor informal resolution or is not resolvedproperly in that fashion, staff may takefurther action through the organizationalmanagement structure, human resourcedepartment and/or hospital grievanceprocedure.

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We are committed to giving you qualityservice. We are constantly monitoring oursystem and programs and looking for waysto improve the service you receive.Throughout your stay, the staff will askabout your satisfaction with the care you aregetting. We encourage you to be open andhonest about how things are going and whatyou would like done differently.

Within 30 days after you leave, you may becontacted by our consulting group who willask you questions to see if you were satisfiedwith our program. Our management teamuses this information to plan our programdevelopment as well as improve our servicedelivery.

Members of WakeMed Rehabadministration are available at any time toaddress concerns you may have throughoutyour hospitalization or after discharge. Anystaff member will be able to direct you tothe administrative office area.

S M O K I N G

WakeMed Rehab is a smoke-free facility.Smoking is not permitted inside the buildingor on any WakeMed property.

L A U N D R Y

We encourage your family to take your clothinghome to wash. The nursing staff will wash anyclothing that becomes soiled due to spills orbowel/bladder control accidents. You may beencouraged when appropriate to do your ownlaundry as part of your therapy. Your therapistwill make the necessary arrangements.

T E L E P H O N E

You will have your own phone in your room.To make calls within the hospital, you do notneed to dial the 350-prefix, simply the four-digit extension number. If you need assistance,dial “8000” to reach the hospital operator.

To make outside local calls, dial 9 + the localnumber. There is no charge for local calls.

To make long distance calls, dial 9 and thenyou will need to use your calling card.

M E D I C A T I O N S

Your attending physician must prescribe allmedications you will use while you are here,and they will be dispensed by our pharmacy.This ensures your medications are coordinatedby one health care professional. If you preferto have certain medications left at yourbedside, please discuss this with your physicianand/or the charge nurse.

M E A L S

WakeMed’s Food and Nutrition Servicesprepares all meals. If you would like to bringin outside food, please discuss it with the staffahead of time. Family members are welcometo bring their own food and join you duringlunch and dinner. The dining schedule isbelow:

Breakfast – Served around 7:30 am in your roomLunch – Served at noon in the patient dining areaDinner – Served at 5:00 pm in the patient dining area

Y O U R R O O M

Your room is equipped with a telephone andcolor television. Most rooms are shared, soyou will likely have the company of aroommate. A limited number of private roomsare available for patients with special needs orwhose medical condition may require privacy.

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M A I L A N D F L O W E R S

Your mail and flowers will be delivered toyour room each day. Your mail should beaddressed:

Your nameWakeMed Rehab - (your room number)P.O. Box 14465Raleigh, NC 27620-4465

C A F E T E R I A

Cafe 3000 is open from 6:30 a.m. to 8:00 p.m.

P A R K I N G P A S S

Criteria for obtaining 7-day or 14-daydiscount parking passes:

Patient must be in the hospital for seven (7)full days prior to obtaining an extended pass.Visitors, family members, etc., must go tothe security office to get the discountauthorization slip before the parkingattendant is allowed to issue these passes.

Cost: 7-day pass $1014-day pass $15

V I S I T I N G H O U R S

Visiting hours at WakeMed have beendesigned to compliment your rehabilitationprogram. It is through visits from family andfriends that you get encouragement andreinforcement for continued recovery.

While visiting hours are scheduled dailyfrom 11:00 a.m. to 8:00 p.m., there may betimes that you are not available for visitorsbecause of your therapy schedule. Becausethe therapy program cannot be interrupted,please have your visitors check with yournurse or clinical case manager to determinethe most convenient times for a visit.Generally, you will be available to visitMonday through Friday after 4:00 p.m., and on weekends after noon.

We look forward to your family and friendsinvolvement in your recovery, and welcomeany suggestions that they may haveregarding your rehabilitation stay.


Our clinical case management staff will talk toyour family member regularly for variousreasons, which include:• Reports on your progress• Educational information about your

condition• Counseling• Financial information• Discharge planning assistance (helping you

and your family decide where you should goafter being discharged and assist witharranging follow up therapies if necessary)

• Community resource information• Liaison services with interdisciplinary

treatment team

We encourage families to select one person toserve as a contact. We will direct allinformation to that person and ask that he orshe relay the information to the other familymembers. Families may contact your clinicalcase manager at any time by phone. They mayleave a message if the clinical case manager isnot available, and their call will be returned asquickly as possible.

Your clinical case manager will also help youand/or your family in arranging meetings orcontacts with other members of yourtreatment team through family trainingsessions and family conferences as appropriate.

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A critical aspect of the rehab process atWakeMed Rehab is for patients and families tounderstand the illness or injury as much aspossible. We try to address this through a seriesof family education and training sessions.

We offer “Family Training” at various pointsduring hospitalization. The first trainingsession is for observation. This is scheduledearly in your hospital stay and involves yourfamily following you through your therapyschedule. The objective for this session is tofamiliarize your family with your dailyroutine and the treatment team workingwith you.

The following training sessions are forpreparation for pass (a pass is when you areallowed to leave the hospital to go out in thecommunity or home for a visit). This isscheduled for your family to learn actual“hands on” care you may need. It also givesyou the opportunity to “show off ” yourprogress. The objectives for this sessioninclude family participation in your care andpreparation so that they may work with youwhile you are on a day pass outside of thehospital. Your family will again follow yourregular schedule. During breaks in yourschedule other members of your treatmentteam may meet with you and your family asnecessary.

The final training session is to prepare youand your family for your discharge. Thistraining happens at the end of your stay atWakeMed Rehab. The focus of this sessionis to provide education and assistance tohelp you and your family prepare for yourdischarge. This training will help you “tieup” all the loose ends and address questionsand concerns to ensure a smooth, confidenttransition at discharge.

Many times only one training session isneeded. In this case, all of your care needsand any questions you may have will beaddressed during one family visit.

T H I N G S Y O U S H O U L D K N O W

• Your clinical case manager will coordinatetraining sessions with your family andteam.

• Family training is held during scheduledtherapy sessions, so it’s important that youfollow your wheelchair card (listing of yourdaily schedule) and be punctual.

• Family training is scheduled for one-halfday unless otherwise requested by you, theteam or your family.

Please direct all questions regarding trainingto your clinical case manager.

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T H I N G S F A M I L I E S S H O U L D

K N O W

• Park your car in the visitor parking deck.During physical therapy training you maybe asked to bring your car around to thecircular driveway to help your familymember practice getting in and out of the car.

• Parking is free on family training days.Please bring your parking ticket with youand the receptionist will stamp your card.

• Please meet your family member at his/herscheduled therapy session, depending onthe time of your arrival.

We hope family education will be arewarding experience that will help youunderstand the rehab process and allow youto leave WakeMed Rehab feeling preparedto deal with life at home. If there is anythingwe can do to improve this process, please letyour clinical case manager know.

D A Y P A S S E S

After evaluating you, your treatment teammay recommend that you go home on a daypass. Day passes may be used on weekendsfrom 10:00 a.m. to 8:00 p.m. A familymember or other caregiver must havesuccessfully completed training before a passwill be recommended.

Your treatment team will identify tasks foryou to practice while on pass. You candiscuss the results when you return to thehospital.


As you begin to follow your daily treatmentschedule, you will see that WakeMed has ateam approach to individualized care. Youwill have therapies and treatments specific toyour recovery needs.

During the first week of your stay, there willbe an initial team conference to discuss yourtreatment program and goals for rehab andanticipated length of stay. From that pointon, conferences will be held every weekwhere team members review your progress.Your clinical case manager will report yourgoals and concerns to the treatment teamand keep you informed about the teamdiscussion after each team meeting.

T H E F A M I L Y ’ S R O L E

The most important members of thetreatment team are you, your family andyour friends. Your input and feedback isalways welcome, and you may request ameeting with your treatment team at anytime.

Your clinical case manager will coordinatetraining sessions with members of yourfamily so they can learn about your therapy.We want you and your family to feelcomfortable with your program, and beprepared when it is time to leave thehospital.

T H E R E H A B I L I T A T I O N

T E A M M E M B E R S

Rehabilitation Physician: A specially trainedphysician, called a physiatrist, is in charge ofyour treatment and progress while you are apatient in the Rehab Hospital. A physiatristhas completed training in the board-certifiedspecialty of physical medicine andrehabilitation. The physiatrist works closelywith your primary doctor and coordinatesthe overall team treatment program, whilealso consulting other specialists as needed.

Physician Assistant: The physician assistantis Nationally Board Certified and is licensedby the state of North Carolina to practicemedicine under the supervision of aphysician. The physician assistants atWakeMed Rehab work intimately with thephysiatrists to manage your medical care andrehabilitation needs.

Clinical Case Manager: The clinical casemanager is the team leader and a liaison foryou and your family with the treatmentteam. The clinical case manager helps youand your family with personal, financial,emotional and social concerns that may ariseas a result of your illness or injury. You andyour family will have an initial meeting withthe clinical case manager to discuss yourfamily needs. Your clinical case manager canalso arrange individual and group counselingto help you and your family learn to copewith problems. If going home is not anoption after you are discharged, the clinicalcase manager will help you find a nursing

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home or other appropriate facility. The clinicalcase manager can also provide referrals tocommunity resources that may help you andyour family during the hospital stay and afterdischarge. The clinical case manager alsoprovides information to insurance carriers fortheir review and certification for the hospitalstay.

Rehabilitation Nurse: The rehabilitation nurseis a registered nurse (RN) with specializedtraining in caring for patients with disabilities.The nurse works closely with other members ofthe nursing team (Licensed Practical Nurses andNurse Technicians) to provide you with nursingcare and your family with education.

Clinical Dietician: The registered dietitian (RD)is a professional specially trained in the field ofnutrition. The RD reviews your diet, sees whatspecial dietary needs you may have to help youget better, follows your treatment plan to see thatyour recommended diet is carried out andinstructs you on the importance of your specialdiet.

Physical Therapist (PT): The physical therapistworks with you to improve your overallstrength, endurance, balance and coordination.The therapist helps you redevelop walking skillsor learn to move about safely in a wheelchair orwith other equipment, such as a walker or cane.If you have limited range of motion in a joint orcannot move well, you may benefit fromphysical therapy to improve your strength andlong-term physical fitness.

Neuropsychologist: Neuropsychologists arepsychologists with specialized training in brainbehavior relationships. They evaluate and treatcognitive (thinking abilities), emotional andbehavioral effects of disability. Theneuropsychologist may conduct aneuropsychological assessment, providecognitive rehabilitation and behaviormanagement services and education andcounseling to you and your family.

Occupational Therapist (OT): Theoccupational therapist works with you if youhave disabilities that can keep you from doingdaily living activities. These activities may befeeding, dressing, bathing and grooming, ormore complex tasks such as planning a menu,shopping for groceries and cooking a meal ordriving a car. The occupational therapist mayalso design splints and other adaptiveequipment to help you increase your abilitiesand decrease further disability. If you havelimited range of motion in a joint, diminishedmuscular strength and coordination, visualimpairments, or limited thought processingskills, you may benefit from occupationaltherapy.

The Occupational Therapy Departmentincludes a kitchen, living area, bedroom andbathroom where you can work with thetherapist nearby, and simulate at-home activitiessuch as getting on and off of the toilet, into andout of the bathtub, and on and off a bed orcouch. In addition, you may work on laundryskills and kitchen safety techniques.


Speech-Language Pathologist (SLP): Thespeech-language pathologist evaluates andtreats your speech, language, voice andthought processing disorders. The speech-language pathologist evaluates and treatsswallowing disorders that hamper yourability to eat and take medications bymouth. The primary focus of speech therapyis to maximize your ability to communicateand swallow.

Therapeutic Recreation Specialist: Thetherapeutic recreation specialist helps youunderstand the value of leisure timeactivities and address lifestyle changes thatyou may need as a result of your injury orillness. In-hospital activities provide youwith a social environment filled with leisureactivities.

Through education and community outings,the therapist helps you increase social skillsand awareness of accessible, affordablecommunity services and activities. As thefinal link between in-hospital care and thereturn to daily life, the recreation specialistuses these outside activities to evaluate howwell your physical, occupational, and speechtherapy skills are working in real worldsituations.

Spiritual Care: Our chaplains are availableto meet with you or your family members tooffer spiritual support.


Your care plan will be designed just for you.We will focus on every aspect of you as aperson: your lifestyle, relationships,appearance, personality, behavior and physicalabilities.

After an initial evaluation by your treatmentteam an individualized treatment plan (ITP)will be developed. The ITP gives you a writtenassessment of your status and goals, whichyour clinical case manager will review regularlywith you and your family. Your input into yourindividualized treatment plan is veryimportant, and your clinical case manager willpattern the ITP to meet your specific needs.

S E C T I O N S O F T H E I T P I N C L U D E :

• Medical: This is a brief summary of yourcurrent medical status including any acutemedical issues, medical changes, informationrelated to your diet and bowel and bladdercontrol.

• Communication/Cognition: This sectionprovides a summary of your ability to expressand understand language. In addition, asummary of your cognitive abilities includingmemory, problem solving, and safetyawareness is included.

• Mobility: This section outlines your currentstatus as it relates to your ability to movearound in your wheelchair, walk and transferfrom one surface to another. Discharge goalsfor each of these areas are also included inthis section.

• Self Care: This section outlines your currentability to manage activities of daily livingincluding bathing, dressing and personalcare. Discharge goals for each of these areasare also included in this section.

• Discharge: This section indicates the team’srecommendations for your post-dischargecare. Recommendations for follow-up therapyand equipment will be listed as well as theteam’s recommendation for any supervisionyou may need following discharge.

[ I N D I V I D U A L I Z E D T R E A T M E N T P L A N ( I T P ) ]


Your clinical case manager will work with youand your family to ensure that you aredischarged to the best possible setting.Whether you’re going back home or toanother location, we will help you identify thebest possible way to make the transition andto help you identify your needs. To help youand your family when you are discharged fromWakeMed Rehab, your clinical case managerwill work very closely with other treatmentteam members to identify problem areas,continued care needs and equipment needs.

The medical social worker will makeappropriate arrangements for follow-uptherapy and equipment you may need. Thesocial worker will try to schedule you forfollow-up therapy at the agency of yourchoice. Just before you are discharged fromWakeMed Rehab, the medical social workerwill give you the names of agencies and/orvendors who will provide you services afteryou leave WakeMed Rehab.

[ D I S C H A R G E P L A N N I N G ]

If you are prescribed a regular, pediatric, noconcentrated sweets, low cholesterol, or noadded salt diet you can choose your mealstoday for tomorrow. A select menu will begiven to you each morning to make yourchoices for tomorrow’s breakfast, lunch anddinner. Please make your selection andreturn your menu to the nursing staff by10:00 a.m. If you need assistance in makingyour selection, please ask a staff member tohelp you. If you have questions about themenu items call 350-8185.

These items are available daily if our specialon your paper menu is not what you wouldlike. You may write these items in on yourpaper menu. “All Time Favorites” DailySelections: Menu for Regular, LowCholesterol, 3 gram Sodium, NoConcentrated Sweets, No Added Salt Diets.

CHO = grams of Carbohydrate in oneportion

Entrees:• Oven Roasted Chicken • Oven Baked Fish• Hamburger Steak• Fried Chicken (Regular Diets only)• Fried Fish (Regular Diets only)

Entrée Salads:• Cottage cheese fruit plate (45 CHO)• Chef Salad• Grilled Chicken Caesar

From the Grill:• Grilled Chicken Sandwich (30 CHO)• Hamburger on bun (30 CHO)• Cheeseburger on bun (30 CHO)• Hot Dog on Bun (30 CHO) Reg. only• Vegetable Burger (45 CHO)• Grilled cheese sandwich (30CHO)• Grilled Ham & Cheese Sandwich

(30CHO)• Slice of Cheese pizza (45 CHO)• Slice of Pepperoni Pizza (45 CHO) Reg.

only• Deli Select Sandwiches:• Ham on Multigrain Bread (30 CHO)• Turkey on Whole Wheat Bread (30

CHO)• Roast Beef on Kaiser Roll (30 CHO)• Club on Sourdough Bread (30 CHO)

On the Side:• Lettuce and Tomato • Tossed salad • Baked Potato Chips (15 CHO)• Regular potato chips (15 CHO)• Gravy

[ A L T E R N A T E M E N U S E L E C T I O N S ]


Soups:• Homemade vegetable soup (15 CHO)• Cream of Tomato soup (10 CHO)• Chicken Noodle Soup (10 CHO)• Vegetables & Starches • Green Beans• Steamed Broccoli• Pinto Beans (15 CHO)• Macaroni and Cheese (15 CHO)• Rice (15 CHO)• Whip Potatoes (15 CHO)• Flour Tortillas (30 CHO)• Baked Potato (30 CHO)• French Fries (30 CHO) Regular only

Fruit:• Banana (30CHO)• Orange (30 CHO)• Apple (15 CHO)• Melon Cup (15 CHO)• Applesauce (15 CHO) • Fruit Cocktail (15 CHO)• Peaches (15 CHO)

Condiments:• Ketchup/Mustard• Italian Dressing /French dressing• Mayo • Salsa• Vinegar• Tartar Sauce• Sour Cream

Breakfast: Served any meal• Pancakes/ French toast (15CHO each)• English Muffin (1/2 15CHO)• Bran or Blueberry muffin (30 CHO)• Fried Egg

• Scrambled Egg w/ Cheese• Boiled Egg

Snacks:• Peanut Butter• Cheese • Graham Crackers (15 CHO)• Crackers Salt Free (15 CHO)• Crackers Saltine (15 CHO)

Sweets:• Sugar free Gelatin (red) • Regular Gelatin (red) (15 CHO)• Sugar free pudding:

Vanilla (15 CHO)Chocolate (15 CHO)

• Regular pudding:Vanilla (20)Chocolate (20)

• Sherbet (30 CHO)• Ice cream:

Vanilla (20 CHO)Chocolate (20 CHO)

• Sugar Free Vanilla Ice Cream (20 CHO)• Yogurt: Vanilla-Sugar Free (30 CHO)• Fruited-Regular (40 CHO)• Pecan Pie (60 CHO) Regular Only• Carrot Cake (45 CHO) Regular Only• Chocolate Layer Cake (45 CHO) Reg.

Only• Angel Food Cake (30 CHO)



You or your family members may hearphysicians and hospital staff use words orterms that you may not understand. Beloware some of the most common ones used inthe rehabilitation setting. Please feel free toask if you hear staff members using termsyou do not know. It is important to us thatyou and your family understand yourcondition and your treatment plan.

ADL (Activities of Daily Living) -Dressing,bathing, brushing your teeth, etc.

AFO (Ankle-foot orthosis) - A short legbrace.

Ambulate - To walk.

Anti-convulsant - Medication to decreasethe possibility of seizures; examples includeDilantin, Tegretol, Phenobarbital orMysoline.

Aphasia - Inability to express or understandideas.

Expressive aphasia - Inability to expressoneself.

Receptive aphasia - Inability to understandspoken language.

Global aphasia - Combination of both ofthe above.

Apraxia - Partial or total inability to moveeven though there is no evidence ofparalysis, nerve damage or lack ofunderstanding.

Aspiration - When food, liquid or otherfluids enter into the airway/lungs.

Assistive device - Special equipment thathelps a disabled person, such as canes,special eating utensils, hearing aids, etc.

Ataxia - Inability to coordinate movement;for example, a staggering walk.

Attention span - The length of time aperson can concentrate on a task or event.

BSC - Bedside Commode.

Bed mobility - Ability to move oneself ontoa mat or bed, by rolling, sitting or lyingdown.

Bilateral - Both sides of the body.

Catheter - A tube for draining urine that iseither inserted into the bladder internallyby using a foley catheter, or externally overthe penis using what is called a condomcatheter.

Clonus - Uncontrolled rhythmic jerks,usually occurs in ankles or wrists, caused bythe quick stretching of a muscle.

Cognition - Understanding and reasoning;the way the brain gathers and usesinformation.

Cognitive retaining - Learning how to usethe brain to think again.

Comprehension - Understanding orknowing what you see, hear or touch.

[ E X P L A N A T I O N O F W O R D S A N D T E R M S ]


Concrete thinking - Not understanding howsituations are alike; always seeing eachsituation as different; language isinterpreted literally.

Continence - Ability to control bowel andbladder functions.

Contracture - Loss of joint motion;stiffness.

DABSC - Drop arm bedside commode.

Decubitus - A skin irritation from being inbed or in one position; commonly called abed sore.

Dysarthria - A muscle condition whichcauses the patient to have slurred or unclearspeech.

Dysphagia - A swallowing disorder resultingfrom an injury or illness.

Emotional lability - Involuntary,uncontrolled laughing or crying.

Extension - Usually means to straighten ajoint, as in straightening your knee.

Fine motor activities - Activities that usesmall, complex movement of body partssuch as writing and moving small objects.

Flaccid - Lacking muscle tone; flabby.

Flexion - Usually means to bend a joint, asin bending your elbow.

Functional - Ability to perform usefulskills/activities in a reasonable amount oftime.

Gait training - Instruction in walking, withor without equipment; also calledambulation (to walk) training.

Gastrostomy tube - A feeding tube passeddirectly into the stomach from a surgicalopening in the stomach; used when patientcannot eat or has trouble swallowing.

Gross motor activities - Activities that uselarge movements of body parts such asrolling, sitting up or standing.

Hemianopsia - Loss of half the visual fieldin one or both eyes.

Hemiparesis - Lack of muscle control onone side of the body, such as right face,right leg (see Paresis).

Hypertonic - Abnormally tensed muscles.

Hypotonic - Abnormally relaxed muscles.

Independent - Ability to perform an activityconsistently and safely, in a practicalamount of time, without supervision orassistance.

LB - Lower body.

LE - Lower extremity.

Memory - Remembering something thathas been learned.

Motor planning problem - Difficultystarting, continuing and stoppingmovements when there is no actual muscleweakness or damage. May affect speech ormovement or the arms and legs. Alsoreferred to as Apraxia. (see Perseveration).

N/G tube (Nasogatric tube) - A tube that isinserted into the nose and goes to thestomach to provide nutrition, liquids ormedicines.

Non-purposeful movement - Movement orany part of the body which has no apparentpurpose.

Nystagmus - Involuntary movement of theeye.

NPO - A medical abbreviation for aphysician’s order that the patient is toreceive “nothing by mouth.”

Orthotics - Devices to help support aparalyzed leg or to help correct a legdeformity; leg braces.

Orientation - Being aware of self, otherpeople, time and place.

Paralysis - Inability to move a muscle orgroup of muscles voluntarily.

Paresis - Lack of control of a muscle orgroup of muscles; partial or incompleteparalysis.

Perception - Ability to recognize objects,including size, shape, color, and distance.

Perceptual motor - Ability to use eyes andhands together for activities such as eating,picking up objects, etc.

Perseveration - Uncontrolled, involuntaryrepetition of speech or activity (see Motorplanning).

Premorbid - A term to describe the patient’scondition before the injury or illness.

Pressure area - A sore or discolored area ofskin caused by continued pressure, whichcould eventually develop into a bed sore.

Prosthesis - An artificial body part, usually aleg or arm.

Prone - Lying face down.

Quadriparesis - Lack of control of all fourarms and legs (see PARESIS).

Range of Motion (ROM) - How far apatient can move a body part such as liftinga leg or arm. The ROM is measured indegrees.

Passive Range of Motion (PROM) - Whenthe therapist moves the joint without helpfrom the patient.

Active Range of Motion (AROM) - Whenthe patient moves the joint without helpfrom the therapist.

Reality Orientation (R.O.) - An exercisethe care giver goes through with the patientto review names of familiar people, placesor things.

UB - Upper body.

UE - Upper extremity.



[ N O T E S ]

A.E. Finley YMCA9216 Baileywick RoadRaleigh, NC 27615(919) 350-3800

Banks D. Kerr Family YMCA2500 Wakefield Pines DriveRaleigh, NC 27614(919) 350-3800

Cary Family YMCA101 YMCA DriveCary, NC 27513(919) 350-3800

Kraft Family YMCA 8921 Holly Springs RoadApex, NC 27539(919) 350-3800

WakeMed Rehab Hospital3000 New Bern AvenueRaleigh, NC 27610(919) 350-7876

WakeMed Raleigh CampusOutpatient Rehab Program 3000 New Bern Avenue Raleigh, NC 27610(919) 350-8550

WakeMed Wake Forest Road Outpatient Rehab Center 3701 Wake Forest RoadRaleigh, NC 27609(919) 350-4200

WakeMed North HealthplexOutpatient Rehab Center10000 Falls of Neuse RoadRaleigh, NC 27614(919) 350-1470

WakeMed North HealthplexPhysicians Office Pavilion10010 Falls of Neuse RoadSuite 015Raleigh, NC 27604(919) 350-1470

WakeMed Clayton Medical ParkOutpatient Rehab Center555 Medical Park PlaceSuite 101Clayton, NC 27520(919) 350-4242

WakeMed Brier Creek Medical Park10208 Cerny StreetRaleigh, NC 27617(919) 350-0978

WakeMed Fuquay-Varina Outpatient & Skilled Nursing Facility 400 W. Ransom StreetFuquay-Varina, NC 27526(919) 350-4646

WakeMed Zebulon/WendellOutpatient Rehab Program 535 W. Gannon AvenueZebulon, NC 27597(919) 350-4782

WakeMed Zebulon/WendellSkilled Nursing Facility & Rehab Program535 W. Gannon AvenueZebulon, NC 27597(919) 350-4700

WakeMed Home Health 2920 Highwoods Blvd.Raleigh, NC 27604(919) 350-7990

W a k e M e d R e h a b [ O U R R E H A B F A C I L I T I E S ]

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