Chances are, if you or a loved suffer a stroke or other serious illness or have orthopedic surgery, you could be recruited for something called Acute Rehab.
I’d never heard the term until my 93-year-old mother fractured a hip and wrist after a fall last year. She was in the hospital for about 10 days before, during and after the subsequent surgical repairs. But then, instead of her going home or being sent to a nursing home, she was chosen for acute rehab.
And when she fell again this year and faced revision surgery, she entered rehab again. I’m not in the medical field, but I feel somewhat experienced in acute rehab by now, having gone through it with a loved one twice now. And there are some things you should know.
It can be a blessing or a torture-filled experience, and sometimes it’s both. There are several truths you should know about acute rehab in case it touches your life in the future:
1) The good news is, being sent to acute rehab extends a patient’s stay in the hospital. This can be good because often, in my opinion, due to insurance issues people are discharged from a hospital too soon. It allows an opportunity to still be seen by doctors and treated by nurses, since acute rehab units are part of a major hospital. Not all hospitals have them, though, and the patient may have to be transferred to the appropriate facility.
The decision to be admitted to acute rehab is basically out of the patient’s hands, or those of their loved ones. It’s my experience after two times with my mother that it was just announced that we were very lucky and that was the plan. The reason for the decision remains a mystery. I have no idea how one qualifies or is passed over. But I do suspect one’s need to still be hospitalized comes into play, since Mom was in no condition to go home in terms of mobility or health issues.
2) The bad news is, the “acute” in acute rehab does not seem to apply to one’s overall physical condition. In addition to being elderly, Mom has several other health issues and therefore has been slower to recuperate. But this does not mean her condition is acute — it refers to the intensity of the rehab experience.
It’s acute in that it’s grueling. This is not a place where you’re gently prodded to get stronger, to walk a few steps or to try to exercise, which brings up point #3:
3) Welcome to boot camp, regardless of your age or condition! Mom’s being 93 meant nothing. She was required to do the same three-hour daily therapy as the 63-year-olds or the 53-year-olds. No exceptions. A stomach virus swept through the unit for a couple of days. Several patients, Mom included, suffered from the ailment. I heard a woman up and being forced to walk the hallways while protesting, “But I just threw up 10 minutes ago. I’m sick!” The therapists were very disappointed in Mom for refusing her afternoon session due to diarrhea. She feared being too far from the commode. But this was seen as defiance or weakness, not illness.
This brings up another issue:
4) You can be kicked out of acute rehab. Just as the doctors giveth, they can taketh away your time spent there. Refuse therapy a couple of times (for any reason), talk back to therapists who are being tough with you, fail to meet pre-set goals and guidelines, and you could be out. It happened to Mom the first time, and it happened to a patient two doors down from her this time. The nurses and therapists report everything – EVERYTHING – to the Medical Director of the unit. Don’t joke about refusing to obey, don’t say an unkind word or talk back…unless you’re prepared to find lodging elsewhere. It’s my opinion that many who are employed as therapists in acute rehab are frustrated Olympic trainers. This is their chance to train athletes, albeit ones with casts, walkers, crutches and ill health.
5) In contrast to the boot camp therapists, there are a few who adopt an approach better suited to pre-school than a hospital catering to adults. You moved your foot? “Yippee!” they’ll screech while applauding. You pulled up your pants alone? “Woo-hoo!” they’ll yell. It’s true. I would not make this up. Adults who have dementia or Alzheimers might find the technique comforting. I doubt anyone with normal or mostly normal mental capacity would. I found it demeaning and sickeningly cheerful, as did Mom.
6) In spite of it all, acute rehab can work. If you set your mind to the grueling task at hand, play by the rules even though you may hate them and the people issuing them, and if you are truly motivated to succeed, you can. Make friends with anyone possible, stick up for yourself or your loved ones if illness is really an issue, and turn to your doctor for moral support if you feel he or she has any pull with the situation.
One last caveat: When you do return home, your body will be expecting the intense exercises it endured and will need at least a variation on the intensity in order to stay limber, so you’ll need to set up your own mini version of the rehab experience to maintain and continue your progress. Woo-hoo!
