rehab notbk part 1 - wakemed health & hospitals | raleigh ... with you in the hospital so that...

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 ]

WakeMed Rehab is a strong link in the world-class WakeMed health system. All WakeMed rehabilitation services– including in-hospital medical care, inpatient rehab, daytreatment, outpatient rehab and home health – are connected,forming a smooth, well-defined path to your recovery.

We call this a continuum of care. For our patients, this meanswe’ll be with you every step of the way on your journey tomaximum rehabilitation and independence.

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 important part of the full rangeof rehabilitation services provided by WakeMed Rehab. Onceyou enter our doors, we will work to increase yourindependence, so you can return to doing the things that areimportant to you.

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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 Complaints/Grievance Procedures . . . . . 6

Patients Rights and Responsibilities . . . . . . . . . . 7

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

Patient Satisfaction . . . . . . . . . . . . . . . . . . . . . . 12

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

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

Family Training . . . . . . . . . . . . . . . . . . . . . . . . . 16

A Team Approach . . . . . . . . . . . . . . . . . . . . . . . 18

Individualized Plan of Care . . . . . . . . . . . . . . . 21

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

Discharge Programs . . . . . . . . . . . . . . . . . . . . . .22

Health Promotion . . . . . . . . . . . . . . . . . . . . . . .23

Explanation of Words and Terms . . . . . . . . . . . 24

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

WakeMed Rehab Hospital is a 98-bed,state-of-the-art inpatient rehabilitationprogram that will help you if you haverecently had a stroke, brain injury, spinalcord injury, amputation, orthopaediccondition, other physical trauma or medicalcomplication. 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 setting foryou and your family. Please let us know whatwe 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, and, ifappropriate, speech therapy services. You willreceive nursing services around the clock. Youmay also be involved in neuropsychology,therapeutic recreation, community re-entryactivities, counseling and education programs.The staff may coordinate community outingsthat may include shopping, visiting a park,bowling, or enjoying a meal at a restaurant.

Your therapies are all offered on-site in theWakeMed Rehab Hospital. We havecomprehensive rehabilitation gyms where youwill go for occupational and physicaltherapies. Our speech and language therapyprogram will help you with any speech,language, cognitive, eating/swallowing, orfacial movement problems 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 formally begin the day after admission. You will get a dailytherapy schedule to carry with you to yourtreatment sessions. The nursing staff andtherapists will help you get to your 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 | 3

This education notebook is provided to help organize writtenmaterials you may get from various members of your treatmentteam. We are committed to meeting you and your family’seducational needs so that you can actively participate in theoverall rehabilitation plan.

We encourage you to share these materials with your family tohelp them learn more about your rehabilitation. They may takethese materials home to read, but you will want to keep thenotebook with you in the hospital so that materials can be addedthroughout your stay.

This notebook is for you to keep, so feel free to add your owninformation. We hope that it will be a resource for you and yourfamily during and after your stay at WakeMed Rehab.

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

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

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

Alisa Dunn, Manager, Rehab Therapy Services . . . . . . . . . . . . . . . . . (919) 350-6344

Diane Gilewicz, Manager, Rehab Nursing Services (2D) . . . . . . . . . (919) 350-6482

Christine Fernandini, Manager, Rehab Nursing Services (2C) . . . . . (919) 350-2879

Renée Patton, Manager, Rehab Nursing Services (3C) . . . . . . . . . . . (919) 350-8970

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

3C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. WakeMed Rehab Hospital isalso accredited by CARF, the AccreditationCommission for Rehabilitation 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.

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

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 Rehab

management will conduct an investigationand respond to you in writing within 10business days. If you would like to file aformal grievance, you may call or write to:Elaine Rohlik, MD, Executive DirectorWakeMed Rehab 3000 New Bern Ave., Raleigh, NC 27610(919) 350-8852

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

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 protectiveservices) with support from the hospital.The hospital 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 Servicesat 1-800-624-3004. The address for patientswishing to send a written complaint toDivision of Health Services Regulation,Complaint Intake Unit is:

2711 Mail Service CenterRaleigh, NC 27699-2711

In addition, for grievances related to qualityof care or premature discharge, patients havethe right to request review by the NorthCarolina Peer Review Organization.

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 evidence-based 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 conflictwith 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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[ P A T I E N T S A T I S F A C T I O N ]


We are committed to providing you withexcellent care and quality service. We areconstantly monitoring our system andprograms and looking for ways to improvethe service you receive. Throughout yourstay, the staff will ask about your satisfactionwith the care you are getting. We encourageyou to be open and honest about how thingsare going and what you would like donedifferently.

Within 30 days after you leave, you may becontacted by our patient satisfactionconsulting group, called PRC or ProfessionalResearch Consultants, who will ask youquestions to see if you were satisfied withour program. You may also receive atelephone call from an organization calledMedTel Outcomes. WakeMed contractswith them to gather both satisfaction andfunctional outcomes information. These callsare generally made 90 days after discharge.Our management team uses thisinformation 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 may be able towash any clothing that becomes soiled due tospills or bowel/bladder control accidents. Youmay be encouraged when appropriate to doyour own laundry as part of your therapy. Yourtherapist will 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, simply dialthe five-digit extension number. If you needassistance, dial “08000” to reach the hospitaloperator.

To make outside local calls, dial 9 + 919 + thelocal number. There is no charge for localcalls.

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

We welcome you to use your cell phonethroughout most of WakeMed. If you areunsure about using your cell phone in aparticular area, please ask the nurse.

M E D I C A T I O N S

Your attending physician must prescribe allmedications you will use while you are here.They will be dispensed by our pharmacy. Thisensures your medications are coordinated byone health care professional. If you prefer tohave certain medications, supplements orherbs, please discuss this with your 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 yournurse ahead of time. Family members arewelcome to bring their own food and join youduring lunch and dinner in your room or inthe larger dining area. The dining schedule is:

Breakfast – Served around 7:30 am in the patient dining area or in your roomLunch – Served at noon in the patient dining area or in your roomDinner – Served at 5 pm in the patient dining area or in your room

Y O U R R O O M

Your room is equipped with a telephone andtelevision. Most rooms are shared, so you willlikely have a roommate. A limited number ofprivate rooms are available for patients withspecial needs or whose medical condition mayrequire 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)3000 New Bern AvenueRaleigh, NC 27610

C A F E T E R I A

Cafe 3000 is open from 6 am to 1 am daily.

A U B O N P A I N

Sunday – Thursday, open 24 hours; Fridays, 5:30 am to 11 pm;Saturdays, 6 am to 10 pm.

C H A P E L

A meditation chapel is located on the thirdfloor of the main tower between 3A and 3B.The chapel is available to you and yourfamily at any time. Please ask your nurse foradditional information on daily services. Inaddition, if you or your family would likespiritual support during your hospital stay,ask anyone on your treatment team to pagethe chaplain. Chaplains are sensitive to thediverse spiritual needs of patients of allfaiths. Spiritual Care will also be happy tocontact representatives of particular faithtraditions upon request.

P A R K I N G P A S S

Visitors or family members may request a 7-day discounted parking pass from theparking attendant. The cost for a 7-day pass is $18.

Family members of patients who have beenhospitalized at WakeMed for 30 days ormore are eligible for free parking. Parkingtickets may be validated at the E-Towerinformation desks.

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

Realizing the important role visits fromfamily and friends play in the recoveryprocess, visitation at WakeMed is open (nodesignated visiting hours). In general, youwill be available to have visitors at any time.However, please expect that the focus ofyour day will be on completing yourscheduled therapy sessions.

We also have Quiet Hours, which begin at 8 pm. During Quiet Hours, lights aredimmed and noise is kept to a minimum tofurther promote our healing environment.

We look forward to your family and friends’involvement in your recovery and welcomeany suggestions that they may haveregarding your stay at WakeMed.

W I F I

Feel free to access the internet usingWakeMed’s guest network. The name of thenetwork is “WakeMed”.


With your permission, our clinical casemanagement staff will talk to your designatedfamily member regularly for various reasons,which include:• Reports on your progress• Educational information about your

condition• Supportive counseling• Financial information• Discharge planning assistance • 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 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 observationand training sessions and family conferencesas 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.

Another type of training session is forpreparation for pass (a pass is when you arecleared to leave the hospital to go out in thecommunity or home for a day visit). Ifappropriate, this is scheduled for your familyto learn actual hands-on care you may need.It also gives you the opportunity to “showoff ” your progress. The objectives for thissession include family participation in yourcare and preparation so that they may assistyou while you are on a day pass outside ofthe hospital. Your family will again followyour regular schedule. During breaks in yourschedule, other members of your treatmentteam may meet with you and your family asnecessary.

The final, and most critical, type of trainingsession is to prepare you and your family foryour discharge (when you leave the hospitalto return home or go to an appropriatefacility). This training happens near the endof your stay at WakeMed Rehab. The focusof this session is to provide education andassistance to help you and your familyprepare for your discharge. This training willhelp you tie up loose ends and addressquestions and concerns to ensure yoursmooth transition at discharge.

Many times only one training session isneeded. In this case, all of your care needsand any questions your family may have willbe addressed during this 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 your family follow your wheelchair cardschedule and be punctual.

• Family training is scheduled for one-halfday unless otherwise requested by the teamor 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 P1 visitor parkingdeck. During physical therapy training youmay be asked to bring your car 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 Rehab receptionist will stamp yourcard.

• Please meet your family member in his/herroom or scheduled therapy session,depending on the 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 or at a nursingfacility. If there is anything we can do toimprove this process, please let your clinicalcase 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 weekendsbetween 10 am and 8 pm, followingcompletion of any scheduled therapysessions. A family member or other caregivermust have successfully completed trainingbefore a pass will 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, 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 and your family.Your input and feedback is alwayswelcomed.

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 andprepared 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 care doctor andcoordinates the overall team treatmentprogram, while also consulting otherspecialists as needed.

Advanced Practice Provider: The advancedpractice provider is nationally board certifiedand is licensed by the state of NorthCarolina to practice medicine under thesupervision of a physician. The advancedpractice providers at WakeMed Rehab workintimately with the physiatrists to manageyour medical care and rehabilitation 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 yourneeds. Your clinical case manager can alsoarrange individual and group counseling tohelp you and your family learn to cope withproblems. If going home is not an optionafter you are discharged, the clinical case

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manager will help you find an appropriatefacility. The clinical case manager can alsoprovide referrals to community resourcesthat may help you and your family duringthe hospital stay and after discharge. Theclinical case manager also providesinformation as appropriate to insurancecarriers for their review and certification ofyour hospital stay.

Rehabilitation Nurse: The rehabilitationnurse is a registered nurse (RN) withspecialized training in caring for patientswith disabilities. The nurse works closelywith other members of the nursing team(Licensed Practical Nurses and CertifiedNursing Assistants) to provide you withnursing care and your family with education.

Physical Therapist (PT): The PT workswith you to improve your overall strength,endurance, balance and coordination. Thetherapist helps you redevelop walking skillsor learn to move about safely in a wheelchairor with other equipment, such as a walker orcane. If you have limited range of motion ina joint, pain, loss of movement or loss ofsensation, you may benefit from physicaltherapy to improve your strength and long-term physical fitness.

Neuropsychologist: Neuropsychologists arepsychologists with specialized training inbrain behavior relationships. They evaluateand treat cognitive (thinking abilities),emotional and behavioral effects ofneurological injury. The neuropsychologistmay conduct a neuropsychologicalassessment, assist with behaviormanagement services and provide educationto you and your family.

Occupational Therapist (OT): The OTworks with you if you have disabilities thatcan keep you from doing daily livingactivities. These activities may be feeding,dressing, bathing and grooming, or morecomplex tasks such as planning a menu,shopping for groceries, cooking a meal ordriving a car. The occupational therapistmay also design splints and other adaptiveequipment to help you increase your abilitiesand decrease further disability. If you havelimited range of motion in a joint,diminished muscular strength andcoordination, visual impairments, or limitedthought processing skills, you may benefitfrom occupational therapy.

The Occupational Therapy Departmentincludes a kitchen, living area, bedroom andbathroom where you can work with thetherapist nearby, and simulate at-homeactivities such as getting on and off of thetoilet, into and out of the bathtub, and onand off a bed or couch. In addition, you maywork on laundry skills and meal preparationskills.


Speech-Language Pathologist (SLP): The SLPevaluates and treats your speech, language, voiceand thought processing disorders. The speech-language pathologist evaluates and treatsswallowing disorders that may hamper yourability to eat and take medications by mouth.The primary focus of speech therapy is tomaximize your ability to communicate andswallow.

Clinical Dietician: The clinical dietitian is aregistered dietitian (RD) specially trained in thefield of nutrition. The RD reviews your diet, seeswhat special dietary needs you 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.

Therapeutic Recreation Specialist: Thetherapeutic recreation specialist helps youunderstand the value of leisure time activitiesand address lifestyle changes that you may needas a result of your injury or illness. In-hospitalactivities provide you with a social environmentfilled with leisure activities.

Through education and community outings, thetherapist helps you increase social skills andawareness of accessible, affordable communityservices and activities. As the link between in-hospital care and the return to daily life, therecreation specialist uses these outside activitiesto evaluate how well your physical, occupational,and speech therapy skills are working in real-world situations.

Spiritual Care: Our chaplains are available tomeet with you or your family members to offerspiritual support.


Your care plan will be designed just for you.We will focus on every aspect of you as aperson: your lifestyle, relationships,personality, behavior, physical and cognitiveabilities, and available support systems.

After initial evaluations are completed byyour treatment team, a plan of care will bedeveloped. This will be documented andupdated each week in a report called “CarePlan and Team Conference Report”, whichwill be provided to you and your family andreviewed by your clinical case manager. Yourinput into your plan of care is veryimportant, and your clinical case managerwill work with you and your family toidentify your specific needs.

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

C A R E I N C L U D E :

• Current Status: This section will providebrief updates on how you are doing inseveral key areas.

- medical status (medications, painmanagement, bowel and bladder control)

- mobility (how you are moving around inyour wheelchair or walking, andtransferring from one surface to another)

- activities of daily living (how you arebathing and dressing, and toileting)

- cognition/communication (how you areexpressing and understanding language,as well as your memory, problem solvingand safety awareness)

- swallowing (how you are managingdifferent food consistencies and safelyswallowing)

• Discharge Goals: Each therapy disciplineinvolved in your care sets goals onanticipated progress during your time inRehab, and adjusts these goals as needed.This is done to help you and your familyplan for the care and assistance you mightneed at discharge.

• Discharge Information: An estimatedlength of stay or discharge date will beprovided to you on each report. To helpwith planning for post-discharge care,recommendations regarding how muchsupervision and assistance you might need,along with follow-up therapy and medicalequipment needs are included.

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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 identifyyour needs and assist with the transition. Tohelp you and your family when you aredischarged from WakeMed Rehab, yourclinical case manager will work very closelywith other treatment team members toidentify problem areas, continued care needsand equipment needs.

Your case manager will make appropriatearrangements for the follow-up therapy andequipment you may need. Before you aredischarged from WakeMed Rehab, your casemanager will give you choices regardingagencies and/or vendors who can provide youservices after you leave WakeMed Rehab.

D I S C H A R G E P R O G R A M S

Independence Day

Just before your discharge from the RehabHospital, you will celebrate “IndependenceDay”. You will be asked to do everythingwithin your abilities for yourself. Your teammembers will be close by to evaluate andencourage you, but they will challenge youto carry out your tasks of the day asindependently as possible. We will make theday special for you and celebrate youraccomplishments!

WakeMed Pharmacy Discharge Service

The WakeMed Pharmacy offers a service topatients discharging home from Rehab thatsimplifies the process of obtainingmedications. If interested, you can let yourcase manager know and you will becontacted by a pharmacy dischargecoordinator who will take care of yourmedication needs prior to leaving thehospital. The prescriptions will be deliveredto your room, including any over-the-counter items you would like to purchase.The pharmacy accepts all major prescriptioninsurance plans, offers many $4 medications,and payment can be handled over the phonewith a family member.

WakeMed MyChart

All patients now have access to WakeMedMyChart, an online portal that provides24/7 access to portions of your electronicmedical record. WakeMed MyChart savesyou time and allows you to better manageyour health through convenient access toimportant clinical information. Your nursecan help you sign up for WakeMedMyChart while you are in Rehab. Signupinstructions will also be on your Dischargepaperwork, along with a personal activationcode if you do not already have one. Youmay also call 919-350-2288 to havesomeone help walk you through the stepsover the phone.

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There are a number of things that you can doto continue your recovery after discharge. Inaddition to participating with any follow uptherapy services ordered for you, a routine offitness, good nutrition and weightmanagement are all very important to yourwellbeing.

E X E R C I S E

Remember, exercise is medicine – you need adaily dose! It is best to aim for at least 30minutes of exercise each day. Whether it is awalk around the block, dancing to yourfavorite songs, or joining a gym to continuethe gains you have made in Rehab, movementis good. For maximum health benefits, acombination of moderate-intensity aerobics(walking, swimming, etc.) and muscle-strengthening activities (resistance trainingwith bodyweight, resistance bands ormachines, or dumbbells) each week isrecommended.

N U T R I T I O N

Like exercise, nutrition is not “one size fitsall”. However, it is important to eat a well-balanced diet to provide your body withnutrients necessary for proper function.MyPlate is a wonderful resource to help setgoals and incorporate a healthy eating styleinto each day. Visit the MyPlate website(choosemyplate.gov) for a fun, educational,and interactive experience for the wholefamily.

W E I G H T M A N A G E M E N T

Healthy weight control is influenced by severaldaily actions: getting enough exercise, makinghealthy nutrition choices, minimizing stress,and getting 6-8 hours of quality sleep. Aquality diet of fruits, vegetables, lean proteins,and whole grains mixed with a daily physicalactivity regime is one of the best ways tomanage weight. In addition, adequate sleepand minimal stress can help the body betterregulate hormones that help keep weight incheck.

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You and 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.

Ambulate – To walk

Aphasia – Inability to express or understandideas

• Expressive Aphasia – Difficultyexpressing oneself

• Receptive Aphasia – Difficultyunderstanding spoken and/or writtenlanguage

• Global Aphasia – Combination of bothof the above

Apraxia – Partial or total inability to move,even though there is no evidence ofparalysis, nerve damage or lack ofunderstanding

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

Assistive Device – Adaptive or rehabilitativeaid

SPC – Single Point CaneSW – Standard WalkerRW – Rolling WalkerPRW – Platform Rolling WalkerHW – Hemi-WalkerW/C – Wheelchair

SB – Slide BoardBSC – Bedside CommodeDABSC – Drop Arm Bedside CommodeSC – Shower ChairTTB – Tub Transfer BenchRSC – Rolling Shower Chair

Ataxia – Inability to coordinate movement

Attention Span – The length of time aperson can concentrate on a task or event

Bed Mobility – Ability to move oneself on amat or bed, by rolling, sitting or lying down

Braces – (a device used to restrict or assist inbody movement)

AFO – Ankle Foot Orthotic PRAFO – Pressure Relieve Foot OrthosisTLSO – Thoracolumbosacral Orthosis Cervical Collar – Neck Brace to restrictmovement

Catheter – A tube for draining urine that isinserted into the bladder, either remaining inplace (foley catheter) or used per episode ( inand out catheter/ I&O)

Clonus – Uncontrolled rhythmic jerks,usually occurring in ankles or wrists, causedby quick stretching of the muscle

Cognition – Understanding and reasoning;the way the brain gathers and usesinformation in problem solving and memory

Comprehension – Understanding what yousee, hear or touch

Concrete Thinking – Interpretinginformation literally; sometimes called“black and white” thinking

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Continence – Ability to control bowel andbladder function

Decubitus – Commonly called a bed sore

Dysarthria – A muscle condition whichcauses slurred or unclear speech

Dysphagia – A swallowing disorder

Emotional Lability – Involuntary,uncontrolled laughing or crying

Extension – Usually means to straighten ajoint

Extremities – Arms and legsL – LeftR – RightB – BilateralUE – Upper ExtremityLE – Lower Extremity

Fine Motor Activities – Activities that usesmall, complex movement of body parts suchas writing and moving small objects

Flaccid – Lacking muscle tone

Flexion – Usually means to bend a joint

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

Gait Training – Instruction in walking, withor without equipment

G-Tube – A feeding tube passed directlyinto the stomach; used when patient cannoteat or has trouble swallowing

Gross Motor Activities – Activities that uselarge movements of body parts such asstanding, walking, sitting up

Hemiparesis – Lack of muscle control onone side of the body, such as right leg or leftarm

Hypertonic – Abnormally tense muscles

Hypotonic – Abnormally relaxed muscles

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

Independent (I) - Patient is 100% able to dotask without assistance

Modified Independent (Mod I) - Patient isindependent with task, but requires use ofassistive device or needs increased time

Supervision (S) - Patient can do task onown, but needs helper watching to ensuresafety

Set-up – Patient can do task on own, butneeds help setting up (example: puttingtoothpaste on toothbrush)

Standby Assist (SBA) - Patient needs helperto stand close by to ensure safety

Contact Guard Assist (CGA) – Patientneeds helper to place hands-on to ensuresafety

Minimum Assist (MIN) – Patient does 75%of task, with up to 25% assistance neededfrom helper

Moderate Assist (MOD) – Patient does50% of task, with up to 50% assistanceneeded from helper

Maximum Assist (MAX) – Patient does25% of task, with up to 75% assistanceneeded from helper


Dependent (DEP) – Helper does 100% ofthe task for patient

L E V E L S O F C O M M U N I C A T I O N

A N D C O G N I T I O N

Within Normal Limits (WNL) – Patient isfunctioning at a normal level for age ordevelopmental stage

Within Functional Limits (WFL) – Patientis able to function in environment

Mild Deficits – Patient has some difficultywith skills and may require aids to assist,such as to-do lists, memory books, alarms,etc.

Moderate Deficits – Patient’s difficultiessignificantly impact tasks or ability tocommunicate

Severe Deficits – Patient has great difficultywith even basic tasks

Profound Deficits – Patient is unable tocomplete daily tasks or express basic wantsand needs

Memory – Remembering something thathas been learned

Motor Planning – Ability to start, continueor stop movements when there is no actualmuscle weakness or damage

NG Tube – Nasogastric tube; A tube that isinserted into the nose and goes to thestomach to provide nutrition, liquids ormedicines

Non-Purposeful Movement – Movement ofany part of the body which has no apparentpurpose

Nystagmus – Involuntary movements of theeye

NPO – A medical abbreviation for “nothingby mouth”

Orthotics – Devices that help support aparalyzed leg or to help correct a legdeformity

Orientation – Being aware of self, otherpeople, time and place

Paralysis/Paresis – Inability to move amuscle or group of muscles

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 repetition ofspeech or activity

Premorbid – A term to describe thepatient’s condition before the injury orillness


Prosthesis – An artificial body part, usually aleg or an arm

Quadriparesis – Lacking control of botharms and both legs

Range of Motion (ROM) – How far apatient can move a body part

• Passive Range of Motion (PROM) –When the therapist moves the jointwithout help of the patient

• Active Range of Motion (AROM) –When the patient moves the jointwithout help from the therapist

Transfer – Moving from one surface toanother or coming to a standing position

Weight-Bearing Status:NWB – Non-Weight BearingPWB – Partial Weight BearingTDWB – Touch-Down Weight BearingWBAT – Weight Bearing as Tolerated


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 | 2 8

[ N O T E S ]

I N P A T I E N T

L O C A T I O N

WakeMed Rehabilitation Hospital3000 New Bern AvenueRaleigh, NC 27610

O U T P A T I E N T

L O C A T I O N S

WakeMed Raleigh CampusOutpatient Rehab Program3000 New Bern AvenueRaleigh, NC 27610

WakeMed Healthworks3000 New Bern AvenueRaleigh, NC 27610

WakeMed Clayton Medical Park555 Medical Park PlaceClayton, NC 27520

Alexander Family Y1603 Hillsborough StreetRaleigh, NC 27605

Banks D. Kerr Family Y2500 Wakefield Pines DriveRaleigh, NC 27614

Cary Family Y101 YMCA DriveCary, NC 27513

Kraft Family Y8921 Holly Springs RoadApex, NC 27539

WakeMed Wake Forest RoadOutpatient Rehab Center3701 Wake Forest RoadRaleigh, NC 27609

WakeMed Physician Practices –Physical Therapy North10010 Falls of Neuse RoadSuite 015Raleigh, NC 27614Operates as an independent practice

WakeMed Physician Practices –Physical Therapy Cambridge Village of Apex10000 Cambridge Village LoopApex, NC 27502Operates as an independent practice

Home HealthWakeMed Home Health2920 Highwoods Blvd.Raleigh, NC 27604919-350-7990

Wound Care3000 New Bern AvenueRaleigh, NC 27610

To Make a Referral to WakeMed Rehab or WPP-Physical Therapy

Inpatient: 919-350-7876

Outpatient (including WoundCare): 919-350-7000

WPP-Physical Therapy:919-350-1508

WakeMed Clayton Medical Park, Wake Forest Road Outpatient Rehab Center, Kerr Family Y and Alexander Family Y locations are operated byWakeMed Raleigh Campus. WakeMed Apex Healthplex, Kraft Family Y and Cary Family Y are operated by WakeMed Cary Hospital.

R e h a b i l i t a t i o n F a c i l i t i e s [ W A K E M E D R E H A B I L I T A T I O N L O C A T I O N S ]

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