How to choose a medical rehab facility

I mentioned in last month’s mini-rants thread that my wife has been having some significant medical issues. At the time she had been in the trauma ICU for almost a month, dealing with major complications from a hernia surgery. Thanks to those who replied with wise and supportive words!

The bad news is that she’s still in the ICU–we’re coming up on eight weeks now. The better news is she’s making progress both cognitively and physically. The less better news is that she’s still got a long way to go. There are no plans to release her from the ICU, let alone the hospital, as of yet, but I did get in touch with a “care manager”/social worker who explained that rehab was likely the next step whenever she’s ready for it. Not a big surprise, there–I can’t imagine her dealing with home any time real soon.

So I have been given a list of rehab places. I’m to choose three and then they’ll see what they can do. The case manager was very kind and patient and explained that the degree of what my wife’s probably going to need limits the pool. She also noted that wanting a particular place is no guarantee of getting it: there are all kinds of reasons why a particular placement might not work out–no beds, not able to manage her specific needs, etc.

Trouble is, I really don’t have any idea what to base a choice on. The hospital is 50 miles away, and I’d prefer to have her close by–there’s an option just a couple of miles from here–but how important geography is I don’t know. Not even sure I would be able to visit. (Obviously I need to find out that kind of thing.) What else should I be thinking/asking about/looking for? Size? patient/caregiver ratio? Is there a Yelp for rehab facilities?

As you see, I don’t really know how to make an informed decision, and I’d appreciate any suggestions from those who’ve been there or know something about the system. It’s possible that I’ll wind up needing to make the decision on my own too, depending on how quickly the cognitive comes back, so I really want to make sure I get it right!

Thanks for any help!

Wouldn’t the ICU/hospital where she is have knowledge/experience of this sort of situation and be able to advise?

They aren’t going to recommend any one facility over others. There’s liability in not recommending a place or steering people away from facilities. They would likely be sued, at best, facilities not promoted would come down on them in fury.

They gave him a list of the facilities within a certain mileage range, no doubt all the licensed ones. If he’s lucky he might be able to get a staff person to tell him off the record, while they are covering up their name badge.

This would be one good question, especially if you can find out how many of the staff are licensed nurses, physical therapists, occupational therapists, speech pathologists, etc.

Ask whatever state agency regulates rehab faculties if that facility has been ever sanctioned. Grandly, by the time one is sanctioned, it has to be pretty deplorable, but it is a start.

Ask for a consult with a physiatrist, a doctor who specializes in physical rehabilitation, they should be able to steer you to the better places and the ones most appropriate for your wife. If you can find a nurse who has worked in home health care locally, ask them. They’d know because they take care of patients at home after they are released from the rehab facility. Your pastor may even know a colleague who has experiences with the various ones-the good ones have chaplains. Actually, this kind of decision can be something pastors and ministers are very good at helping a person walk through, the emotional support alone will help.

In general, the better ones tend to be non-profit and this atheist would tell you go even one step farther and try to find one associated with a mainstream denomination.

I spent a month and a half at in-patient rehab, 6 months as an out-patient, and later on 4 years on the Board of Directors for the same institution.

Find out how many hours per day of each kind of rehab will be provided and by whom. For example, I had an hour of physio per day one-on-one with a certified Physiotherapist. In addition, a PT assistant would spend another 30 minutes or so walking the halls with me as I graduated from wheelchair to a quad cane.

Interaction with other patients was also helpful for me as it helped me practice my speech therapy. The speech pathologist had an easier time understanding me, but when I talked with other patients I learned to slow down and make myself understood to them.

Thanks for the replies! Yes, ideally the ICU staff and the hospital social worker would steer me in the right direction, but @BippityBoppityBoo explained more cogently than I could why that wouldn’t work. Oh well.

I really like the enumeration of the kinds of rehab provided, and for how long question–thanks @FinstotheLeft. She’s certainly going to be in need of a ton of PT after seven+ weeks lying in a hospital bed.

I’ll definitely look around for people who might be in the know–it occurs to me that the nurse who has administered my wife’s gammaglobulin treatments in our home the last few years might be a good source. If not, maybe she knows someone who would be. And our pastor–duh. I’ve had a couple of really helpful conversations with her about the situations, and can’t think why I didn’t think of that on my own. (Well, I can: stress; I’m forgetting a lot of things. That is why I posted :)) BippityBoppetyBoo, I’m curious; did you know I had a pastor, or did you just assume?

Again, thank you very much. Any other ideas would be appreciated as well.

I’m afraid I don’t have anything to contribute to your decisions, but I hope it all turns out well. Sorry to hear about the travails your missus is going through.

Thank you! I appreciate the kind thoughts.

I didn’t assume, I hoped that it would be something you’d consider because in almost a half century of just this kind of nursing I’ve seen how powerful an ally a pastor/rabbi/priest/minister not only can be but is eager to be. Succor, solace and support is why they choose to be there and walk beside us when we are struggling with the thorniest life and death decisions. I laughed at myself when I typed it-remember I said I was a confirmed atheist? I really am, but I also believe in the depth and power of what I have seen them do.

Many congregations have Stephens Ministries, which also could offer a steadfast listening ear in addition to a pastor/minister/etc. Avail yourself of everything you can. A Bible Study group offers to bring over some casseroles or soup for your freezer? Let them.

Glad to hear you have a lead on a home health nurse-s/he is going to have the most reliable boots-on-the-ground skinny you could hope to get.

In a couple of months come back and we can have a good laugh about this old atheist pushing pastoral counseling at you. Glad it may help. That makes my time well spent (I’m a really slow typist).

Do you know any local paramedics? They tend to see the inside of nursing and rehab facilities in an unplanned and unscripted way. They could tell you if any of the places on your list are ones to avoid.

@pendgwen, good idea. I’ll have scan my mental rolodex. Thanks!

@BippetyBoppetyBoo, thanks again. Especially since you are a slow typist! I do appreciate the time and energy you’re putting into these responses. You’d written “Your pastor,” as though of course I had one, which made me wonder if you had Inside Information (and if so, how), because I do! I’m going to write her an email now.

I really like the “is eager to be” in your comment–that has been my experience as well, and it’s a great way to put it. We don’t have a Stephen Ministry, but several members of my church have helped us eat much better than we would have lately :slight_smile:

Anyway, from my point of view your response was indeed time well spent, so thank you.

Thank for the warm fuzzies. I’m honored to be invited into your life. I will handle with care.

Once a nurse, always a nurse. My typing fingers are yours-both of them.:upside_down_face: