On the Road Again: Reintegrating NeuLife’s Clients into Independence

The goal of everything we do for our clients in their post-acute rehabilitation experience at NeuLife is geared toward advancing them toward independence to the fullest extent of their physical and psychological abilities. NeuLife consistently provides the highest standard of care in the delivery of clinically relevant services to achieve successful, sustained outcomes and exceed the expectations of all persons served.

In the first 72 hours of admission to NeuLife, the staff evaluates the client and based upon the results of that evaluation, an customized Client Goal Plan is developed. The Client Goal Plan not only sets benchmarks for the functional rehabilitation that NeuLife provides, but also the roadmap as to how those benchmarks will be reached.

Broadly, the roadmap consists of a regimen of rehabilitation and specialized rehabilitation. More narrowly, it consists of brain injury rehabilitation, cognitive therapy, learning compensatory strategies, spinal cord injury rehabilitation, neurorehabilitation, neurological interventions and a host of other therapies and rehabilitation. The therapy and rehabilitation at NeuLife in Mount Dora is provided by members of our multidisciplinary team.

The goal of NeuLife is not for you to stay with us forever. It is to work with you on your rehabilitation with the goal of ensuring the best possible outcome for you. In short, we strive to propel you to create for yourself a new life with the superior care that we provide. That new life may be fully independent living or living with some degree of support, such as with your family. But we also recognize that because of your catastrophic injury — whether it was a brain injury, a stroke, a spinal cord injury, a traumatic amputation or a catastrophic injury of some other type, reintegration to complete independence or even to supported living with family, much less into society, can be hard.

Let’s take strokes, for example. Emotional alterations often happen after strokes. Anxiety results from the suddenness of the occurrence, the fear of the potential disability and what may be a more restricted lifestyle. One study looked at reintegration into the community of individuals who had strokes but had received physical therapy. Among other measures, their activities of daily living were measured, as well as a measurement called the Reintegration to Normal Living Index to measure their reintegration into normal social activities. The conclusion of the study was that physical impairment had a very great correlation with reintegration of individuals who had strokes into society. With the improvement of their physical condition, though, the individuals who suffered strokes were far more easily integrated into society[1].

Much of the rehabilitation and specialized rehabilitation that is used to help reintegrate an individual into, or toward, independent living is occupational therapy. Contrary to what you might think, “occupational” does not only refer to the return to work by a person who has sustained a catastrophic injury. Instead, occupational therapy involves the treatment of injured, ill or disabled patients through the therapeutic use of everyday activities. It helps these individuals develop, recover and improve the skills needed for daily living and working, and to obtain and to implement additional ones.

The precise course of post-acute rehabilitation differs depending upon the kind of catastrophic injury sustained. Therefore, the Client Goal Plan for each of NeuLife’s clients for whom post-acute rehabilitation is provided is different and will be modified to include an element to prepare the client for community integration to facilitate the final step in the process: the attainment of independence, however that might be defined — living alone, living with family or otherwise. An occupational therapist plays a key role as part of an multidisciplinary team in achieving reintegration in some or all of the following ways that can be applied to day-to-day independent living:

• Teach the use of memory compensation techniques such as daily planners, technological devices, checklists and cueing systems.
• Assist in developing effective schedules and routines.
• Instruct individuals and family members in techniques to cope with changes in behavior and low frustration tolerance.
• Recommend environmental adaptations to assist with physical, perceptual and cognitive functioning, such as labeling cupboards and drawers, or using lighting to improve vision and/or attention.
• Assist in re-learning social skills through techniques such as pre-processing and rehearsal, where the individual and therapist anticipate challenging social situations and practice appropriate responses.
• Provide cognitive retraining exercises to address specific cognitive skills, such as attention, memory and executive functioning (e.g., using computer-based programs).
• Provide training and adaptation (if needed) for activities of daily living, such as dressing, bathing and grooming.
• Provide training and assist in the development of compensatory techniques for instrumental activities of daily living, such as preparing meals, shopping and caring for children.
• Facilitate the identification and development of healthy, fulfilling hobbies or other leisure activities for individuals who may not be able to return to work[2].

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best achieved in a positive and uplifting therapeutic environment where caring staff encourages, assists and supports each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to achieve function and independence.

NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

2725 Robie Avenue

Mount Dora, Florida 32757

[1] Murtezani, Ardiana, Hajrie Hundozi, Sanie Gashi, Teuta Osmani, Valbona Krasniqi, and Bukurie Rama. “Factors Associated with Reintegration to Normal Living After Stroke.” Medical Archives 63 (2009), 216–219.

[2]http://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/Community%20Reintegration%20fact%20sheet.ashx