Hunter Holmes McGuire VA Medical Center - Richmond, VA

Frequently Asked Questions - Polytrauma

1. Who is on the interdisciplinary rehabilitation team?

Our team is made up of specialists across a variety of fields. At the beginning of your rehabilitation stay, the team leader will be our Physiatrist (rehabilitation doctor), but by the end of your stay we hope to transfer leadership to yourself or a family member. Team members specialize in a variety of services, including:

Physiatry (rehabilitation doctor) Pharmacy
Admissions Coordination Patient/Family Education
Nursing (specializing in rehabilitation) Internal Medicine
Social Work/Case Management Amputee Care
Psychology and Neuropsychology Wound Care
Physical Therapy (PT) Assistive Technology
Occupational Therapy (OT) Fisher House
Kinesiotherapy (KT) Military Liaisons
Speech & Language Pathology (SLP) Animal Assisted Therapy
Recreation Therapy (RT) Chaplaincy
Vision Therapy (BROS) OEF/OIF/OND Care Management

2. What does a typical day look like?

Typically, patients wake up between 6am and 7:30am. Breakfast is between 7:00am and 8:00am. Then you will have 1-3 therapies between 8:00am and 12:00pm. Lunch is from 12:00pm to 1:00pm. After lunch, you will have 1-2 therapies until 3:00pm. Dinner is at 4:30pm.

Sample schedule:

Most patients have PT, OT, KT and SLP daily. BROS, Psychology and RT are usually not every day of the week.

3. Will I have my own room?

Yes, our state-of-the-art rehabilitation unit is specially designed for patients rehabilitating and recovering from injuries and illnesses. Each of the 20 rooms is a single person room with its own bathroom including shower. Each room has ample space for your personal care items. 

4. Do you have WiFi?

Yes, we do have WiFi for patient and family use.

5. What are visiting hours?

The unit does not have restricted visiting hours; however, we recommend that visitors leave the unit by 9:00pm so patients can have adequate rest. Children under the age of 12 must be supervised by an adult at all times and need to be quiet. Children under the age of 12 need to leave the unit by 8:00pm.

6. What is my rehabilitation plan and how long will I be here?

Developing a plan for your rehabilitation is one of the most important first steps of your stay. All rehabilitation starts with an assessment. Doctors, nurses, therapists, social workers, and other team members will be conducting these assessments during the first week you are here. The overarching goal of rehabilitation is to help you achieve the maximum level of independence possible. Some of that work happens here, and some of it continues after you leave the hospital. Your admission here is only one part of your overall rehabilitation.

A big part of this initial assessment includes learning what your goals are for rehabilitation. Once we have this information from you and from all of the team members, we can develop a plan for how we can help you reach your goals. Usually this plan is developed within the first week of your admission. While we will estimate how long it will take us to reach these goals, there are times when progress happens faster or slower than we or you anticipate. In this case, team members will be re-evaluating both your goals and estimated length of stay.
For some people, their goal includes walking again; for others, gardening, driving, or returning to work or active duty. For some, their goal is to get to a level where they can leave the hospital as soon as possible. One important point to remember is that your goals are not “right” or “wrong”. They are your goals, and we will work as hard as we can with you to meet them. You may have one main goal or lots of goals. Your goals may also change as you go through rehabilitation. That’s ok. Please communicate this with the team if it occurs.
By letting us know what you want to work toward, your rehabilitation will be more effective.

7. How do I get passes to go out?

The recreational therapist is a key team member in getting you back out into the community. This individual’s role is one of assisting our patients to once again have as much independence as possible in pursuing leisure activities. The first trip into the community will be one of applying practical skills in real-life situations. Once it is determined that you and your family member can safely navigate through the obstacles of the community, you will be able to ask for passes to go outside the hospital without staff. Your first pass may be for a few hours, then a longer period, perhaps all day on the weekend. Then an overnight stay may be tried, to assess skills acquired, with a weekend away being the final pass as your discharge is being planned.
Your social worker/case manager is critical to acquiring passes once you have received this permission to leave the hospital alone. All passes require a doctor’s written order, and processing through the pharmacy for any medications which may need to be taken during the course of the pass, so our procedure is that all passes must be initiated prior to 12 noon. For just an evening pass, speak to your social worker in the morning hours, while passes for the weekend days, evenings or nights are determined by the treatment team at the IDT meetings.
Pass instructions and ID are required to pick up pass medications, if they are needed.  You must check out with the nurse and sign out prior to leaving on pass, signing back in once you return at the designated return time.

8. What is the role of the caregiver?

Caregivers have an integral role in the rehabilitation process. Each caregiver may decide for him or herself how involved they want to be in their loved one’s rehabilitation.  For some, this may mean being present every day and attending therapies. For others, this may mean visits on weekends or frequent phone calls. Caregivers and patients must decide what is best for them.
The goal of rehabilitation is for the patient to have as much independence as possible. Out treatment team works with the patient with these goals in mind. When patients first arrive to our unit, they may not be very independent at all. Some may be more independent for some aspects of functioning than others. Our staff assesses patients to figure out where they can gain more independence, and then works using a team approach to help them build their skills and confidence.
Caregivers are a very big part of this process. Patients will often rely on caregivers for support during difficult times. Studies show that social support, which includes family and caregiver support, actually helps patients recover.
Many caregivers will also want to help their loved ones in any way they can. Seeing our loved ones struggle to complete certain tasks may be difficult, and many caregivers may want to help by doing certain things for the patient. However, there may be times when helping means taking a step back so that the patient can take steps forward. Our treatment team will help guide you and let you know the times when we may need caregivers to help less with a patient’s care so that he or she may learn to do certain tasks independently. There may be times where we ask you to not assist with specific tasks.
Please make sure to ask any of our team members if you have questions about how to best help your loved one. Working together as a team is the best way for everyone to move forward!

9. May I go to therapies with my loved one?

Know that your presence is important and welcome. During evaluations or testing, alone time with your family member may be necessary. But during therapy, it may be perfectly fine to come along and watch. However, also be alert to the therapist’s guidance regarding your direct involvement during the session, participating only when invited to do so. Ask where you can sit to be unobtrusive and try to allow your family member to do all of the work, remembering this is their opportunity to reach their highest level of independence.
We welcome your involvement. There are times when nursing may need to conduct an assessment or perform and element of nursing care without interruption. This is not an effort to exclude you, but is an opportunity for the staff to work more effectively with your loved one for that particular day or activity.
Keep assessing and talking about your involvement on a daily and/or weekly basis, as it may change that frequently. Remember the goal: The highest level of functional independence possible for your loved one and we are all working towards this together.

10. What can you tell me about TBI?

During your time on our unit, we will provide educational sessions for patients and family members. Beyond that, please feel free to review any information below:

Defense and Veterans Brain Injury Center 
Virginia Commonwealth University TBI Model System
Brain Injury Association of America 

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