Restoring freedom

There are many components to the word "care" in the context of the Cheney Care Community. There are the direct components provided at the care center and the assisted living units, and there are the indirect componenets such as programs available to residents of the community's Sessions Village.

One program of direct care gaining more use these days is the rehabilitation program, led by rehabilitation director and occupational therapist Linda Norman. The program's capabilities have been enhanced the past couple of years through two additions: creation of an actual activities room and switching to a new health services provider.

When Norman first came to the care center in 2005, the rehab services were performed out of the confines of a typical patient's room. As the program grew, the space needed to help patients regain use of physical abilities diminished.

"It was very small, and we pretty much had people stacked on people," Norman said.

A couple years ago a discussion began on how much the program had expanded and the needs that created. Norman said Cheney Care Community Director Keith Fauerso undertook a project that modified a larger room on the care center's south side that had been used at times as an activities center and a dining hall into a rehabilitation room.

The center also expanded its selection of rehab equipment, renting some while working with other community organizations to build others, such as an exercise cabinet where weights can be stored. The cabinet, built by the woodworking group, "The Cheney Chipsters," also includes a large mirror, a feature Norman said is important for patients because they need to be able to make sure they are maintaining good posture during their exercises.

In October 2014, Cheney Care Center contracted with a new health services provider, Consonus Healthcare. According to its website, Consonus has been providing consulting, rehabilitation, pharmacy and post-acute care transformation (PACT) services for over 25 years, currently operating in over 300 facilities nationwide.

Norman and her full-time team of three - a physical therapist, physical therapist assistant and a speech therapist - are actually employees of Consonus. She also has additional resources of another physical therapist, assistant physical therapist, certified occupational assistant (CODA) and two speech therapists.

She also has the resources of Consonus at hand, with information on the latest therapies and procedures available. But while the national company is the one covering paychecks, Norman said their hearts and minds lie solely at the care center.

"We're really just part of this team here," she said. "We're here eight hours a day, six days a week to provide whatever services are needed."

The program at Cheney Care Center provides rehabilitation and restorative nursing, but is focused mainly on the former. Norman defined rehabilitation nursing as treating a patient who goes to the hospital due to some traumatic incident such as replacement surgery or a fracture from a fall.

To qualify, Norman said a patient must be authorized and needing to have a minimum of five days of therapy per week. The average length of time for a patient in the rehab program is 7 – 25 days, and Norman said their caseload can fluctuate due to the dynamics of Medicare.

"We can have 15 patients and then suddenly drop to eight," she said.

Exercises are low-key and not too technical. Therapists develop workout programs utilizing equipment ranging from several electronic apparatus that monitor biofeedback, to arm bikes, to things as simple as small safety cones arranged between a pair of parallel bars.

Norman said they work as a team with other care center staff, taking part in regular staff meetings to apprise nursing assistants and other center staff about patients' programs and specific needs. They also provide training and instruction to help assistants keep patients working on rehab programs when the therapists aren't present.

Besides helping care center residents with tasks they have difficulty with, nursing assistant Camille Kawakami also works with the rehab patients to keep them active in order to restore their range of movement. The Prosser High School and Eastern Washington University graduate, who started at the center in December 2015, said rehab provides a schedule and work instructions, such as making sure a patient walks so many times during the day and for a specific distance.

Kawakami helps keep them on their rehab schedule. The biggest challenge, she said, is persuading patients to keep working at their program when they're tired and want to stay in bed or go home.

"We need to encourage them that the rehab is helping and will get them to where they can go home to their families," Kawakami said.

Patients in the rehab program need not be residents at the care center. In an email, Fauerso said they provide free transportation from the hospital to the center. Residents having elective surgery can call them to schedule pre-surgery consultation.

"We have private rooms with no scheduled visiting hours and family members can share a meal of our excellent food if desired for a small fee," Fauerso said.

The restorative nursing program feature is available to long-term care patients to provide therapy on a maintenance level. Norman said they set up programs to assist with their overall health to prevent decline and increase function.

Finally, Norman said she and her staff can do in-home evaluations for patients who are within 3 – 5 days of being released from therapy. Therapists visit their home to make sure obstacles to care are either removed or modified in order to enable their therapy to continue to fruition.

"We adapt their environment so it's (therapy) successful when they return home," Norman added.

John McCallum can be reached at jmac@cheneyfreepress.com.