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Hospital's IRU works on body, mind and spirit

Kelly Tunney | Herald-Standard - John McDougle of Menallen Township gets into the test vehicle in the Inpatient Rehabilitation Unit at Uniontown Hospital, helped by physical therapist Kim Murphy.

Rehabbing Hope

By Tara Rack-Amber trackamber@heraldstandard.com

John McDougle of Menallen Township smiled brightly as he garnered the attention of the group of ladies surrounding him.

Tomorrow would be a very special day for him because he was going to be graduating from the Uniontown Hospital Inpatient Rehabilitation Unit (IRU).    

John McDougle of Menallen Township smiled brightly as he garnered the attention of the group of ladies surrounding him.

Tomorrow would be a very special day for him because he was going to be graduating from the Uniontown Hospital Inpatient Rehabilitation Unit (IRU).

Two weeks ago, McDougle was admitted to the unit because of complications related to Parkinson’s disease.

His smile grew from ear to ear as he received many warm wishes from the gathered nurses for his new, healthier life. He promised to come back as a visitor instead of a patient next time. But, for now, he was happy to be returning home to his family.

For about 20 years, the unit has been caring for people to help them get back on their feet after a life-altering incident or diagnosis.

Centered around care that encompasses the whole body, patients who are admitted will receive various types of therapy including physical, cognitive, speech and more.

According to Cheryl Kramer, IRU clinical director, there can be between six to seven therapists in the unit on a daily basis working with the patients, which can amount to 11 at a time.

In addition to the therapists and nurses, the department is overseen by Dr. Paul Hartley, medical director of the IRU, who has frequent meetings together to discuss the total care of the patient.

Each patient will receive three hours a day at least five days a week or 15 hours within seven consecutive days worth of intensive rehab in a one-on-one setting.

“Our main diagnosis is stroke and hip fracture,” said Kramer.

Walking through the newly remodeled unit, Kramer explains that while most of the rooms are similar, one special room, located next to the nursing station, provides the staff with close monitoring of the patient through a window with blinds that can be closed by the patient for privacy.

Kramer indicated that this room is for those who are more impulsive about getting out of bed. This way the staff is nearby to help reduce the risk of falls.

The age of patients is typically over 80, according to Kramer.

“It is definitely a geriatric unit. Almost everyone is 65 (or older),” she said.

Kramer said that the turnaround for the length of time a patient can stay at IRU has been shortened over the years, even though the program has a high success rate.

“Eleven to 14 days (is the length of stay). We are over 95 percent discharge to the community,” she said.

Josh Krysak, coordinator of community relations, Uniontown Hospital, said the reason why the percentage is so high is due to the collaboration of the IRU.

“That is why that 95 percent is there. It is because everyone is working together,” he said.

While the unit works on strengthening the patient to get them ready to return to their lifestyle, they also work on helping people relearn everyday tasks such as bathing and walking on an incline.

“There are many things that a lay person doesn’t know or think that they are going to [need to] do,” said Krysak.

Several areas are established to help patients relearn the skills needed to do everyday tasks.

For example, IRU has created its own grocery store where patients can “shop” for ingredients to make a recipe. They will pick the items from the shelves, go to the cash register and “pay” for them. After paying, the patient then can cook the recipe, using the ingredients from the store, in the unit’s wheelchair accessible kitchen.

There is also a pet area where patients can practice feeding a stuffed dog or cat and even try cleaning the litter box.

One of the biggest sources of pride for IRU is the practice car.

Situated in a gym-like area is a special half car that was built by a medical company that has real working doors and a steering wheel that is used to teach patients how to safely get in and out of a car.

Before the unit had this car, Kramer said that this process was practiced by having patients seated in a chair with a box next to it to simulate the car.

While the program offers a high level of care to its patients, over the years it has become increasingly difficult to be enrolled in IRU.

According to the American Hospital Association, “In-patient rehabilitation facilitates (IRFs) have faced significant scrutiny from Congress and the Centers for Medicare & Medicaid Services in recent years, which has led to multiple interventions, including strict criteria for IRF patients, multiple payment cuts and other policy restrictions.”

Sixty percent of admissions must be diagnosed as one of the following: stroke; spinal cord injury; congenital deformity; amputation; major multiple trauma; fracture of femur (hip fracture), brain injury; neurological disorders including multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy and Parkinson’s disease; burns; active polyarticular rheumatoid arthritis, psoriatic arthritis and seronegative arthropathies; systematic vasculities with joint inflammation; severe or advanced osteoarthritis; certain hip or knee joint replacement, plus it must be bilateral, have a body mass index over 50 or be 85 or older.

Another key component to the recovery of the patient is support from the family.

Kramer said that the IRU works closely with family members to see what help they can provide before the patient is discharged.

For example, if a patient is going to be released to the care of their child who works during the day, Kramer said they will work with them to make sure they are able to safely function while the caretaker is away from the home.

Tammy Yarris of Uniontown, the daughter of McDougle, said she was very happy with the care her father received during his time with IRU.

“It is wonderful here. It definitely would have been a hardship to travel to Pittsburgh,” she said.

Having happy and healthy patients and families that are looking forward to the future is what IRU strives for.

“That there is hope,” said Kramer about what she wants patients to take away from their experience. “That this is a stepping stone. That we are here to help them on the journey to rehabilitation.”