A World-Famous Medical Center with the Latest in Medical Technology and a Network of Services

As a national leader in health care, the U-M system provides access to the latest in medical technology for all of our patients. Our inpatient rehabilitation program on the 6A unit of the U-M Hospital and our outpatient rehabilitation program, MedRehab, are located in our acute-care hospital with its network of off-campus satellites. Spinal cord injury specialists can draw upon the unparalleled expertise of collaborating physicians, faculty, staff, and colleagues when needed. This ensures that all the resources you may need are interconnected, and your rehabilitation will not have to stop due to any complicating medical problems that may arise.

Three Important Strengths: Comprehensive Care, Continuity of Care, and Patient Satisfaction

At the U-M Medical Center, you will be under the direction of physicians who are specialists in comprehensive spinal cord injury management. You also will receive the immediate attention of a team of rehabilitation professionals, including primary care nurses, physical therapists, occupational therapists, speech pathologists, dietitians, rehabilitation engineers, prosthetists and orthotists, social workers, rehabilitation psychologists, independent living specialists, and recreational therapists.

Your rehabilitation team will get to know your individualized needs and those of your family. Because the U-M program is committed to maximizing continuity of care, SCI team members will be involved with you throughout your stay, maintaining regular contact after discharge into the community. We also will stay in close touch with you and your family members regarding your satisfaction with the care we are providing, answering any questions you may have regarding your care.

Rehabilitation and More: The University of Michigan Health System Network of Services

We are located in a tertiary-care, acute-care hospital, so all the resources you may need are interconnected.

In addition to the team of rehabilitation experts who are part of the adult and pediatric spinal cord injury programs, other medical expertise you may require as your rehabilitation progresses is also readily available. This includes specialty services such as orthopedic surgery, neurosurgery, urologic surgery, trauma surgery, anesthesiology, plastic surgery, internists, pulmonary medicine, vocational rehabilitation, and other subspecialties.

Unique in the State

The U-M Spinal Cord Rehabilitation Program is unique in Michigan. Federally funded since 1985, it is the only Model SCI Care System in the upper Midwest region, and it provides patients with access to specialized programs.

Ventilator Program

U-M's program for ventilator-dependent patients is one of a few such programs in the country that provide the necessary equipment, training, and staff expertise to care for individuals who are unable to breathe adequately for a prolonged period and need physical rehabilitation.

Rehabilitation Engineering

U-M is Michigan's only SCI program with full-time rehabilitation engineers on staff who help apply the latest technological developments to maximize independence for people with disabilities.

Pediatric Rehabilitation

U-M is the only SCI program in the state that has specialized services for children with SCI, and schooling for pediatric patients can continue through the Medical Center's School Program.

Center for Independent Living Partnership

U-M's strong partnership with the Ann Arbor Center for Independent Living (AACIL) offers opportunities for community re-entry and consultations by trained peer resource counselors (PRCs) who can serve as role models.

Positive Transitions Thanks to a Committed Local Community
Our program has strong ties with:

• the Ann Arbor Transportation Authority's Dial-A-Ride minibus service for persons with disabilities.
   
• the Ann Arbor Center for Independent Living (AACIL), serving persons with disabilities who are still under treatment at the U-M so that they may try out their new daily living skills on their own. During your inpatient stay, you may receive services from trained peer resource consultants from the AACIL.
   
• the Michigan Department of Career Development Rehabilitation Services, the state agency for vocational rehabilitation of people with physical disabilities, that provides an experienced and highly qualified counselor on site in the hospital to facilitate early vocational rehabilitation planning.

"My daughter was six months old when I was injured. One of my goals in activities of daily living was learning how to independently parent."

Our Goal: Your Freedom and Wellness

Our aim is to inspire you to achieve the highest personal goals you desire. We strive to maximize your recovery and health to allow you full participation in the rehabilitation activities necessary to enable you to achieve your goals. We do this by helping you to reach independent mobility and the optimal ability to care for yourself, and to rediscover the positive aspects of yourself, your family, your work, and other parts of your life.

In summary:

• we involve both you and your family in decision-making during rehabilitation.
   
• we introduce you to important community services, such as the Centers for Independent Living and the Michigan Department of Career Development Rehabilitation Services.
   
• we provide you with peer support, independent living skills training, and educational/vocational opportunities.
   
• we remain available to you for lifetime follow-up care from inpatient treatment, through ongoing vocational rehabilitation, to answering your questions over the phone after you leave the hospital.

The Rehabilitation Team- Every Component is Vital

1. Physician-Directed Case Management
Board-certified physicians in Physical Medicine and Rehabilitation, called physiatrists, are attending physicians and treatment team leaders for all patients in the SCI Rehabilitation Program. They provide your daily medical care and are trained to diagnose and manage the medical problems associated with spinal cord injuries. Several U-M physiatrists are also board certified in the subspecialty of spinal cord injury medicine.

2.Primary Nursing
A registered nurse is assigned to you upon your admission to the rehabilitation unit and maintains a close relationship with you and your family until discharge. These highly skilled nurses are responsible for developing a nursing care plan to meet your unique physical and emotional needs and for ensuring continuity of care by other nursing staff and therapists.

3. Physical Therapy
Physical therapists provide you with a thorough evaluation and an individualized treatment program to increase strength and mobility, relieve pain, and restore function. They work closely with you, your family, and other rehabilitation team members to help you achieve the maximum level of independence.

4. Occupational Therapy
Occupational therapists design programs to help you achieve maximal independence in your daily living activities. Services may include helping you achieve independence in self-care (dressing, grooming, bathing, and eating), home management activities, parenting, functional communication, recreation, and community activities. Treatment sites may include your bedside, the Occupational Therapy clinic, the community, and when indicated, your home, school, or worksite.

5. Social Work
The goal of the social worker is to prepare you psychologically and emotionally for returning to your home community following inpatient rehabilitation. Social workers provide supportive counseling to assist you and your family in coping with your injuries and disabilities. They also facilitate plans for discharge, coordinating your needs with your family's, your rehabilitation team's, and your insurance representative's. Social workers also assist with early identification and referral to community resources. These resources may include housing, transportation, support groups, or financial assistance.

6. Rehabilitation Engineering
Rehabilitation engineering is the application of technology to increase the functional capabilities of people with disability. With rehabilitation engineers as integral members of your team, you can explore the latest technology and discover which applications can improve the quality of your life. Rehabilitation engineers evaluate and recommend commercially available equipment; and design, create, and specially configure hardware and software to meet individual needs for home, school, work, and community. The U-M SCI Program is one of the few programs nationally that has full-time rehabilitation engineers on staff.

7. Rehabilitation Psychology
Our rehabilitation psychologists are diplomats of the American Board of Professional Psychology and fellows of the American Psychological Association. They assist persons with spinal cord injuries with coping and adjustment issues. The psychologist's role is to provide a supportive environment in which you can focus on regaining self-direction and independence. To do this, psychologists address emotional, cognitive, and behavioral aspects of your adjustment and prepare you for your return to home and community.

8. Therapeutic Recreation
Certified therapeutic recreation specialists (CTRS) conduct assessments of your previous leisure lifestyle to determine leisure needs, abilities, and interests. The CTRS will work with you, your family/caregiver, and other rehabilitation team members to design and implement your individualized treatment plan. Therapeutic recreation services promote independence in leisure lifestyle activities by improving your physical, cognitive, emotional, and social skills. Activities are designed to assist you with recovery and coping with your life changes.

9. Speech Therapy
Speech-language pathologists are available to provide evaluation and treatment for voice difficulties and dysphagia (swallowing impairment), with cognitive-communicative intervention as needed. They offer patient-tailored augmentative communication methods should you be ventilator-dependent, have a tracheostomy tube, or otherwise be unable to communicate. Speech- language pathologists help you achieve maximal benefit from therapy and optimal independence with communication and swallowing.

10. Independent Living
Trauma or injury creates new and challenging accessibility and mobility considerations. An independent living specialist works with you and your family/caregiver to begin the process of re-entry into the community. The focus of independent living services is to create opportunities for you to make choices, participate in community life, make decisions, and take responsibility for actions. Staff from the Ann Arbor Center for Independent Living provide peer support and co-lead classes with the independent living specialist.

"I give credit to the people at the University of Michigan for helping me get back to work. Obviously they've been in the business for a while."

11. Discharge Planning
Discharge planning staff arrange for the services of visiting nurses, if skilled nursing care is necessary, or home health aides. They also set up in-home therapies, including physical and occupational therapy. They facilitate the ordering and delivery of durable medical equipment. Discharge planning staff verify the patient's benefit coverage for in-home and outpatient therapies and medical equipment for the treatment team. Discharge planning staff are also contacts for the case managers who may be assigned to a patient by a benefits provider.

Frequently Asked Questions

1. How long will I be here?
The average length of stay in the Rehabilitation Unit for persons with new spinal cord injuries varies according to the severity and level of injury. A tentative discharge date will be established within a week of your admission to the rehabilitation unit and will be assessed at the weekly multidisciplinary team conference. Average stays for those admitted to the Rehabilitation Unit range from one week to six weeks.

2. How much therapy will I receive?
The number and length of daily therapy sessions will depend on your condition and treatment priorities, as determined by the attending physician and rehabilitation team. A minimum of three hours a day of therapy from Monday through Friday and up to three hours during the weekend are offered. Therapies are provided in one-on-one and group settings. The treatment is individualized for you, and your attendance to therapy is essential to maximize recovery.

3. Can my family be part of this?
Families are encouraged to become involved as early as possible with rehabilitation program activities. Your family or friends are taught how to provide needed assistance and how to encourage you in achieving maximal independence as quickly as possible. They also can take advantage of the hospital's convenient on-site hotel-Med-Inn-during rehabilitation hospitalization. After you are discharged from inpatient care, Med-Inn can be a convenient place for you to stay when involved in outpatient care. The number for Med-Inn is 1-800-544-8684.

4. How old are the other patients?
Our patients on the 6A rehabilitation unit of U-M Hospital may be of any age over 18. Typically, over half of our patients are between 18 and 40 years of age. Generally, patients under age 18 are treated in the rehabilitation unit of C. S. Mott Children's Hospital, on the U-M Medical Center campus.

5. Can I go back to school or to work?
More than 90% of our patients with new SCI are discharged to private residences after comprehensive inpatient rehabilitation. Every effort is made to assist you in your return to a productive life-including employment, homemaking, and education. Referrals are made to community resources, such as the Center for Independent Living and the Michigan Department for Career Development, to assist with the transition from home to the community.

6. How is research progressing? Will there ever be a cure for spinal cord injuries?
Currently there are no proven cures for SCI, although many persons show some improvement of nerve function during the first year after injury. However, innovative research efforts on nerve regeneration and cell transplantation are growing. Active participation in rehabilitation activities helps to maximize functional skills and avoid complications, while waiting to benefit from future research. As a Model System, the U-M program is well aware of all new drug trials and treatment protocols designed to find faster recovery for those with SCI.

Please contact us!
We invite you to visit and tour our inpatient and outpatient facilities.

inpatient program (734) 936-7059
outpatient services (734) 936-7175

U-M Model Spinal Cord Injury Care System
300 N. Ingalls, Room NI2A09
Ann Arbor, MI 48109-0491

research and education activities (734) 763-0971

e-mail us at model_sci@umich.edu
http://www.med.umich.edu/pmr/modelsci/