A Q&A with Dr. Alexander Bajorek
Welcome to “Ask an Expert,” a Q&A series with Sarasota Memorial’s team of doctors, nurses and other health experts, where you can get thorough answers to your health and wellness queries from a local source you can trust. Have a medical- or wellness-related question that you’d like to “Ask an Expert”? Email them to AskAnExpert@smh.com.
Because inpatient rehabilitation isn’t something most people think about until they—or a loved one—need it, patients understandably have many questions when they are faced with choosing a rehab facility. We reached out to Sarasota Memorial Physiatrist and rehabilitation specialist Dr. Alexander J. Bajorek, MD, to learn more about inpatient rehab and to find out what rehab patients can expect.
Q: What is Inpatient Rehab?
With illness and injury, it takes only a single moment to completely turn a life upside down—whether it’s you or a loved one who has suffered a stroke, traumatic brain injury, spinal-cord injury, amputation or hip fracture.
My colleagues in acute care are tasked with saving the lives of patients who pass through that moment and with getting them on the road to recovery. But what does that recovery entail? When does it start? How much can a patient expect to return to their “normal” life?
Inpatient rehabilitation is a hospitalization for medically stable patients left either physically or mentally impaired by an illness or injury. In many ways, inpatient rehab is similar to an acute hospital stay.
The length of stay varies considerably depending on the injury, but you can expect to be in rehab for more than a week and less than three weeks, on average. You can expect around-the-clock monitoring by a nursing team, daily physician care and an assigned case manager. Most importantly, you must be able to participate in up to three hours of therapy a day, five days a week. This therapy will include working with a physical therapist, an occupational therapist and in many cases, a speech language pathologist.
This is considered intensive rehabilitation. If you are unable to participate in that level and duration of therapy, a less intense level of care such as that provided at a skilled nursing facility, may be more appropriate for your recovery.
Q: When Should I start Inpatient Rehab?
Studies have consistently shown that in general, the sooner that patients begin rehabilitation, the better the long-term outcome. Time in bed is time wasted. Every single day of inactivity amounts to a percentage of muscle atrophy and strength lost. Once a patient’s care team deems him/her in need of rehab and stable enough to safely participate in intensive rehab, the patient should be referred for review and potential admission.
Once you make it to rehab, be prepared to work! Trained and specialized therapists are excellent at adjusting the pace and content of therapy sessions to match a patient’s energy level, pain status and medical stability. In other words, they will find the right balance of pushing your comfort zone, in a controlled environment.
That environment has changed a lot in the past few decades. There are some new and exciting technologies, therapies, equipment and even pharmacological approaches that are improving patient outcomes and engagement in inpatient rehab. These range from simple taping of your skin to robotic exoskeletons that can assist movement and posture. This is truly a revolutionary time in rehabilitation medicine. (Many of the latest, evidence-supported technologies can be found the Sarasota Memorial Rehabilitation Pavilion; click here to learn more about these tools.)
Q: When Will I be Myself Again?
This is one of the most common and, simultaneously, most challenging questions I get as a rehabilitation physician. On one hand, the expressed purpose of rehab is to regain as much of your previous strength, function and independence as possible. Another, perhaps more important process, will be working with you and your loved ones to navigate a new normal. In many cases, there are lasting changes—ranging from subtle to severe—that require a team approach to manage. To this end, Sarasota Memorial’s inpatient rehab care team relies on a patient’s family support system, psychologists, case managers, support groups, peer mentors and even dog therapy to help them cope and adjust to the injury/illness.
The rehabilitation process does not end when your inpatient stay is complete. When your stay is nearing its end, our team works hard to ensure that your transition to the next step in recovery goes as smoothly as possible. This may be to a skilled nursing facility, going home with home health services care or going home with outpatient rehab appointments. The next step might include referral to vocational rehabilitation, neuropsychological testing or a driving evaluation.
Rehab is a continuum of improvement. Inpatient rehabilitation is only one point on the journey to recovery.
Dr. Alexander J. Bajorek, MD, is a physical medicine and rehabilitation specialist at Sarasota Memorial Rehabilitation Pavilion. He provides inpatient and outpatient rehabilitation services for people recovering from brain and spinal-cord injuries, stroke and other neurological, orthopedic and musculoskeletal conditions.