Program Questions

Standard Programs

• Is the physician in charge a Physiatrist? If not, what credentials does he/she have? How long has the physician in charge been directing programs specializing in SCI?
• Is there physician coverage seven days a week? Twenty-four hours a day?
• Do the regular nursing staff and other specialists responsible for providing treatment have specific training in treating SCI? Is the nursing staff employed by the hospital or through an outside agency?
• Does the program ensure the availability of rehabilitation nursing and respiratory care on a twenty-four hour basis?
• Are there consultants available at the facility or nearby medical centers? These should include neurosurgery, neurology, urology, orthopedics, plastic surgery, neuropsychology, internal medicine, gynecology, speech pathology, pulmonary medicine, general surgery, and psychiatry.
• How often and for how long each day will participants get treatment by specialists such as occupational and physical therapists? (Treatment should be no less than three hours per day)
• Are other specialties—such as driver education, rehabilitation engineering, chaplaincy, and therapeutic recreation—available if needed?
• Are activities planned for SCI program participants on weekends and evenings?
• How much time is spent teaching SCI program participants and their families about sexuality, bowel and bladder care, skin care, and other essential self-care activities?
• Does the SCI program offer training in the management and hiring of personal care assistants? If so, how much time is spent on this topic?

Pediatric Programs

The incidence of SCI among children is relatively low, so rehabilitation hospitals and programs usually do not maintain a separate program or unit exclusively for children. An alternative would be placing children with SCI in units with other children with chronic disabilities. This may create opportunities to share common experiences and information, and lead to the development of support networks in the community.

One caveat: Children generally benefit from undergoing rehab with other children who are actively involved in the rehabilitation process, not with children who are too ill for rehabilitation.

• Are the beds for children with spinal cord injuries in one area or in the same location as children with similar disabilities?
• Are children of the same sex and similar age currently in the program/facility?
• Is the physician in charge an individual with experience in rehabilitation? Does this physician have experience with children? If not, what are his/her qualifications? Do the other staff members specialize in pediatrics?
• How many children with SCI does the program/facility admit on an annual basis?
• Does the program/facility offer educational programs for children and young adults undergoing treatment? If not, does the facility coordinate tutoring programs with local schools? If so, who is responsible for payment?
• Are there child life or therapeutic recreation specialists on staff? (Child life specialists develop programs for children and families which strive to maintain normal living patterns and minimize the clinical environment. Therapeutic recreation specialists focus on teaching persons with disabilities new leisure and sports skills to maximize their independence)
• Are young siblings and friends allowed to visit the unit?
• Does the program/facility offer adaptive technology to help children communicate and learn?
• Is counseling available for siblings and family members?
• Is the equipment used by therapists, i.e., physical therapists and occupational therapists, appropriate for children?
• Does the facility/program provide patient education materials for children and family members?

Ventilator Programs

• Is the physician who directs the program a board certified Pulmonologist or a Physiatrist? Does he/she have experience with SCI?
• Are ventilator users treated on the same unit?
• How long has the facility been providing treatment for ventilator users?
• If the treatment team determines that an individual cannot breathe independently, what kind of services are offered to assist them in living as independently as possible?
• Are people in the unit similar in age to the person considering admission?
• Will they have the opportunity to meet ventilator users who have returned to the community and maximized their independence?