Going home from any hospital stay can be daunting, but for Craig patients, who have likely been here for two to six months, preparing to go home can feel incredibly overwhelming. And that is true for both patients and their families or caregivers who may not fully know what challenges are ahead.
While much of the rehabilitation program at Craig focuses on preparing patients for life after leaving the hospital, nothing compares to the actual process of returning to their homes. While at Craig, the staff takes care of all of a patient’s needs in a very accessible environment, so once home, it can be challenging to problem-solve how to complete activities of daily living (ADLs) without support systems like an overhead lift system or a large roll-in shower.
Making it even more difficult, patients and families often aren’t able to return to their previous homes because they aren’t accessible. It can be intimidating to return “home” to an environment you’ve never been to before and to face the uncertainty of whether the new home will be accessible for the new equipment you now require to complete your daily activities.
Recognizing a need to address this critical component of a patient’s rehabilitation experience, Craig conducted a 10-person “soft landing program” trial that sent adult patients home with an interdisciplinary team of two to three skilled clinicians including any of the following disciplines: physical therapists, occupational therapists, psychologists, case managers and speech therapists.
“We wanted to understand first-hand what challenges patients faced when transitioning home so we could address them as quickly and efficiently as possible,” said Candy Tefertiller, PT, DPT, NCS, director of Physical Therapy at Craig. “We’ve taken what we learned from the soft landing trial program to improve the rehabilitation program we provide at Craig to ensure we’re focusing on a successful transition to the individual’s home and community.”
Tefertiller noted that more than 50 percent of Craig’s patients come from out of state, and many patients are sent home with very complex technology and specialized equipment. Not only does the equipment need to arrive in good working order, but the patient’s family or caregivers need to be confident with tasks like breaking down a wheelchair and troubleshooting electronics.
Craig received an enormous amount of information from completing the soft landing pilot program and is currently working on ways to incorporate the feedback the clinicians received from these experiences to improve the success patients have when they discharge home.
Following the pilot study of adults, a Craig donor funded a similar soft landing program for 10 adolescents, and Jason Sitruk was one of the beneficiaries. Jason sustained a spinal cord injury and spent three-and-a-half months at Craig before going back home to Montreal, Canada.
The Sitruk family was very apprehensive about returning home because their house was not accessible and they had to rent an apartment site unseen. The clinical team at Craig recognized they were a family who could benefit from the soft landing program to ensure they make a successful transition into a brand new, unfamiliar home environment.
Jason said having his occupational and physical therapists travel with him and his family helped tremendously. “It can be very stressful dealing with the airlines, going through security, and the added time it takes to break down my power chair. Having the team with us it made it a lot easier for me and my parents.”
Jason’s family had rented an apartment that was supposed to meet ADA guidelines, but when they arrived, the door to the apartment was narrower than expected and his wheelchair couldn’t fit through it. “My team helped us figure out how to get my chair through the door,” he said.
His team also accompanied Jason on trips to restaurants and stores including Costco, which were all new experiences for him since his injury. “We had to learn how to maneuver my chair through many different situations. The wheelchair management in the first few days would have been really challenging without them. They were a huge help.”
But the biggest benefit of having the soft landing team for the first three days at home was the ability for Jason to ask questions. “I knew I could ask anything I needed to and did not have to wait or call a nurse to get an answer because they were right there,” Jason said.
Karen Sitruk, Jason’s mom, said that knowing they would have support from the soft landing team made the months leading up to his discharge less stressful as well. “It even took away a lot of the stress we had while we were still at Craig. We knew we’d be okay. We knew we would be taking a little piece of Craig home with us,” she said.