Dave Fox has been thanking Sanford Health Inpatient Rehabilitation in Sioux Falls, South Dakota, for more than a decade now in a manner that makes everyone involved feel a little better about themselves.
In 2005 while on a business trip to Fargo, North Dakota, this former financial analyst had a serious stroke. The battle since then has never really ended, though it’s spiced with victories.
Fox struggles with the throw rugs on his floors because he can’t lift his right foot so well. So get rid of the throw rugs, right? No. After 15 years of taking on the challenges of living after a stroke, he doesn’t give up so quickly.
“We had throw rugs and we still do,” Fox said. “My wife said ‘You’re going to learn how to step over those things instead of stumbling on them.’ To this day I still stumble on them due to lack of sensation on the right side of my body, but I deal with it. There are a lot of things where if you can’t change them, you join them.”
Fox spent two weeks in a Fargo hospital after his stroke then rode in an ambulance back to Sioux Falls. There was no emergency. In this case, it was just the best way to transport a guy who couldn’t do much.
“I went directly into inpatient rehab,” Fox said. “I spent a month-and-a-half learning how to walk, talk, write — all the good stuff.”
He had a conversation with his physical therapist when he left that set him on a path he’s still on. Not only was he essentially helpless when he arrived, he wasn’t much interested trying to get better.
Six weeks later he was walking, talking and writing.
Inpatient rehabilitation volunteering
“My physical therapist told me we should have videotaped my recovery so they could show it to other people who’d had a stroke,” Fox said. “And then he said, ‘But the next best thing is that you can volunteer and talk to those people about it.’ That’s the short story about why I volunteer in inpatient rehab.”
He was helping stroke patients shortly thereafter. It was because of Sanford’s inpatient rehabilitation program. The staff got him back on his feet. Literally in this case.
The program, which began as part of Sioux Valley Hospital, got its start in April of 1990. Thousands like Fox have come through since then.
“We like to think of ourselves as completing the circle of care for some folks,” said Dr. Peter Johnson, medical director. “For some patients, we take them from the brink of maybe not making it to bringing them to the point where they can get back home again.”
The average stay is about two weeks, though that can vary widely depending on the complexity of a patient’s diagnosis. The people who stay there are largely stroke patients, though it also includes those dealing with spinal cord injuries, traumatic brain injuries, as well as others who are facing temporary, progressive or permanent disabilities.
“Our colleagues in the hospital save a patient’s life and get them stabilized,” said Sue Christensen, director of therapy and rehabilitation. “We strive to get patients back into their life.”
Rehab goes beyond physical care
It is a noble assignment, in some cases made more challenging by the presence of the coronavirus in recent months.
The process varies for every patient, which means the therapists, nurses and patient care assistants need to be sensitive to the needs of those engaged in the recovery process. The physical challenges are easiest to identify but the inpatient rehabilitation role goes well beyond that.
“We see people who might be devastated emotionally,” Dr. Johnson said. “Part of the recovery is dealing with that emotional status. We want them participating. We want them to have a positive attitude about getting better. I’ll talk to a patient who says, ‘You know, I saw that person a week ago and they weren’t even able to stand and now they’re standing and walking.’ They see that and are encouraged.”
Crysta DeSmet, senior social worker at Sanford Health, is a part of that healing process as well.
“They’re in a good place because they’re preparing to get home,” she said. “But it’s been very difficult for them because their loved ones haven’t been able to be here. We try to provide that extra level of support during their stay.”
Helping patients deal with the ramifications of the coronavirus is a reality for the staff and the people they’re caring for. Getting better can be a challenge under the best of conditions. Not having easy access to family and loved ones can make it tougher.
That extra level of care is possible because the department has the staff in place to deliver it.
“One of the good things about our rehab unit is that we have the interdisciplinary team that is really involved in everything,” DeSmet said. “We actually have the time as we’re working with our patients to really get to know them. We get to know their interests and their families and who they are as people. That helps build those connections, too.”
The unit includes 21 beds. About 80 percent of the program’s patients are able to return home, Christensen said. Outpatient therapy often continues after patients are discharged from the hospital.
“We have the resources we can pull in whether the needs are physical, emotional or cognitive,” Christensen said. “After a significant stroke or injury, there is a rebuilding of confidence in yourself and the ability to take care of yourself. It can be a life-changing event but people can still get back into their life. They may need to do things differently or use equipment they’ve never been exposed to before, but that’s our job — we show them how to get back into doing those things.”
Stroke: Accepting a new challenge
Fox spends time with inpatient rehabilitation patients twice a week. While there were some moments during his own ordeal that he can’t remember, most of it he can remember vividly.
His willingness to share his story can be informative and even inspirational to those forced to confront similar challenges.
“The first thing for me — and I think everyone has a problem with it — is accepting it, what a stroke has done to you,” Fox said. “It’s extremely hard to accept that the life I knew was pretty much gone. I was going to have to start another one.”
It is with exceeding patience — and in Fox’s case, the added wisdom of experience — that the program approaches obstacles that can seem overwhelming through the eyes of the patient. Most of the time, the people involved understand early that this is not going to be easy.
“There were times when I first got there when the therapist would try to get me to do stuff and I’d simply refuse to do it,” Fox said. “And they’d take me back to my room and I’d start over the next day.”
Parts of those first few weeks are foggy, though he does remember at least small sections of the day he planned to crawl to the bus station and go home.
“What I do remember is that I was behind the nurses’ station looking at the wall,” he said, laughing. Translation: That meant the team identified that he needed closer supervision.
Inpatient rehabilitation staff inspires
Life got better for Fox. He started by bringing a better attitude to therapy sessions. His son played a part in that. Coupled with the staff’s patience, expertise and encouragement, he left with knowing he had more life to live. As it applies to the inpatient rehab program, he also had more to give.
Shortly after Fox began volunteering he sat down in the cafe with a family that included a stroke survivor’s wife, children and their families. They asked a lot of questions, especially after learning Fox had been through some of the same hardships. He assured them this patient was going to get the best possible care.
A day later he talked with the family again, though a daughter he’d talked with the day before was absent.
“Her mother told me she went back to Denver,” he said. “She said her daughter was satisfied after talking to me, and seeing how things were being done, that her father was going to get good care.”
Seeing people get better
Fox thought about that for a while and decided that would become a target in this role volunteering.
“I thought ‘Wow, I guess I did some good,’” he said. “In this case, that was the ultimate blessing — that she would see the care her father was getting and decide we had this figured out.”
Dr. Johnson has been working with the program for 23 years. Christensen has been involved for 29 years. They have been witnesses to former patients, even years later, coming back to tell them of the impact the staff’s efforts made in helping them overcome what seemed at the time to be overwhelming obstacles.
“We want to get people back into society,” Dr. Johnson said. “We want to get them back to where they can take care of themselves again, or set up services that can help them remain as independent as possible. It’s one of the reasons I got into rehab medicine. It’s wonderful seeing people get better.”
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