If a Veteran or Servicemember needs acute long-term care and rehabilitation, he or she will likely enter one of the 5 Polytrauma Rehabilitation Centers (PRC). Following initial assessments, the members of an interdisciplinary medical team will have an admission conference, typically within the first week or second week of admission, to discuss their findings and to design a rehabilitation treatment plan, including an estimated length of stay. The patient and family/caregiver will be informed about the team’s findings and recommendations following the conference and be encouraged to provide input about goals and expectations for rehabilitation. The team also meets in weekly rounds to evaluate the patient’s progress and to adjust or redefine the treatment goals accordingly.
The next step in a patient’s recovery is often a Polytrauma Network Site (PNS). The PNS offers continued medical care and rehabilitation services for those who are transitioning closer to home following discharge from a PRC. PNS programs will also be the entry point for those who have experienced a mild or moderate Traumatic Brain Injury (TBI). Depending on need, services may be provided on an inpatient or outpatient basis.
Polytrauma Support Clinic Team (PSCT) programs, located in 87 VA medical centers across the country, may be the next step for a patient. PSCT programs offer continued medical and rehabilitation care closer to a patient’s home community.
Regardless of what type of medical facility you may be in, VA encourages patients and caregivers to always ask questions and strongly recommends keeping a notebook to write down questions, concerns, or other information that you would like to discuss with the doctors and other team members. You will find that it is much easier to refer to a written list than to try to remember all of your questions on the spot.
It is important to provide a structured environment for TBI patients and to establish new routines to help them relearn old skills and develop new strategies. VA recommends that caregivers get involved as much as possible with nursing routines and the different therapies so that they can learn new critical care giving skills (i.e., positioning, transfers, feeding, bathing, toileting, and medication management). Throughout this process, the medical team will help and support you and your family member.
Caregivers should anticipate that your family member will participate in various intensive therapies each day. There may be times when a therapist feels that a one-on-one session with your family member will be more productive. Likewise, nursing may need to conduct an assessment or complete an element of nursing care without interruption. This is not an effort to exclude you, but rather, is an opportunity for the staff to work more effectively on promoting your family member’s return to maximum independence.