Rehabilitation Therapies, Nursing and Services
Younker Rehabilitation, a service of UnityPoint Health - Des Moines, is an acute rehabilitation unit and can manage complex medical and therapeutic needs. The team includes rehabilitation physicians, nurses, therapists and other staff who work together to improve the functional independence and quality of life for our patients. If the person served is cognitively unable to make decisions, a family member or legal representative must be identified to speak on behalf of the person served prior to the decision for admission. Our facility specializes in rehabilitation therapies and services for persons aged 14 and older who require:
- An inpatient hospital setting with 24-hour rehabilitation RN care.
- At least two therapy disciplines (physical therapy, occupational therapy and/or speech therapy) for three hours per day, five days per week.
- A rehabilitation physician (physiatrist) to lead the interdisciplinary team and assess progress and goals via face-to-face visits with the patient three times per week.
- Our facility also offers a full recreation therapy program for its residents.
Our team of physical therapists has over 60 years of combined experience. Physical therapists and physical therapist assistants provide physical therapy rehabilitation services to improve function, focusing on gait training (walking), mobility, pain control, strengthening, motor planning, balance and coordination activities. Physical therapists work with patients so they can maneuver within their environment more independently. This may include:
A physical therapist who is a wheelchair specialist will evaluate patients to determine the best wheelchair or other assistive mobility device. Our therapists are skilled in fitting the best solution to each patient, whether it is a manual wheelchair or customized power wheelchair. Pressure mapping may be performed to determine what cushion is best for each patient to reduce potential sources for pressure ulcers or wounds. Our therapists have many tools they can use in your physical rehabilitation. When working with patients who have had a stroke, we work to improve strength and control of parts of the body that need physical therapy.
- Getting in and out of bed
- Accessing the shower/tub and toilet
- Going up and down stairs
- Getting in and out of chairs and other furniture
- Getting in and out of the car
- Electrical stimulation is sometimes used to "facilitate" or excite the muscle, so it contracts more fully during muscle training.
- We have the Bioness L300, which is a device that delivers electrical stimulation in a way that assists with gait training, or walking.
- An electrical stimulation bike (RT300 Arm and Leg FES) may be used to strengthen and retrain muscles after a stroke, or spinal cord injury.
- Patients who are beginning to walk and need support may work with the Lite Gait, which is an overhead harness system to reduce the weight bearing through the legs during walking.
Read more about rehabilitation therapies and our team members.
UnityPoint Health - Des Moines' occupational therapy programs focus on techniques to become more independent with daily living tasks. Our team of occupational therapists and Certified Occupational Therapist Assistants (COTAs) have practiced for over 85 years. They are experienced in making custom splints, use of adaptive equipment and educating in adaptive ways to dress and do other self-care tasks when injury or illness limits independence. Our occupational therapy programs are structured so that we often work with patients in the mornings on skills they need to get ready for the day. They may use commercially available adaptive equipment or equipment fabricated for a specific person's needs. Younker Rehabilitation has a full kitchen, laundry and mock apartment so our patients can practice homemaking skills in a setting that simulates home.
Occupational therapists specialize in helping your loved one regain use of their arms and hands. This is vital as we use our arms to complete so many daily tasks. The Younker Rehabilitation occupational therapy program uses equipment like the Deltoid Aide or the SaeboMAS to support an arm and allow the patient to work on strengthening and control of the arm even if they are not yet able to lift against gravity. Electrical stimulation may be used to strengthen a muscle contraction during "neuromuscular training." We may fit patients with a lightly compressive glove, position the arm on an elevating arm rest or perform massage to reduce swelling in the hand.
After an injury to the brain or a stroke, an occupational therapist may screen the patient for visual and perceptual changes. We involve both the patient and their family in our visual assessments to help educate everyone about how to make the home environment easiest to navigate for the patient. We'll help to maximize vision, train the patient in methods to reduce the effect of a visual field cut or neglect or inattention to one side, and work toward restoration or compensation for visual/perceptual changes. There are a variety of assessments an occupational therapist may select to look at your visual skills, like the Dynavision D2TM. The Dynavision helps with visual skills, weight shifting, use of one or both arms and improving attention and concentration.
Sometimes simple changes to the home environment can improve a patient's vision. We make suggestions to improve lighting so our patients can avoid harsh glares, see books and magazines more clearly and walk feeling safe and independent when they return home. Our occupational therapists work with patients, families and staff to see what types of aides they might need. We call these, "environmental controls and assistive technology." Sometimes these aides are high-tech, like a voice-activated controller for lights, TVs, and phones. Other devices are very simple, such as a pointer for people who have trouble bending or using their hands and arms.
Younker Rehab Facility's advanced technology and equipment.
Speech-language pathologists evaluate and treat communication and swallowing disorders; frequently called speech therapy. Our speech-language pathologists, or speech therapists, evaluate a person's safety and ability to swallow, which can prevent aspiration (or food and liquids entering the lungs instead of the stomach) which leads to a type of pneumonia. Speech therapists specialize in dysphagia, frequently known as the impaired ability to swallow. The speech therapist will sometimes do a test called a videofluoroscopy with a radiologist present. This records a person swallowing, which allows the speech therapist and radiologist to see if the patient is swallowing safely. Based on the test's findings, speech therapists recommend food and liquid with the safest consistency for the patient's differing needs. Mealtime observations give us the chance to monitor patients and teach or help them work toward feeding themselves.
Much of a speech therapist's time is spent assessing cognition. Cognition, or thinking skills, can be affected by an injury to the brain such as anoxia, seizures or stroke. Cognition can also be affected by dementia, alcohol or drug use/abuse, medications and metabolic imbalances. Speech therapists plan an individualized program to focus on improving thinking skills so patients can quickly return to caring for necessary things like managing medication or paying bills.
A stroke or brain injury sometimes changes how people talk, sound or receive information from others. It may be hard to understand them when they speak or read aloud. Speech therapists train and educate patients in the use of techniques and exercises that help them maximize or regain their ability to communicate. iPad programs may be used to work on certain cognitive skills or to compensate for cognitive losses.
At Younker Rehabilitation, our experienced speech language pathologists have worked more than 30 years in their field and bring their knowledge to the treatment of their patients.
Younker Rehab Facility's advanced technology and equipment.
Younker Rehabilitation offers recreation therapy, which can include many types of activities that enhance our patients' well-being and therapeutic recovery. The recreational therapist at Younker Rehabilitation brings over 10 years of experience in caring for our patients. Individual recreational therapy treatment sessions revolve around working on a patient's problem areas (such as games using reasoning skills for a patient with cognitive deficits), training them to relax and better deal with anxiety or stress related to their new diagnosis or educating them about incorporating leisure into their lives.
Rehab wellness, spirituality and group leisure activities make up the core of our therapeutic recreation program. Rehabilitation Wellness group allows patients a chance to discuss their daily challenges and share coping strategies. Weekly group meetings with the chaplain are also available to those who are interested in the spirituality group, and other group leisure activities include card games or bingo.
With over 90 combined years of Certified Rehabilitation Nursing experience, our nurses have the skills and knowledge to assist patients with new or worsening disability and/or chronic illness to attain and maintain maximum function. The nurses assist patients in adapting to an altered lifestyle, while providing a therapeutic environment for patients and their family's to develop skills to assist the patient in achieving a safe transition to the community.
Our nurses collaborate with the interdisciplinary team to design and implement the rehabilitation plan. Nursing interventions and care are holistic and evidence-based and include self-care and promotion of physical, psychosocial, and spiritual health. Some areas of rehabilitation nursing expertise include: skin care and wound prevention, medication management, disease process education, diabetes management, bowel and bladder management, care coordination and discharge planning.
Physical Medicine and Rehabilitation Physicians – Physiatrists
A physiatrist is a physician who specializes in physical medicine and rehabilitation. Our physiatrists meet with their patients regularly and direct the rehabilitation plan. Each patient at Younker Rehabilitation has a physiatrist who leads the patient and family conference, a weekly team conference and regular visits with the patient.
The social worker is a member of the rehabilitation team who works with therapists, nurses and providers to create and ensure a safe discharge plan. The social worker can assist in answering questions related to the rehabilitation process and next steps following an acute inpatient rehabilitation stay. The social worker can help in setting up additional services needed upon return to home, as well as provide information about community resources patients may qualify for.
The care managers meet with patients and their families once they have been referred to Younker Rehabilitation. They help to evaluate if a patient meets the requirements for a rehabilitation level of care and work with insurance carriers to ensure coverage before admission to Younker Rehabilitation.
Patient Care Techs
Our patient care technicians are Certified Nursing Assistants (CNAs) who are also trained by our therapists and nurses to care for patients with specialized needs after injury or illness. The patient care techs work in close collaboration with nursing and keep an eye on our patients' progress outside of the assigned rehabilitation therapy times. The patient care techs help patients practice the techniques they are learning in therapy sessions to reinforce them. Two patient care techs work in the therapy gym, assisting the therapists and helping patients get to and from their therapy appointments.
Dietitians and Dietary Techs
The dietitian has an important role in ensuring our patients are well nourished while on rehabilitation. The dietitian counts calories and recommends supplements to ensure patients have enough nutrition to heal and perform their exercises. They calculate the number of tube feedings and times for patients who are unable to swallow. Dietitians educate patients about their prescribed diets. The dietitians and dietary techs help patients select foods they will like from their prescribed diet.
The Interdisciplinary Team Approach
The rehabilitation team meets formally each week to share progress toward goals, any barriers and make new goals for the coming week. Discharge planning occurs both at this meeting, after initial evaluation by team members and throughout a patient's stay. As an interdisciplinary team, each caregiver reinforces the teaching done by other health care disciplines.