Fall 2014 - Rainbow Rehabilitation Centers
Transcription
Fall 2014 - Rainbow Rehabilitation Centers
RainbowVisions A Magazine for Brain and Spinal Cord Injury Professionals, Survivors and Families Rainbow Rehabilitation Centers Inc. FALL 2014 www.rainbowrehab.com Post-traumatic Amnesia What kind of recovery can be expected after a person experiences a traumatic brain injury? Experts look to the length of time an individual remains in post-traumatic amnesia for clues. Sensory Integration in the Classroom Adapting to a child’s difficulty in processing input from their environment Encouraging School Success How Rainbow school liaisons support students and their teachers Volume XI No. 3 President's Corner KEY TO IMPROVEMENT 2014 Employee Survey Results By: Bill Buccalo, President Rainbow Rehabilitation Centers Some of the employment categories where we saw the most significant improvements are outlined here. Administrative Spirit of teamwork Overall employee morale Communication between employees and management Rehabilitation Assistants Spirit of teamwork Seeking out and implementing employee ideas Rainbow’s focus on employee safety Communicating Rainbow’s corporate direction Residential Program Managers Recognition of employee contributions Overall employee morale Communication between employees and management Rainbow’s focus on continuing education Communicating Rainbow’s corporate direction Rainbow U Staff Use of employees’ skills and experience Rainbow’s ability to solve customer service issues Rainbow’s tangible benefits Therapists Recognition of employee contributions Overall employee morale Rainbow’s tangible benefits Communicating Rainbow’s corporate direction 2 | RainbowVisions ainbow is a people business. People taking care of people; people inspired by each other; people making or breaking the company reputation, and the list goes on. I love working at Rainbow because of the people I work with and work for. Many of my fellow employees feel the same. I wrote this article on the heels of our quarterly Employee of the Season luncheon (See page 25.) This long standing event is one of my favorite Rainbow traditions. Employees, clients, families, and the community can nominate employees for special recognition. The stories shared are truly inspiring. We understand that a key to this business revolves around how people treat, value, communicate, and listen to each other. In the spirit of listening, Rainbow recently completed the 2014 Employee Opinion Survey to gain information on how employees feel the company is performing in a variety of areas. We were pleased to learn that employees feel the company is moving in the right direction. Overall, the 563 employees who participated scored Rainbow higher in nearly every category as compared to 2013. Rainbow’s overall score improved to an “Above Average” rating. Rainbow strives to be the market’s provider of choice. To achieve this status, stakeholders must be highly satisfied with our services. Listening to employees, just like the need to listen to customers, is incredibly important. Meetings held with all employees this summer resulted in some wonderful dialog regarding areas where the company can continue to improve. While the overall improvement noted in the survey is directionally outstanding, Rainbow is committed to working with all employees on further improvement in results. www.rainbowrehab.com FALL 2014 Features 2 President's Corner – Employee Survey Results 4 Medical News – Sensory Integration in the Classroom 6 Clinical News –Post-traumatic Amnesia 12 Survivor Perspective – David Abrams 16 Therapy Corner –Encouraging School Success 20 Conferences and Events On the Cover Bill Buccalo, President, Rainbow Rehabilitation Centers The length of time that a person experiences post-traumatic amnesia may be a predictor of the severity of their injury. Katherine Dumsa, MS, OTR/L, CBIS Carolyn A. Scott, Ph.D. Barry Marshall, Editor Barry Marshall, Editor News at Rainbow 19 Rainbow U—Fish On! 22 Artists display work at brain injury conference 24 New Professionals at Rainbow 25 Employees of the Season Page 6 4 12 19 800.968.6644 www.rainbowrehab.com Our mission is to inspire the people we serve to realize their greatest potential SM Editor—Barry Marshall Associate Editor & Designer—Celine DeMeyer Contributor—Nick Galluch E-mail questions or comments to: [email protected] Copyright September 2014 – Rainbow Rehabilitation Centers, Inc. All rights reserved. Published in the United States of America. No part of this publication may be reproduced in any manner whatsoever without written permission from Rainbow Rehabilitation Centers, Inc. Contact the editor: [email protected]. RainbowVisions | 3 Medical news Objects such as fidget toys and therapy balls offer sensory feedback that may help calm hypersensitive children thoughtout their school day. 4 | RainbowVisions www.rainbowrehab.com FALL 2014 Sensory integration in the classroom HOW DOES IT HELP THE CHILD WITH A BRAIN INJURY? By: Katherine Dumsa, MS, OTR/L, CBIS Rainbow Rehabilitation Centers S Sensory processing is the brain’s ability to interpret information from the environment and determine how to respond with emotion, attention and motor responses. Sensory processing dysfunction may affect young children, individuals diagnosed on the autistic spectrum and someone who has sustained a traumatic brain injury. While symptoms and presentation can vary highly between individuals, symptoms seen in children with sensory processing disorder include: clumsiness, unwanted behaviors, agitation, difficulty in a structured environment and trouble relating to peers or siblings. The National Institute for Neurological Disorders completed research showing a breakdown of synaptic activity following injury to the brain. The breakdown often depletes communication and normal responses between neurons. Following a traumatic brain injury, a child may have difficulty processing input from their environment. This is described as hyper or hypo responsive to stimuli. Hyper-responsive individuals may have anxiety, respond intensely or be resistant to change. Hypo-responsive children can present as lethargic and slow to respond with reduced motivation to participate. How does this affect the child’s daily functioning? A child that is hypersensitive to sensory information can also be referred to as a “sensory seeker.” A child will seek sensory input to help regulate and calm them throughout the school day. This may present as: • Insatiable desire for sensory input, highly active • Poor safety awareness, poor perception of pain • Fidgety, difficulty sitting in chair at school • Easily bored Symptoms stated above will affect the level of arousal and ability to sustain attention in a learning environment. Development of language, motor and cognitive skills along with social interaction can all be delayed. What modifications can we make to the classroom? Occupational therapists provide sensory integration therapy to create a “sensory diet” to regulate or provide stimulation to improve and maintain optimal functioning. The sensory diet can be carried over from school into the home to provide strategies for the child to utilize independently. Adaptations within the school may include: • A sensory space—An area to be active and physical or to be calm with quiet time • Activities to provide touch and texture—Play-Doh®, beads, stress ball • Alter lighting—natural or soft lighting that may be difficult for visually impaired individuals • Improve classroom seating—adjust chairs for optimum fit, provide textures (therapy ball) or a vibrating cushion for sensory feedback • Physical activities/sports in between classes • Fidget toys—large bands for student to stretch legs while seated, theraputty for hands • Programs to provide sensory stimulation such as “Handwriting Without Tears” Occupational therapists play an important role in the evaluation and treatment of children with sensory processing disorders. While the treatment plan is individualized, it takes a full treatment team including the family, therapists and school teachers to facilitate a successful environment for the student at home and in school. v References NINDS, (2002) Traumatic Brain Injury: Hope Through Research, NIH Publication No. 02-2478 Retrieved from http://www.ninds.nih. gov/disorders/tbi/detail_tbi.htm RainbowVisions | 5 Clinical News Post-traumatic Amnesia By: Carolyn A. Scott, Ph.D. Rainbow Rehabilitation Centers 6 | RainbowVisions www.rainbowrehab.com www.rainbowrehab.com WI NTE R 2014 FALL 2014 When a friend or family member experiences a traumatic brain injury, your natural reaction may be to ask how severe the injury was and what kind of recovery can be expected. Medical providers and those involved in acute, sub-acute, and long-term rehabilitation are also interested in understanding the severity of the injury, as this is important information to have in order to address the second question: how will the injured individual recover? Continued on page 8 RainbowVisions | 7 Clinical News Post-traumatic Amnesia Continued from page 7 There are multiple methods to assess the severity of a traumatic brain injury (TBI). Providers look at loss of consciousness score on the Glasgow Coma Scale, and how long it takes someone to follow directions after their injury. Providers also consider the length of time an individual who experienced a TBI remains in post-traumatic amnesia (PTA). PTA was described in the 1930s by Russell (1932) and Symonds (1937) as a loss in full consciousness and therefore an inability to make new memories (Trzepacz, Kean, & Kennedy, 2011). This definition was tweaked some so that for the past several decades PTA was defined as a period of disorientation and difficulty consistently making new memories following TBI. The resolution of PTA was complete when an individual was consistently oriented and able to make new memories. However, many researchers and clinicians recognized that this definition of PTA did not fully capture the spectrum of impairments commonly found early in the recovery from a TBI. Post-traumatic confusion (PTC) is a term that better captures the deficits individuals may experience as they recover after their injury. Specifically, Stuss et al. (1999) described a post-traumatic confusional state as a “transient organic mental syndrome with acute onset characterized by a global impairment of cognitive functions with a concurrent disturbance of consciousness, increased psychomotor activity, and a disrupted sleep-wake cycle.” Individuals who have regained consciousness after a TBI but who remain in PTC may demonstrate decreased daytime arousal, fluctuations in cognitive and behavioral symptom severity, psychomotor agitation, affective lability, perceptual disturbances, and impaired cognition (in particular, 8 | RainbowVisions Understanding how long someone is in post-traumatic confusion is important in labeling the severity of the injury, and it can be helpful for predicting outcomes from the injury as well. difficulty with attention and memory) (Nakase-Richardson, Sherer, Yablon, Nick, & Trzepacz, 2004; Sherer, NakaseRichardson, Yablon, & Gontkovsky, 2005). Regarding cognitive impairments, deficits in attention and memory are particularly pronounced during PTC. These difficulties with sustaining attention and forming new memories add to the individual’s overall confusion and misinterpretation of their surroundings. Additional behaviors that may be observed in someone in PTC include difficulty sitting still and a desire to pace, or someone who is often fidgeting with their feeding tubes or wheelchair lap belt. Agitation may also be noted when someone curses, yells at family, and refuses therapies. As noted above, some fluctuation in abilities is not uncommon during PTC. An individual in PTC may appear able to focus during therapy one day and unable to focus and follow instructions the next day. This does not mean that the individual is motivated one day and not the next, although variations in motivation are normal and to be expected during the long course of recovery. Clinicians can track PTC proactively and serially until an individual “clears” from the confusional state. This measurement can be carried out by neuropsychologists or therapists with standardized tools. Understanding how long someone is in PTC is important in labeling the severity of the injury and it can be helpful predicting outcomes from the injury as well. The duration of post-traumatic confusion or post-traumatic amnesia has been shown to predict return to work (van der Naalt, van Zomeran, Sluiter, & Minderhoud, 1999) and level of cooperation (Silva et al., 2012) in rehabilitation. Severity of confusion has been shown to predict productivity and employment one year after injury (NakaseRichardson, Yablon, & Sherer, 2007; Sherer, Yablon, Nakase-Richardson, & Nick, 2008). It is also important for us to understand whether someone is in PTC, because it influences how clinicians target treatments and expectations. There are resources available for family members and friends who have loved ones in PTC. The Rancho Los Amigos Levels of Cognitive Functioning Scale (see sidebar at right) describes the cognitive and behavioral functioning of a TBI survivor as it is likely experienced by family and therapists. Levels IV, V, and VI all describe the period of post-traumatic confusion. The scale also provides expectations for behavior and recommendations for interacting with an individual in PTC. Clinicians at Rainbow can also serve as a resource to understand your family member who remains in PTC. Given the cognitive deficits present in an individual in PTC, much of the treatment is repetitive and environmental in nature. For example, an environment with reduced stimulation (low lights, no television/ limited background noise and distractions, and limited simultaneous visitors) can be helpful. Individuals should be www.rainbowrehab.com www.rainbowrehab.com WI NTE FALL R 2014 2014 Rancho Los Amigos Levels of Cognitive Functioning Scale exposed to natural daylight to assist in reducing daytime fatigue and resetting circadian rhythms. When communicating with an individual who is in PTC, statements should be clear, brief and at a slower pace in order to maximize comprehension. When post-traumatic confusion resolves, an individual may continue to demonstrate deficits related to their injury. Regardless of where they are in their cognitive recovery, the clinicians and rehabilitation assistants at Rainbow are equipped to help manage the symptoms they demonstrate and help propel them towards recovery. What follows is an example of a client who arrived for treatment in a post-traumatic confusional state. Case Study: Mr. Jones Mr. Jones is a 45-year-old man who was injured when the car he was driving was struck by another vehicle that lost control and crossed the highway median. EMS was called by a witness to the accident and when they arrived, Mr. Jones was found to be unconscious in his car. Mr. Jones was transported to the hospital where he was found to have a fracture to his left leg and several ribs, and he had cuts and bruising on his arms and face. Imaging of his brain demonstrated a TBI with subarachnoid hemorrhage, intracranial hemorrhage, and hemorrhagic contusions in both frontal lobes and the left temporal lobe. After being stabilized medically, Mr. Jones transferred to an acute rehabilitation unit at the local hospital. He then transferred to a residential rehabilitation facility for continued rehabilitation services and a supported environment. When Mr. Jones arrived, he remained confused (Rancho level V) and therapists Continued on page 10 Coma levels are commonly assessed by two different scales; the Glasgow Coma Scale and the Rancho Los Amigos Scale. The Rancho Los Amigos Scale is most helpful in assessing the patient in the first weeks or months following an injury, because it does not require cooperation from the patient. These Rancho Levels are based on observations of the patient’s response to external stimuli. They provide a descriptive guideline of the various stages a brain injury patient will experience as he/she progresses through recovery. Rancho Los Amigos Scale 8 Levels: An understanding of the eight levels provides insight into the progression through recovery and rehabilitation. I. No Response - Patient appears to be in a deep sleep and is unresponsive to stimuli. II. Generalized Response - Patient reacts inconsistently and non-purposefully to stimuli in a nonspecific manner. Reflexes are limited and often the same, regardless of stimuli presented. III. Localized Response - Patient responses are specific but inconsistent and are directly related to the type of stimulus presented, such as turning head toward a sound or focusing on a presented object. He may follow simple commands in an inconsistent and delayed manner. IV. Confused-Agitated - Patient is in a heightened state of activity and severely confused, disoriented, and unaware of present events. His behavior is frequently bizarre and inappropriate to his immediate environment. He is unable to perform self-care. If not physically disabled, he may perform automatic motor activities such as sitting, reaching and walking as part of his agitated state, but not necessarily as a purposeful act. V. Confused-Inappropriate, Non-Agitated - Patient appears alert and responds to simple commands. More complex commands, however, produce responses that are non-purposeful and random. The patient may show some agitated behavior in response to external stimuli rather than internal confusion. The patient is highly distractible and generally has difficulty in learning new information. He can manage self-care activities with assistance. His memory is impaired and verbalization is often inappropriate. VI. Confused-Appropriate – Patient shows goal-directed behavior, but relies on cueing for direction. He can relearn old skills such as activities of daily living, but memory problems interfere with new learning. He has a beginning awareness of self and others. VII. Automatic-Appropriate – Patient goes through daily routine automatically, but is robot-like with appropriate behavior and minimal confusion. He has shallow recall of activities and superficial awareness of, but lack of insight to, his condition. He requires at least minimal supervision because judgment, problem solving, and planning skills are impaired. VIII. Purposeful-Appropriate – Patient is alert and oriented and is able to recall and integrate past and recent events. He can learn new activities and continue in home and living skills, though deficits in stress tolerance, judgment, abstract reasoning, social, emotional, and intellectual capacities may persist. RainbowVisions | 9 Clinical News Post-traumatic Amnesia Continued from page 9 began to assess his cognition so that therapies and the environment around him could be targeted to maximize his recovery. On a standardized measure of orientation, Mr. Jones was noted to know his name and birthday but he could not remember his age. He was able to identify the month but not the date or year and when asked what time it was, he glanced at a nearby clock to provide the right answer. Mr. Jones knew he was in rehabilitation and working on his legs in therapy, but he could not recall how he had been injured or provide further details about the consequences of his accident. When given prompts, Mr. Jones became more accurate, but he remained confused. He could not remember the name of the team member who worked with him daily, but he was able to remember the names of his children and wife. Furthermore, Mr. Jones was noted to be unable to focus on a conversation or therapy exercise for longer than a few minutes. At times, Mr. Jones became irritable. He would pace around the home, swear at therapists or direct care staff, and refuse therapies. His family noted that this behavior was not typical for Mr. Jones. They were embarrassed despite reminders from his therapy team that this agitation was not uncommon for someone who had an injury like his and who was at that point of recovery. In addition, Mr. Jones had disturbed sleep. The treatment team worked together to determine if there were specific triggers for Mr. Jones’ agitation and discovered that he felt he had been treated like a child in the hospital and that he wanted more independence. To address his concern, therapists and team members provided options whenever possible to improve Mr. Jones’ sense of control over his environment. Environmental cues to help orient Mr. Jones were added to his room, and he was encouraged to wear his watch. This sense of control and assistance with reorientation resulted in more appropriate language and fewer refusals of therapy. To address sleep issues and pacing, Mr. Jones was encouraged to be up and active during the day, and the drapes in his room were opened to increase his exposure to sunlight. Mr. Jones was also directed toward pleasant activities when he paced or became irritable. Therapists worked to improve Mr. Jones’ span of attention in sessions and team members provided frequent breaks, repeated instructions, and checked for comprehension in consideration of Mr. Jones’ level of confusion and difficulties with attention. Working with his physician, medications were reviewed to minimize any negative side effects that they may have on cognition. Family members and Mr. Jones were provided with education about brain injury and recovery from injury. Over time, Mr. Jones became more oriented to his surroundings and less irritable. Serial evaluations indicated that Mr. Jones cleared post-traumatic confusion after 67 days. While he continued to demonstrate areas of cognitive weakness, his progress in therapy accelerated, and discharge plans were developed so that Mr. Jones could return to his home safely while continuing therapy as an outpatient. His successful transition was another indication of progress in his recovery from brain injury. v About the author Carolyn A. Scott, Ph.D. Psychologist Dr. Scott earned her Ph.D. in Clinical Psychology at Wayne State University. After an internship at the John D. Dingell VA Medical Center, she completed specialized post-doctoral training in Neuropsychology and Rehabilitation Psychology at the Rehabilitation Institute of Michigan. While there, Dr. Scott worked with individuals who had experienced traumatic brain injuries, stroke, spinal cord injuries, and other neurological and orthopedic conditions on both an inpatient and outpatient basis. In addition to other responsibilities, Dr. Scott provides client and team consultation services and brief and expanded neuropsychological evaluations at Rainbow Rehabilitation Centers, Inc. 10 | RainbowVisions www.rainbowrehab.com www.rainbowrehab.com FALL 2014 WI NTE R 2014 References: Nakase-Richardson, R., Sherer, M., Yablon, S.A., Nick, T.G., & Trzepacz, P.T. (2004). Acute confusion following traumatic brain injury. Brain Injury. 18(2):131-142. Nakase-Richardson, R., Yablon, S.A., & Sherer, M. 2007). Prospective comparison of acute confusion severity with duration of post-traumatic amnesia in predicting employment outcomes after traumatic brain injury. Journal of Neurology, Neurosurgery, and Psychiatry. 78:872-876. Russell, W.R. (1932). Cerebral involvement in head injury: a study based on the examination of two hundred cases. Brain. 55:549-603. Scherer, M., Nakase-Thompson, R., Yablon, S.A., & Gontkovsky, S.T. (2005). Multidimensional assessment of acute confusion after traumatic brain injury. Archives of Physical Medicine and Rehabilitation. 86: 896904. Scherer, M., Yablon, S.A., Nakase-Richardson, R., & Nick, T.G. (2008). Effect of severity of post-traumatic confusion and its constituent symptoms on outcome after traumatic brain injury. Archives of Physical Medicine and Rehabilitation.89(1): 42-47. Silva, M.A., Nakase-Thompson, R., Sherer, M., Barnett, S.D., Evans, C.C., Yablon, S.A. (2012). Posttraumatic confusion predicts patient cooperation during traumatic brain injury rehabilitation. American Journal of Physical Medicine and Rehabilitation. 91(7): 1-4. Stuss, D.T., Binns, M.A., Carruth, F.G., Levine, B., Brandys, C.E., Moulton, R.J., Snow, W.G., & Schwartz, M.L. (1999). The acute period of revoery from traumatic brain injury: Posttraumatic amnesia or posttraumatic confusional state? Journal of Neurosurgery. 90(4): 635-643. Symonds, C.P. (1937). Mental disorder following head injury. Proceedings of the Royal Society of Medicine. 30:1081-1094 Trzepacz, P. T., Kean, J., & Kennedy, R. E. (2011). Delirium and posttraumatic confusion. In J.M. Silver, T.W. McAllister, & S.C. Yudofsky Textbook of traumatic brain injury: Second edition (pp.145-171). Arlington, VA: American Psychiatric Publishing, Inc.. van der Naalt, J., van Zomeren, A.H., Sluiter, W.J., Minderhoud, J.M. (1999).One year outcome in mild to moderate head injury: the predictive value of acute injury characteristics related to complaints and return to work. Journal of Neurology, Neurosurgery, and Psychiatry. 66:207-213. Earn 10 CCM CEUs Become a Certified Brain Injury Specialist The Academy of Certified Brain Injury Specialists (ACBIS) offers a national certification program for experienced professionals working in the field of brain injury. ACBIS provides an opportunity to learn about brain injury, to demonstrate learning with a written examination, and to earn a nationally recognized credential. As a service to our brain injury community, Rainbow offers a free 9-week training course to prepare for the CBIS exam. Nurses, case managers and other professionals who partner with Rainbow and have at least one year of experience working in the field of traumatic brain injury rehabilitation are invited to attend. Sessions will be held every Thursday from 8 – 9:30 a.m. January 15 – March 19, 2015 Join more than 1,500 Certified Michigan Professionals Rainbow Rehabilitation Centers’ Livonia Corporate Center 38777 Six Mile Rd., Suite 101, Livonia, MI 48152-2660 To participate in CBIS training, contact: Lynn Brouwers at [email protected] RainbowVisions | 11 Survivor Perspective Motivation. Persistence. Success. By: Barry Marshall Editor, RainbowVisions Magazine meet David Abrams has been making a name for himself in the jewelry-making business over the last four years because of his high-quality work. He started working on this skill through a trade program in jewelry repair and stone setting at Groves High School in Birmingham, MI. He continued his work following high school through an additional specialized program in engraving and precious stone setting in Virginia. He also worked as an apprentice for a few years at MHG Jewelry Studio in Berkley, MI. His highquality work is a result of years of experience; his additional training and developing skills are in great demand. Few people possess the skills that David has. Life was good and headed in the direction David wanted. But on November 16, 2013 he was hit by a car while riding his motorcycle. Thankfully, he was wearing a helmet at the time of the accident. At the accident scene, he reportedly had altered levels of consciousness. As a result, he sustained a traumatic brain injury as well as fractures in his pelvis, the occipital area of the skull, a nasal bone and his wrist. His brain began to swell on the back side of his head, and it was bleeding in a small area in the front. David was transferred to Beaumont Hospital where he was flailing all four extremities and became combative. He required surgical repairs of his fractures, and spent a month at Beaumont Hospital before discharging to Rainbow’s NeuroRehab Campus (NRC) in Farmington Hills, MI. He recalls questioning himself and wondering if he was going to get past this. He wondered if this was the new reality for him. A full array of therapies David entered the NRC right before Christmas last year in a wheelchair and wearing a cervical collar. For the next month, he participated in a full array of intense therapies. He demonstrated to the therapists at Rainbow that he was very motivated to get back to his life and his work. “My daily therapies were pretty intense,” he said. “At that point, I had the capacity to understand why I was there, and I was beginning to accept it.” Speech & Language Pathologist Lisa Niziolek worked with 12 | RainbowVisions David Abrams David three times per week. His treatment goals revolved around his memory, high-level problem solving tasks and executive functioning skills. “David actively participated in his rehabilitation, always completed homework tasks and utilized strategies that were provided to him in therapy sessions,” said Lisa. David recalls working on leg strength with Physical Therapist Tina Kowalski. He said he was 85% weight bearing on his right leg and 15% on his left. Primarily in a wheelchair, he used a platform walker for short distances. Tina said that once his weight bearing precautions and cervical collar were no longer in place, he quickly progressed. By the time he discharged, she and David were working on high-level balance and yoga-type activities, dynamic workouts including plyometrics, and high-intensity exercises targeting the core and legs. She recalls that David regularly stayed after their one-hour sessions to complete another 30-45 minutes of exercise on his own. Tina noted that David was very motivated, made significant progress in a short period of time and was extremely involved in his discharge planning. “It was a struggle, but I had to get through it,” David recalls. “I might feel bad at the end of the day, but tomorrow was always a brand new one. Every day, I felt better.” “She kicked my butt,” said David of Occupational Therapist Kori Morden. “She really put me to work, and I’m thankful for that.” Kori noted that because he was a highly skilled jeweler, working on upper body strength, hand strength and dexterity was important. David increased his upper body strength with yoga, kickboxing and weight training. Though he felt unsteady and admittedly awkward doing these exercises, Kori said he mastered them. David improved his hand strength and dexterity through various coordination games and strengthening exercises. In fact he would often diligently do his hand strengthening exercises on his own outside of therapy. Kori also worked with David on his medication Continued on page 14 www.rainbowrehab.com FALL 2014 Clockwise from left: David runs his own business, Jewelry Designs by David Abrams, from his work space in Berkley, MI. In appreciation of their hard work and support, David designed a Rainbow logo pendant for each of his NRC therapists. He has also created a piece for Rainbow’s booth at the Brain Injury Association of MI conference. In addition to design, David also repairs jewelry, resizes rings and sets new stones into existing jewelry. RainbowVisions | 13 Survivor Perspective: David Abrams Continued from page 12 management and meal preparation skills in anticipation of his eventual return home. Kori noted that as David’s attention and memory improved, he made dramatic gains in his ability to complete these higher-level tasks. He made several impressive food dishes and always had the sense of humor to laugh it off if it didn’t turn out quite like he had planned. David said that in recreational therapy, he and Recreational Therapist Lauren Cetnar “worked to forget.” “You feel pain almost every single day,” said David, “and then there’s someone with a smile on their face and you smile back and forget about what you’re going through.” He went on to say he couldn’t figure out why they played Uno nearly every day for two weeks. And then he realized he didn’t feel pain while they played. Vocational rehabilitation and returning to work was extremely important to David. Vocational Therapist Maria King said that he figured out in advance of starting back to work that he needed a quieter environment, so he arranged to start work in the afternoon and work into the evening when fewer people were around. She said he was keenly aware of his fatigue and was not afraid to turn down work if he did not think he could manage the time frame required by the customer. “David was one of the most motivated individuals I have ever worked with,” said Maria. “He is one of those patients that a therapist goes back to in memory and celebrates. He reminds us that we can make a difference, and that is why I got into this line of work.” David recalls being terrified to take his neuropsych exam. “It was a little frustrating,” he said. “It was a long day of working your brain out—it’s really put to the test.” Rainbow’s Neuropsychologist Dr. Carolyn Scott had been consulted to assist with David’s treatment planning in January. He completed several hours of testing that looked at his processing speed, memory, problem solving, language, attention, visuospatial, and academic skills. The testing can be boring or challenging at times but David worked diligently throughout the process according to Dr. Scott. David indicated he would like to take the test again to see how far he has progressed since taking the first one. David said he enjoyed his sessions with Mental Health Therapist Anne Marie Caldwell. “You can just talk and be yourself with her,” he said. “It was good to get out some of my frustrations.” Anne Marie helped David with identifying coping strategies to deal with stressors, negative feeling states and everyday problems. David may have entered the NRC in a wheelchair, but he walked out a month later. He credits his success to the therapists at the NRC. They challenged him. They pushed him. “I have more confidence in myself now,” said David. “I’ve always been timid and never put myself out there. I still might be timid but I’m building up my own self-confidence because I had a team of people at Rainbow telling me I could do it.” David discharged from the NRC and returned home. He began outpatient therapy at Rainbow’s newest treatment center in Farmington Hills, MI for three months. He continued his therapy regimen three times per week. He also successfully completed a final driving assessment and was cleared to drive. He discharged from Rainbow completely on April 25 of this year because, according to David, “I surpassed all my goals.” “The team at the NRC is stupendous,” said David. “What blows my mind is that the people there make you feel like their life is second to yours. I’ve never experienced anything like that. Such a helping hand. Great people to be around. They do nice gestures and that’s what they do day in and day out, for not just me, but all patients at the NRC. What they do there is amazing.” David is back to work full time. When asked how he feels now, he responds with “Great! My walking is not as good as it once was, but I’ll keep working on it.” v It's about reaching your potential! Young Adult Program Vocational programming Designed to assist young adults in gaining meaningful Therapeutic services employment and developing the skills necessary to initiate and maintain long-term relationships. Residential services Flexible scheduling 800.968.6644 E-mail: [email protected] 14 | RainbowVisions www.rainbowrehab.com www.rainbowrehab.com FALL 2014 no greater hope of recovery… A full Continuum of Care including active therapy, community outings and supported living for individuals with medical needs. FEATURING Two 20-bed facilities Private rooms and baths Physician visits on-site Nursing services available on-site 24/7 Interdisciplinary treatment team ha or ation m r o inf for m o b.c to schedule a tour. Email ad miss io ns @ rai nb ow re Executive chef 800.968.6644 www.rainbowrehab.com RainbowVisions | 15 Therapy Corner School Liaison and Pediatric Divisional Director Sue Finney (above) communicates regularly with parents, students and school personnel. She has worked in the field of traumatic brain injury since 1992. At right, School Liaison Sheryl Carpenter works with a student at the Genesee Treatment Center during the after school program. Sheryl’s background is in occupational therapy and she also functions as the clinical manager of the Genesee Treatment Center. 16 | RainbowVisions www.rainbowrehab.com FALL 2014 How Rainbow’s School Liaisons support students with brain injuries Encouraging School Success By: Barry Marshall Editor, RainbowVisions Magazine For over 20 years, Rainbow has been providing therapeutic support to children in its pediatric program. Through therapy, counseling and activities, Rainbow works to set children up for success in their adult lives. One important aspect of this is supporting them while going to school. As individuals with brain injuries, the kids need extra support and understanding to be successful in school. Sue Finney, divisional director at Rainbow’s Oakland Treatment Center, and Sheryl Carpenter at the Genesee Treatment Center, both work as school liaisons and child advocates for our pediatric clients attending school. Working with Educators One of the first orders of business when a pediatric client enters a school is to educate the school staff on traumatic brain injuries. This includes teachers, para professionals and the school’s special education division. “It’s important to open the lines of communication with all teachers,” said Sheryl. “I get their email addresses so I can get updated information on attendance, test dates, missing assignments and any behavioral issues that may be going on.” Sheryl also tries to get an extra set of textbooks so if the child forgets their books, they can still work on homework while at the treatment center. Sue and Sheryl work with the school’s occupational and physical therapists as well as the speech pathologists to update them on the goals for the child and provide them with any medical information they need to know. Because students may exhibit maladaptive behaviors, school liasons will make sure that successful behavior plans are shared with the school team. A therapist can go into the school to assist and educate teachers how to safely handle the behavior. Establishing a Plan Typically, an Individual Education Plan or IEP is developed that outlines the educational goals and accommodations made for the student. Few families have insight into this process. Sue and Sheryl are there to support families during the process and explain the rights of the child under the state of Michigan Educational Laws. Sue points out that Rainbow pediatric residential clients and those receiving tutoring support have educational goals listed in their plans of care. School liaisons attend all IEP meetings to ensure the appropriate accommodations are listed and enforced. They also ensure that the correct plan is written, be it an IEP or accommodations based on the 504 plan (see sidebar on next page.) It’s also important that the student receive appropriate technology, like an iPad or other communication device that can help set them up for success. Sue and Sheryl assist with acquiring the technology to ensure the client is able to effectively use it, and that if needed, others around them can support it from a technological perspective. Collaboration with Families An integral part of the school liaison role involves spending time with families. Their work assisting families with the IEP process is an important part of what they do, but it is not all they do. Sue and Sheryl also educate families on an ongoing basis regarding brain injury education, providing information about the school, assisting them with access to homework hotlines (so that families are alerted about tests or quiz dates), and just being an all-around resource. Communication is important in the whole process and Rainbow’s school liaisons find themselves central to all interested parties, including insurance companies, physiatrists, and external case managers. Children living with brain injuries have needs both in and out of school, and Sue and Sheryl work diligently to help them succeed! v RainbowVisions | 17 What’s the difference between an IEP and a 504 plan? An IEP or Individual Education Plan is mandated by the Individuals with Disabilities Education Act (IDEA), a federal law that ensures specially designed instruction to meet the unique educational needs of children with disabilities such as brain injury. Individuals who do not qualify for special education services through IDEA may be eligible for accommodations under a 504 Plan. Here are a few basic differences. IEP 504 Plan An IEP is the indivdualized plan mandated by IDEA. IDEA is a federal statute whose purpose is to ensure a free and appropriate education for children with disabilities. Section 504 of the Rehabilitation Act of 1973 requires schools to eliminate barriers that would prevent a student from participating in the programs and services offered. An IEP is a legal document that includes goals and objectives, and specifies the educational services to be delivered free of charge to the family. A 504 Plan outlines educational services and accommodations to be provided to the student such as extra time for tests or repeated/simplified instructions. Services specified may go beyond those offered to students in the general curriculum such as speech therapy, counseling or individual instruction. Services specified are limited to accomodations that give students an opportunity to fully participate with their peers. An IEP meeting is required before any change in placement or services is made. A meeting is not required for a change of placement. An IEP is to be reviewed each year or earlier if it is not fulfilling the educational needs of the child. A 504 Plan requires yearly reevaluations or periodic review. References Michigan Administrative Rules for Special Education (MARSE). (2013). General Provisions. Michigan Department of Education, Office of Special Education. Retrieved from http://michigan. gov/documents/mde/MARSE_Supplemented_with_IDEA_Regs_379598_7.pdf Section 504 of the Rehabilitation Act of 1973 | ADAAA & Section 504. (2014, May). National Center for Learning Disabilities. Retrieved from http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504-rehabilitation-act-1973 Section 504 and IDEA Comparison Chart. (2014, August). National Center for Learning Disabilities. Retrieved from http://www.ncld.org/disability-advocacy/learn-ld-laws/adaaa-section-504/section-504-idea-comparison-chart Independence: Where do you want to go and when do you want to get there? We have one of the largest service areas in Michigan so chances are good that we’re going your way. Experienced drivers are also specially trained in caring for individuals with special needs. So while you are enjoying your independence you’ll also have confidence that comes from knowing you are safe. Rehab Transportation. We are… GRAND RAPIDS LANSING TRI-CITY AREA your license to GO! METRO DETROIT A Specialty Transportation Company 800.306.6406 www.rehabtransportation.com 18 | RainbowVisions www.rainbowrehab.com FALL 2014 What's new at Rainbow U is a unique outpatient and day treatment program offering dozens of interesting elective courses in addition to an individual's core therapies. Therapeutic fishing? Absolutely! For staters, ask any fisherman and they’ll tell you about the stress-relieving benefits of a trip to the lake. At Rainbow U, we also know that casting, tying lures and even removing hooks are excellent activities that encourage the practice of fine and gross motor skills, concentration and attention to safety. Rehab Tech Jeff Brozoski who designed the “Fish On!” course last summer, says that more than a dozen Rainbow clients are enjoying this bonus to traditional therapy with the opportunity to reinforce skills they’ve learned in treatment. “I’ve seen many gains and improvements along the way. I’ve had clients show up extra early just because they are excited to go fishing and enjoy the fresh air. They also enjoy time interacting with fellow clients.” Participants in “Fish On!” also learn about Michigan lakes and rivers, lures and baits, casting techniques, knots and reel stringing, species identification, safety and etiquette. Regular fishing outings are especially anticipated, as is the opportunity to yell, “Fish On!” Above, Ed Pttman and Rehab Tech Jeff Brozoski cast their lines at Walled Lake in Oakland County, MI. Ed was an avid fisherman before his injury and loves every opportunity to participate in the sport. Left, Autumn Lujan displays the impressive small mouth bass she landed after a 10 minute struggle “The excitement and look on her face was priceless,” said Brozoski. “I walked her through how to handle the fish, remove the hook and properly place the fish back in the water. She talked about it all day!” RainbowVisions | 19 2014 Conference & Event Schedule Fall September September 14-17 Contemporary Forums Case Management Conference Las Vegas, NV www.contemporaryforums.com September 16 Michigan ARN Dinner Presentation Rainbow’s Ypsilanti Treatment Center, MI www.miarn.org September 16 CMSA Gr Rapids/Kalamazoo Dinner Conference Bluffs Conference Center, Grand Rapids, MI www.cmsa-westmi.com September 17-20 Contemporary Forums Brain Injuries Conference Grand Hyatt—San Francisco, CA www.contemporaryforums.com September 20-21 International Symposium on Life Care Planning Marriott City Center—Minneapolis, MN www.isicp.com September 29-30 Michigan Assoc. for Justice Auto NoFault Seminar Westin Hotel—Southfield, MI www.michiganjustice.org October October 3 ACMA Great Lakes Chapter Conference Suburban Collection Showplace—Novi, MI www.acmaweb.org October 14 CMSA Detroit Breakfast Conference Farmington Hills Manor—Farmington Hills, MI www.cmsadetroit.org October 18 CPAN Gala Dinner Eagle Eye Banquet Center - E. Lansing, MI www.cpan.us October 24-27 American Association of Nurse Life Care Planners Atlanta, GA www.aanicp.org October 27-30 NASHIA Annual State of the States Meeting Courtyard Downtown—Philadelphia, PA www.nashia.org October 28 MSU Case Management Conference Kellogg Center—East Lansing, MI [email protected] October 29-Nov. 1 ARN Education Conference Disneyland Exhibit Hall—Anaheim, CA www.rehabnurse.org November November 18 CMSA Gr Rapids/Kalamazoo Dinner Conference Borgess Medical Center - Kalamazoo, MI www.cmsa-westmi.com November 19-20 National Worker’s Comp & Disability Conference Mandalay Bay - Las Vegas, NV www.wcconference.com 2015 Preview January 11-14 Craig Hospital Brain Injury Summit Vail Cascade Resort/Spa—Vail, CO www.braininjurysummit.org March 22 Carnival of Care Suburban Collection Showplace—Novi, MI www.carnivalofcare.com April 31-May 2 NABIS 12th Annual Conference on Brain Injury Westin Riverwalk Hotel—San Antonio, TX www.nabis.org 20 | RainbowVisions www.rainbowrehab.com www.rainbowrehab.com MBIPC Michigan Brain Injury Provider Council FALLR 2014 SUMME 2014 RINC Rehabilitation & Insurance Nursing Council meetings MEMBERS ONLY Registration at 11:30 a.m. / Lunch at Noon Presentation begins at 12:45 p.m. Learn Over Lunch Meeting times are noon – 2:00 p.m. (Registration at 11:30 a.m.) Cost: MBIPC Member $25 / Non-member $60 For information call 810-229-5237 or [email protected] October 14, 2014 Topic: Health Disparity Within the LGBTQ Community and Creating a Welcoming Environment Speaker: Dr. Grace Hoyer; Asst. Prof., Grand Valley State University Location: Prince Conference Center, Grand Rapids, MI November 11, 2014 Topic: Veterans Administration Topic September 19, 2014 Topic: Proposed Changes to No-Fault Law Speaker: James Iafrate, JD, Robert E. Logeman, JD, Adrienne D. Logeman, JD Location: The Townsend Hotel 100 Townsend St., Birmingham, MI 48009 RSVP to: Kim Newman at 734-709-1602 October 17, 2014 Topic: Pediatric Traumatic Brain Injury Speaker: Dr. Harmony Sierens Location: Detroit Golf Club 17911 Hamilton Rd., Detroit, MI 48203 RSVP to: Shannon Higdon at 877-214-1541 [email protected] November 21, 2014 Speaker: TBD Location: Holiday Inn, Livonia, MI Topic: Evaluation and Management of Sexual Dysfunction after TBI December 9, 2014 Topic: Promoting Universal Design to Meet Diverse Needs from the Home Setting to the Community Location: Fleming’s Prime Steak House 17400 Haggerty Rd., Livonia, 481522 Speaker: Carrie Pilarski, Ph.D., LP, CBIS; Vicki Helson, AIA, ACHA, B Arch; Michael O’Connor, OTRL, CAPS, CBIST Location: Prince Conference Center, Grand Rapids, MI January 13, 2015 Topic: Emotional Intelligence in the Rehabilitation Setting Speaker: Mary Newton, Ph.D., LMSW, CBIS, CCM Rainbow Rehabilitation Centers Location: Holiday Inn, Livonia, MI Speaker: Lawrence Horn, MD RSVP to: Rabecca Plenchette at 734-732-0212 RINC meetings are presented the third Friday of each month. For more information on meetings and membership contact Adrienne Shepperd: 248-953-4079 NOTICE: The conferences and events information listed on these pages is dated information. For the most up-to-date information on industry-related conferences and events, please visit: www.rainbowrehab.com RainbowVisions | 21 News at Rainbow artists display work at brain injury conference Rainbow clients come from all walks of life and several have artistic backgrounds. Some take a new path during their recovery and have discovered a love and talent for art while receiving therapy at Rainbow. Rainbow U offers many classes in various artistic media. Woodshop, pottery, photography, canvas painting and fibre arts are just a few offered in 2014. These talented artists create one-of-a-kind works to be included in a drawing at the Rainbow booth during the Brain Injury Association of Michigan annual conference in September. Jamie Jamie Choate has been taking pictures all his life. “My dad did photography as a hobby, and I got interested in it in junior high school when I participated in yearbook,” he said. Jamie has recently taken photography classes in Rainbow U and finds it to be therapeutic in nature. “To me, it’s about grabbing a scene and passing it along—sharing it with someone. I like to capture the moment. “ Jamie’s favorite subjects are nature photography and portraits. He also paints in acrylics and will sometimes paint the photos that he takes. Ashley Ashley Dixson’s previous experience with art comes from Rainbow U groups and Rainbow’s vocational program where she created beaded jewelry. Her favorite media are textiles and wood, and she loves to play with color and texture. Ashley is inventive and frequently asks, “What if I combined…?” as she begins planning her next project. When asked if making art helped with her therapy, she replied, “Yes, art makes me believe that I can do more and express myself better. My mood shows in my work. The bright colors indicate that I am happy.” Char Sobieski, a Rainbow U fibre arts instructor, indicates that Ashley has become a more confident person, “She is thoughtful, focused, creative and seeks challenges that help her grow.” 22 | RainbowVisions www.rainbowrehab.com FALL 2014 Sharon Sharon Brown takes every Rainbow U art course that she can. She has participated in pottery, jewelry and woodshop classes, but her favorite is pottery. She is creating a vessel for Rainbow’s booth at the Brain Injury Association of Michigan Conference and really enjoys working with clay because she feels that it helps her hands. In addition to her Rainbow U art classes, Sharon loves to crochet, an activity she has enjoyed for many years. When asked if she has any goals for her work, she says that she’d like to try drawing. “Art makes me happy,” she said. Nikki Nikki Markham creates artwork in many media but particularly enjoys textile art and beaded jewelry. Whether in a Rainbow U course or working on pieces at home, she loves to embellish her work with color. She is a joyful class participant and is quick to offer encouragement to her fellow artists. Nikki’s goal for her work is to become more creative and do her best to make it even better. She loves to visit museums, particularly the Chicago Institute of Art, and is intrigued by artwork that is created by animals. “Art helps create who you want to be, you can express yourself through art,” she said. Tom Tom Sparschu was born with the ability to draw. He is a serious artist who puts a great deal of thought into his work and is very focused while he is creating. Tom regularly visits art galleries and museums. In addition to his Rainbow U art classes, he currently enjoys throwing pottery at a local art studio. An accomplished artist in 2-D and 3-D media, Tom says he never stops learning and is always seeking a new challenge for his own personal growth. Tom’s goal is to eventually sell his artwork to the public. While art is his first love, Tom also enjoys gardening, maintaining an aquarium and volunteering at a local animal shelter and conservatory. RainbowVisions | 23 News at New Professionals Coryanna Ku, MA, LPC, NCC Mental Health Counselor Coryanna works with Rainbow’s pediatric population at the Oakland Treatment Center in Farmington, MI. She earned a bachelor’s degree and Master of Arts in Professional Counseling from Eastern Michigan University. Coryanna has experience working with children at CALM Child Abuse Listening Mediation in Santa Barbara County, CA as well as Penny Lane Centers where she was a residential therapist for adolescent clients released from juvenile detention centers. Andrea Mason, PT, DPT Physical Therapist Andrea earned a Doctor of Physical Therapy degree from Central Michigan University and a bachelor’s degree in kinesiology from Michigan State University. She is a recent graduate and performed clinical rotations at Sparrow Hospital in Lansing, MI and at Origami Brain Injury Rehabilitation Center. Andrea works with clients at several Rainbow treatment centers in Washtenaw and Oakland counties. Kaitlin O’Hara, PT, DPT Physical Therapist Kaitlin is a recent graduate with a Doctor of Physical Therapy degree from Washington University in St. Louis. Her clinical experience includes work at TIRR Memorial Hermann Healthcare System in Houston, TX, Barnes-Jewish Hospital in St. Louis and the Rehab Institute of Michigan. Kaitlin treats clients at Rainbow’s NeuroRehab Campus® and the Farmington Hills Treatment Center, both in Oakland County. Julie Ferry Nursing Secretary Julie joins the team at our NeuroRehab Campus® in Oakland County. She has extensive experience in the health care field as an office manager for Dwight Orthopedic Rehabilitation and ATI Physical Therapy. Julie completed a certificate program in medical billing from Ross Medical Education Center. Workwith Us Interested in a career with Rainbow? We welcome applications from qualified candidates for a variety of positions. To learn more, just visit: www.rainbowrehab.com/workwithus 24 24 ||RainbowVisions RainbowVisions www.rainbowrehab.com FALL 2014 Rainbow Employees of the Season Spring 2014 Rehabilitation Assistants Ann Arbor Apts: Christian Smith, Labor Pool: Diane Lee Stoney Creek: Justin Wargo, Kayci Drake Ashanda King Maple: Riad Alhakim Talladay: Mykyla Whitehurst Arbor: Ryan Miller NRC: Mercedes Mitchell, Salina Brown, Carol Textile: Andrea Martin, Debora Farrrow, Belleville: Pamela Joseph D’Angelo, Amber Watson, Antonia Starks Tanille Scott, Brianna Minor, Falisha Matthews Bemis: Janifer Eddins Page: Kristen Johnson Westmoreland: Darlene Townsend Briarhill: Glen Kurz RIPROC: Anise Chappell Woodsides: Danielle Scott, Mesha McCloud, Elwell: Janae Taylor Shady Lanes: Jacqueline Dunne, Bridgette Michael Rangel Garden City Apts: Emonda Burroughs Fox, Chenoa Mays, Christine Cervantes Ypsilanti Treatment Center: Genesee Treatment Center: Brittany Hepburn Southbrook: Kelly Goodman Raymond Trabulsy, Christina Dulaney, Spring Valley: Felicia Woods Jessica Lupone Professional/ Administrative Therapy Vickie Bey-Walker Residential Program Manager Julie Mooring Karen Violette Ron Williams Celine DeMeyer Tomeka Beaty Bonnie Tatterton Sandra Yarbrough Christine Boujoulian Megan Fryer Lisa Hildebrandt Kevin Michels Joe Wurmlinger Jenny Auty Susan Arney Amy Hocken Danyell Solomon Nicole Jeanguenat Jennifer Griewahn Kate Sobbry Victoria Buggs Demetrius Kirk Rehab Techs Michelle Trojniak Sabrina Miles-Bentley Kelly Jarzynski Rehab Transportation Joy Sharp Cheryl Helber Vanessa Queen Heather Garavaglia Please join us in congratulating these outstanding team members! RainbowVisions || 25 RainbowVisions 25 One Thousand Words Ah, Summer Fun! It’s hard to see it go, but we still have the memories of new experiences and the benefits of therapeutic goals met. Our pediatric clients enjoyed at least one outing to area attractions each week this year. They went camping, visited the state capitol building, rooted for the Detroit Tigers and recorded their own music in a real recording studio. On this warm July day, the Oakland County group cooled off at Red Oaks Water Park in nearby Madison Heights, MI. In spite of a little trepidation, client Kevin made a big splash on the water slide. Find out more about the vast offerings of Rainbow’s Pediatric Program by calling 800.968.6644. Locations Toll free: 800.968.6644 E-mail: [email protected] Visit: www.rainbowrehab.com GENESEE COUNTY Genesee Treatment Center 5402 Gateway Centre Dr., Suite B, Flint, MI 48507 T: 810.603.0040 F: 810.603.0044 OAKLAND COUNTY Farmington Hills Treatment Center 28511 Orchard Lake Rd., Suite A Farmington Hills, MI 48334 T: 734.482.1200 F: 248.306.3197 Now Open! Oakland Treatment Center 32715 Grand River Ave., Farmington, MI 48336 T: 248.427.1310 F: 248.427.1309 NeuroRehab Campus® 25911 Middlebelt Rd., Farmington Hills, MI 48336 THROUGHOUT MICHIGAN Home Care T: 248.471.9580 F: 248.471.9540 T: 800.968.6644 WASHTENAW COUNTY Ypsilanti Treatment Center Functional Recovery / Home and Community -Based Rehabilitation 5570 Whittaker Rd., Ypsilanti, MI 48197 T: 734.482.1200 F: 734.482.5212 T: 810.603.0040 F: 810.603.0044 WAYNE COUNTY Rainbow Corporate Headquarters A wholly-owned subsidiary of Rainbow Rehabilitation Centers T: 800.306.6406 38777 Six Mile Rd., Suite 101, Livonia, MI 48152 T: 734.482.1200 F: 734.482.3202 Rehab Transportation® Two vocational treatment centers and 37 residential facilities 26 | RainbowVisions www.rainbowrehab.com FALL 2014 no finer promise of achievement… The Farmington Hills Treatment Center A full Continuum of Care including active therapy, Rainbow U day treatment, and vocational rehabilitation FEATURING OT/PT gym Fitness facility Individual treatment space Computer lab Therapeutic kitchen and laundry Group treatment rooms Spacious activity center to tion or a m r fo or in f om b.c a h schedule a tour. Email ad miss io ns @ rai nb ow re Conveniently accessed by major freeways, the Farmington Hills Treatment Center serves residential and outpatient adults with brain injuries and spinal cord injuries. 800.968.6644 www.rainbowrehab.com RainbowVisions | 27 38777 Six Mile Road, Suite 101 Livonia, Michigan 48152 Presorted Standard U.S. Postage PAID Permit 991 Ypsilanti, MI INSIDE: Post-traumatic Amnesia—Learn about this period of confusion that often follows a traumatic brain injury. Tell us what you think about RainbowVisions! Do you have a story idea or comment? Email: [email protected] Therapeutic After School & Saturday Programs Take steps to boost academic and social success Rainbow’s After School and Saturday Programs provide education and structure for children pre-school age through adolescence who have experienced a traumatic brain injury. Discover the program developed by pediatric rehabilitation specialists to be therapeutic, safe and fun. Now offered in Oakland and Genesee Counties 800.968.6644