Trisha Meili speaks about Hope and Possibilities

Transcription

RainbowVisions
A Quarterly News Magazine for Acquired Brain Injury Professionals, Survivors & Families
www.rainbowrehab.com
WINTER 2008
Rainbow Rehabilitation Centers, Inc.
Volume V
No. 1
In this issue ... Clinical News on the Interdisciplinary Team approach: A case study review.
Featuring an interview with the Central Park Jogger
Trisha Meili speaks about Hope and Possibilities
Letter from the
Editor ...
Dear Readers,
As Rainbow celebrates
25 years of serving individuals
with brain and spinal cord injuries, I
would like to thank you, our readers,
for your patronage and many words of
encouragement.
Through this magazine, the Rainbow
executive committee and professional staff
have been committed to providing insight
into our organization and news about
current events, clinical advancements, and
industry technologies as well as sharing
survivor success stories. We try to keep pace
with industry developments and make sure
that you, our clients, family members and
industry professionals, are informed about our
practices and future plans.
In this celebration issue of
RainbowVisions, we are featuring our
interdisciplinary therapy team approach to
rehabilitation through four documented
case studies. Each story is unique and well
illustrates Rainbow’s comprehensive approach
to recovery. Because of our company success
and growth, we have changed and improved
our care delivery systems and invested in
professional talent. We want you to know that
we are committed to continued excellence
and quality care – and we look forward to
serving you for many years to come.
Table of
Contents
INDUSTRY NEWS
What’s News in the Industry 2
Clinical News – Interdisciplinary therapy case studies
3
Therapy Disciplines – A look at recreational therapy
7
Technology Corner – Susceptibility Weighted Imaging
9
CARF – A measure of quality rehabilitation
13
Industry Conference & Event Calendar 15
TBI SURVIVOR STORIES
Survivor Corner – An Interview with Trisha Meili
INSIDE RAINBOW
Employee of the Season – Spring 2007
10
Rainbow Community Education
16
Rainbow’s approach to nutrition 17
New professional hires
28
The Last Word – Staff of Professionals
29
Yours,
Kimberly Paetzold
RainbowVisions Editor
Editor & designer – Kimberly Paetzold
Assistant editor & staff writer – Kirstin Olmstead
Staff photographer – Heidi Reyst
Please e-mail questions or comments to:
[email protected]
1
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5
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2007 / 2008
What’s News in the
Industry
I
25 Years of Rainbow
By
Bill Buccalo, President
t was at this time in the fall of 1982 and early 1983 that Buzz Wilson
completed the incorporation papers for
establish innovative programs. Currently
your injury, whether in a vehicle or on
Rainbow Tree Center, Inc. and we began
there is legislation in progress due to the
the playing field, should not determine
providing services. Buzz’s law partner had
wars in Iraq and Afghanistan and significant
whether or not you receive rehabilitation
won a verdict on behalf of a young man
research in the area of TBI will result.
or needed life-long support. Cognitive
with a brain injury and it was his need
America has a tremendous opportunity at
rehabilitation needs to be recognized by
for care, community reintegration, and
hand to learn.
health plans. We need to advocate for
companionship that prompted Rainbow’s
In 1983, Rainbow’s processes were
change.
founders to begin the adventure. In the
totally paper dependent. Today we have
Clinical Research needs to be funded.
subsequent 25 years, we have seen
200 PCs, PDA’s, cell phones, and the like.
Research to date has improved diagnostics
incredible change. For Rainbow, the theory
Computer based systems have transformed
tools such as imaging; we are learning
remains the same – bring a team of experts
how we do business and improved client
more about brain plasticity, concussion
and care givers together to assist our clients
care. We have much more to do in this
management, and decreasing functional
in recovery and to live full, productive
area.
limitations post injury. With more
lives. What has changed is what we now
Safety and prevention efforts, along with
research, the industry can improve the
know and the tools that are available to
societies’ views, have come a long way in
prognosis.
assist in recovery.
the past 25 years. MADD was established
We need to support the BIA and
In 1983 CT Scans were just becoming
just a couple of years before Rainbow.
advocate for continuing education on the
available. It took days for the computers
In 1984, the federal ‘Age 21’ minimum
topic of brain injury via programs such
to reconstruct one scan into a low quality
drinking age was enacted and states have
as AACBIS. We need to look out for our
image. Today, we get these incredible
enacted tougher drunk driving standards
senior population and young children as
diagnostic tools in fractions of a second
and penalties.
falls are one of the highest causes of brain
and the picture quality is unparalleled.
Helmets for bicyclists and sports
injury.
In the early years, Rainbow performed
have become part of our culture. Other
Rainbow is very proud of our first 25
limited modification to our homes. About
advances include automobile safety;
years. Today, we have employees who
half our clients shared bedrooms and
worker safety initiatives, sports concussion
were part of the very first group hired in
homes had little accessibility features.
guidelines; advances in EMS and ER
1983 and we have many others who have
Today, our team involves architects to
protocols and pharmacology, and the list
dedicated their careers to the field. We are
focus on accessibility features, ADA
could go on.
proud of the work we have done with our
compliant bathrooms, and other beneficial
The advancements made in the last 25
clients, the relationships we have built,
modifications.
years and their impact on people with
and the opportunities we have created for
New laws have changed both business
brain injury, public perception, and the
the future. For the next 25 years, Rainbow
and mindsets. The Americans with
field are incredible. Yet, at the same time
is dedicated to providing the best care
Disabilities Act was signed into law in
there is so much more that we need to do.
for our clients and pushing for greater
1990, establishing rights for people with
We need to establish standardized
opportunities for all of those living with
disabilities and changing attitudes. In
outcome measures and benchmarks on an
the consequences of brain injury. We are
1996, the TBI Act was instituted becoming
industry-wide basis to clearly demonstrate
hopeful. We have much to accomplish.
the first piece of federal legislation to
the value of rehabilitation for those we
Thank you for all your support over the
expand the studies of brain injury and to
serve. TBI is an epidemic. The source of
years. 
RainbowVisions
2
Clinical
News
CASE STUDIES ON THE ...
Interdisciplinary Team Approach
Kimberly Paetzold, Editor
W
By
hat is an interdisciplinary team approach to recovery? An interdisciplinary therapy team
approach to rehabilitation draws from two or more
therapy disciplines – integrating them together in the
pursuit of recovery. This approach develops a greater
understanding of an individual’s complex and wideranging issues following a traumatic brain injury, and
more importantly, the therapy results are greater than
the sum of each discipline implemented individually.
her to try Rainbow’s “interdisciplinary team approach” to therapy. As it turned
To illustrate the advantages of this approach, we
out, receiving therapy with a professional team focused on meeting her
have documented four Rainbow client rehabilitation
unique needs was exactly what Betty needed.
stories focused on each person’s therapy. The stories
Betty did not have a brain injury, but she did have serious orthopedic
are unique, but the results of combined therapies and
issues, severe pain and medical conditions, including colitis. Marianne Knox,
an integrated team approach yielded superior results in
the admission coordinator assigned to Betty’s case, met with Betty and her
each of the following cases.
husband, Ralph. Marianne evaluated Betty and produced a plan of care based
on her assessment, medical records and Betty’s physician prescription. After
selecting Rainbow’s NeuroRehab Campus as the appropriate treatment center
Case Study #1 - Betty Korte
February 2007 – Betty is an independent, vibrant
73-year-old, married to Ralph, the man she loves and
her second husband of 35 years. She has three children,
three grandchildren and three great grandchildren. But
on February 11, her life changed drastically when she
and residential home, her therapy team was assigned – physical therapists,
“After receiving treatment for pain, Betty felt better and could
participate in therapy. When clients have varied needs, the
interdisciplinary team approach becomes invaluable.”
Gaurav, Rainbow OT
was in a car accident that left her injured with multiple
fractures. After receiving acute care, Betty transferred to
3
an inpatient rehabilitation center close to home. After
occupational therapists, a Rainbow case manager and nurses.
weeks of therapy, she was having a very difficult time
For someone who is neurologically intact and has not incurred a brain
getting out of bed, was wheelchair bound and unable
injury, the treatment process can be less complex. Eliminating the need for
to progress in physical therapy sessions. She felt ill and
adaptive cognitive strategies allowed Betty’s therapy team to strategically
had completely lost her self-confidence. Her lack of
focus on improving her range of motion, overall strength, stability and
success caused an extreme amount of anxiety and her
balance. This became Betty’s daily rehabilitation.
first response to therapy quickly became, “I can’t do
As Betty worked with her therapists, she grew to trust them, and her
that.”
confidence increased, translating into a more positive outlook. There was
After two months of unsuccessful treatment, Betty’s
regular communication between her therapists on a daily basis and formal
case manager felt she needed a change. She wanted
monthly team meetings. When Betty was tired or in pain, her therapists would
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WIN T E R
2007 / 2008
communicate that information, and Betty would receive pain management
following the therapy session. If necessary, therapies would be rescheduled
later in the day, enabling her to rest. “We cater to our clients’ needs
or issues,” stated Gaurav Rainbow, a occupational therapist. “If Betty
needed a break or pain management, such as a hot pack, ice pack or
pain medication, that need was communicated to nursing. After receiving
treatment for pain, Betty felt better and could participate in therapy. When
clients have varied needs, the interdisciplinary team approach becomes
invaluable.” Within a short period of time, Betty grew stronger and was
able to handle back-to-back therapy sessions.
On September 27, only four months after admitting to Rainbow, Betty
was ready to go home. Unfortunately, she had to wait until her house
renovations were complete, but when her home received a passing grade,
her discharge was quick.
When Betty arrived at Rainbow’s NeuroRehab Campus, she needed
assistance to stand and was unable to ambulate. When she left, she
was able to walk with a cane and could handle almost all of her daily
living tasks independently. The Rainbow team is always grateful to see
Betty Korte
clients progress and return home. Betty is well on her way to complete
independence, and more importantly, she is happy with her outcome.
Case Study #2 - Tom Chadwick
March 1987 – Thirteen-year-old Tom Chadwick
stepped out of his school bus and was struck by
a car. He incurred a severe traumatic brain injury
and initially did not have funding for rehabilitation
services. It would be years before funding became
available, and during that time, Tom lived with his
parents.
Continued on page 11
Betty Korte is a vibrant woman in her 70s.
Her hobbies include working in her yard
and frequenting garage sales and flea markets.
Betty has three children, three grandchildren,
and three great grandchildren. She and her
husband, Ralph, have been married for over
35 years.
Betty feels that she progressed very well at
Rainbow and is delighted to be home again
following her four months of therapy.
She thanks her treatment team for helping
her through the rehabilitation process.
“I would recommend this place to anyone,”
she says of Rainbow’s NeuroRehab Campus.
“The staff will help you in any way.
They are very kind to their patients.
I’m very appreciative to have come out on
my own two feet.”
RainbowVisions
4
Traumatic Brain Injury
Survivor
Corner
The answer to that question is
yes, but they didn’t push in an
obnoxious way because that would
have turned me off. My therapists
AN INTERVIEW WITH
were as invested in my recovery
Trisha Meili
B
Interview by
as I was. As a team, we set goals
together. The best example of that
Kimberly Paetzold, Editor
was when the head of the physical
therapy department encouraged me
to join a running group. I joined one
Saturday, and I remember a man
orn in 1960, Trisha Meili was raised
in a wheelchair as well as a young
in Paramus, New Jersey and
Pittsburgh, Pennsylvania. She completed
boy with spina bifida. I thought, “If
her undergraduate degree at Wellesley
they can do this with their disabilities
College and graduate studies at Yale
then so can I.” I wasn’t in great shape
University. After graduation, she went
at that time, but running gave me
on to work as an associate at Salomon
Trisha miraculously survived the brutal
the sense that I could conquer the world. It
Brothers, a Wall Street investment bank.
beating and eventually returned to her
filled me with such hope – like I was taking
On April 19, 1989, shortly after 9 p.m.,
previous life and work while remaining
something back. In hindsight, I realize that
Trisha went for a run in New York’s
out of the public eye for fourteen years.
my physical therapist knew just how much
Central Park. During her run, she was
In 2003 Trisha told her story in a book
to push.
violently assaulted. Hours later, two
titled “I AM THE CENTRAL PARK JOGGER:
men found her near death after being
A Story of Hope and Possibility” (a New
You worked very hard in therapy. At one
raped and beaten—she was in a coma,
York Times best seller) and began a career
point, you attended 35 one-hour group
had a fierce blow to the head, severe
as an inspirational speaker.
sessions of academics to bring you up to
college reading level. Could you tell us
hypothermia and 75 percent blood loss.
The initial prognosis was that she would
Thank you for interviewing with
how you motivated yourself for this?
die or remain in a permanent coma.
RainbowVisions. You have made a
I believe a couple of things were going
remarkable recovery and tried to turn
on. Without being aware of it, I only
what was a horrible experience into
focused on the present. In rehabilitation,
something positive. You write in your
concentration matters. I focused on the
book that the attack ultimately has given
here and now very intently and worked as
you a richer and more meaningful life.
hard as I could to make my reality the best
Could you expand on this thought?
it could be. Almost instinctively, I realized
I have a much greater appreciation
that wallowing in the past or wishing for
for what I do have – for life and all that
a different future was not going to help.
surrounds me. To me, that increased
Working in the present and focusing
awareness, appreciation and attitude make
my energy eventually led to gradual
life so much richer. My work is more
improvements, however small. Those gains
satisfying than the job I had before my
motivated me to keep pushing forward.
injury.
Improvement is a powerful
reinforcement. I wasn’t sure what I would
5 9 RainbowVisions
RainbowVisions
During your inpatient residential
be doing in the future, but I had a sense
rehabilitation, one of your doctors said
that I would be OK. That thought brought
that the brain isn’t always automatically
a sense of peace. It also helped that I
self-healing, but that it sometimes needs
was getting tremendously encouraging
a push. Did you feel pushed by your
messages from around the world. People
rehabilitation team?
wanted me to get better – I can’t tell
WIN T E R
2007 / 2008
you how powerful that was. Maybe
unconsciously, that caused me to work
harder.
You’ve always had a love for running. At
some point during your recovery, your
attitude about that activity changed.
Could you tell our readers about this?
I think the irony of my story is that my
running compulsion nearly killed me, but
it also helped save my life because I was
in such good physical shape. One major
change since my accident is that I no
longer feel that I’ve wasted a day if I do not
run. I still exercise a fair amount, several
times a week, but in moderation. Running
has become a vehicle for feeling proud of
what I can do – but it’s no longer a crutch.
Could you tell us what type of
deficits you had to work around and
what compensatory strategies you
implemented?
I used a planner more and tried to follow
established routines. If I stayed organized,
I functioned better. When I was rushed
or disorganized, the results were rarely
optimal. I also got plenty of sleep. Lack
of adequate rest still affects my mental
abilities and that, combined with a healthy
diet and regular exercise, helped quite a
bit.
Your employer (Salomon Brothers) kept
Pictured above: In June 2004, Trisha Meili made a run through the streets of New York City
carrying the Olympic torch. She was selected to represent New York in the Olympic Torch Relay.
your job open and actually created a
position better suited to your abilities
To be wanted and welcomed back gave
got more involved in different financial
and stage of recovery. Could you tell us
me a sense of belonging and provided
transactions and with clients. Later, I was
about your job, post-injury, and how you
a tremendous psychological boost. It
able to travel and worked to a position that
gradually took on more responsibilities?
also increased my desire to work hard in
was fairly close to what I had been doing
My employer played a vital role in my
rehabilitation so I could be professionally
pre-injury.
recovery. A job is part of an individual’s
effective and productive.
My experience was similar to Bob
identity. When that is suddenly gone, it
When I returned to work, at first I didn’t
Woodruff’s current situation – Bob is back
becomes much harder to regain confidence
have any client interaction, which was a
at ABC but not employed in the exact same
and abilities. My employer stood by me
large component of what I did pre-injury.
position. (Pre-injury, Bob Woodruff was
from the beginning and let me know there
Instead, I performed a fair amount of
the “World News Tonight” anchor and
was a place for me at work. Early on, they
administrative tasks. For example, I set up
now he is a journalist.) I’m sure that being
told my father, “Trisha will have a job
a system to make sure that our corporate
employed as a journalist with ABC is aiding
whenever she gets out of the hospital.”
expenses were recovered. Gradually, I
in his recovery.
RainbowVisions
6
TBI
Therapy
Disciplines
A LOOK AT
Recreational Therapy
By
R
Elizabeth Stahl, Recreational Therapist
ecreational therapists provide treatment
to individuals with disabilities or
n
o
i
t
a
e
r
c
e
R
illnesses through recreational activities.
Using a variety of techniques including
arts and crafts, animals, sports, games
and community outings, they treat and
help maintain the physical, mental and
emotional well-being of their clients. These
activities help reduce depression, stress and
anxiety. They help individuals recover basic
motor functioning and reasoning abilities;
they also build confidence and social skills.
In addition, recreational therapists help
Recreational therapists help integrate individuals with disabilities
into the community by teaching them how to use community
integrate individuals with disabilities into
resources and recreational activities.
the community by teaching them how to
use community resources and recreational
activities.
7
Recreational therapists treat a wide
Rainbow Recreational Groups
unable to walk on land can often walk
variety of individuals including those with:
Fitness groups help clients to lose
in the water. This can enhance both their
• Substance abuse issues
weight, increase muscle flexibility, build
physical and psychological condition.
• Psychiatric issues
strength and endurance, and increase
Arts and crafts groups help clients feel a
• Mental retardation (MR/DD)
cardiovascular health. Physical exercise
sense of accomplishment and satisfaction,
• Physical disabilities
can also improve one’s self-concept.
and can also be used as a fun way to
• Traumatic brain injury
Overall fitness increases a person’s general
improve fine motor skills and expressive
health and releases endorphins that
functioning. Individuals are exposed to
At Rainbow, each treatment facility is
enhance mood. Fitness groups are often
many adaptable items such as fingertip
assigned a recreational therapist (RT) who
an invaluable resource to help clients in
brushes, which require a downward push
leads leisure skills and leisure education
wheelchairs combat the negative effects of
with the hand instead of squeezing.
groups. These groups help clients explore
a sedentary lifestyle.
Group games and activity nights
activities that build skill sets and promote
Aquatic groups help clients facilitate a
provide clients with a chance to interact
a healthy lifestyle. Many individuals with
healthy lifestyle in many of the same ways
with peers and encourage appropriate
traumatic brain injuries cannot participate
that physical fitness groups do, but aquatic
social interactions. Playing games with
in activities in the same way they did before
exercises can also increase balance and
others at different skill levels gradually
their accident. It is especially important
coordination. Water can also be used as
teaches appropriate behaviors. Games can
that they are able to participate in a leisure
resistance to increase muscle strength and
include cards, board games or physical
group so they can discover new activities
endurance. For many clients, the water
competitions. Social interaction has also
or relearn hobbies they enjoyed before they
can be a freeing environment, making it
been found to play a large role in an
were injured.
possible for them to do things that they
individual’s emotional well-being and helps
cannot do on land. Even clients who are
lower levels of depression.
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Community skills groups take
2007 / 2008
About the Author...
clients into the community, providing
opportunities for interaction with the
important to individuals who have a
Elizabeth Stahl,
traumatic brain injury because their
Education: Elizabeth Stahl has a Bachelor of Science degree
decision-making skills that guide
in recreational therapy from the University of Toledo in Ohio.
general public. Community skills are
appropriate social interactions have often
been impaired. In order to rejoin the
Recreational Therapist
Experience/Specialty: Elizabeth interned with Rainbow at
community, many clients need to acquire
the Ypsilanti Treatment Center under recreational therapist
basic social skills taught in this group. The
Nancy Miller and took the position of activities coordinator
skills they learn are vital to their success
at the NeuroRehab Campus in August of 2007. Elizabeth has
following their rehabilitation. These
concentrations in pediatrics and geriatrics. She is a member of
community outings also help alleviate
the Michigan Therapeutic Recreation Association (MTRA) and
depression and provide opportunities
the American Therapeutic Recreation Association (ATRA).
for individuals to regain social contacts.
Recreational therapists will visit many
different places with client groups as they
attempt to find activities and locations that
interest the majority of the group. These
venues include sporting events, museums,
Pictured left:
movies, theaters, shopping malls and parks,
to name a few.
Yaseni Caballero-Amaya
Pet therapy is another intervention
at Rainbow’s Ypsilanti
technique that is used by Rainbow
Treatment Center with
recreational therapists. Interacting with
Wilber, a pet therapy dog.
animals can alleviate stress and enhance
overall mood. Animals can also give
individuals a sense of normalcy, and petting
can stimulate sensory perception. 
Benefits of Recreational Therapy
Psychosocial
Cognitive
Community Reintegration
Physical Outcomes
Enhances body image
perceptions
Increases mental alertness
Prevents social isolation
Increases immune system activity
Increases attention span
Develops/maintains social skills
Reduces pain
Enhances memory skills
Develops self-advocacy skills
Increases muscular strength
Improves organizational skills
Minimizes disability stigma
Improves flexibility & balance
Improves problem-solving
Helps management of environmental
barriers (e.g. stairs)
Improves cardiovascular functioning
Changes attitudes toward
disability
Improves sense of self
Helps control stress
Enhances self-efficacy
Provides sense of mastery
Provides knowledge of community
resources
Increases activity level
Source: www.ncrta.org/Professional/benefits.htm
Develops consistent activity
routines for diabetes maintenance
Reduces decubiti and urinary
tract complications
Increases endurance
RainbowVisions
8
ABI
Technology
Corner
Susceptibility Weighted Imaging
By
I
Kirstin Olmstead, Assistant Editor
What does it do?
identifying multiple sclerosis by detecting
SWI is effective in detecting brain
lesions and demonstrating the presence of
n September 2007, Dr. Mark Haacke, a
abnormalities due to head trauma, stroke,
iron in the gray matter.
world-renowned physicist and professor
tumors, hemorrhages, multiple sclerosis
This new imaging technology offers
of radiology and biomedical engineering
and Alzheimer’s disease.
medical professionals and researchers
at Wayne State University, spoke on the
For example, SWI can display images of
more precise and well-defined images of
topic of Susceptibility Weighted Imaging at
hemorrhages in the brain for those suffering
the brain that could prove useful in the
the Brain Injury Association of Michigan’s
from stroke. It may also be able to pinpoint
diagnosis and treatment of brain injury and
annual conference. I had the privilege of
the origin of the stroke itself and identify
neurological disorders. We hope to hear
participating in this session and learning
the exact location of the at-risk tissue.
more from Wayne State and other centers
more about this fascinating new technology.
Although the specific reason SWI is able to
about this exciting new breakthrough in
The overview below is a combination of
capture these images is still being explored,
medical imaging. 
what Dr. Haacke presented and information
it may be due to increased venous blood
provided in a SWI brochure, available
volume or reduced oxygen-saturation
online at www.mrimaging.com.
levels in the tissue.
This technology also offers improved
What is SWI?
detection of tumors in the brain. Since
Susceptibility Weighted Imaging (SWI)
aggressive tumors tend to have a rapidly
is a cutting-edge technology that uses
growing network of blood vessels with
extremely high-resolution imaging to
frequent microhemorrhages, SWI’s
detect damage to the brain caused by
sensitivity to venous blood and blood
microhemorrhages, shearing and diffuse
products makes it possible to detect these
axonal injuries. The technology was
hemorrhages and identify the boundaries
originally developed to map the brain’s
between the tumor and healthy tissue. This
venous architecture.
imaging technique also has the capacity
This high-resolution imaging allows
to capture changes in blood flow within
medical professionals to see even the
the brain caused by tumors or aneurysms.
smallest lesions in the brain. By exploiting
It may be the future in determining the
the susceptibility differences between
status of a brain tumor and predicting its
tissues, SWI’s high-resolution enhanced-
expansion into the surrounding tissue.
contrast imaging maps areas of the brain
It has already proven useful in detecting
that exhibit venous blood, hemorrhage and
abnormalities in patients with Sturge-
iron storage.
Weber disease when conventional MRI
methods revealed none.
9
Why is it useful?
While iron content in the basal ganglia
This technology has the potential to help
of the brain is normal, SWI can indicate
medical professionals provide more precise
abnormal iron content levels in this area of
diagnoses for a wide range of neurological
the brain linked with Alzheimer’s Disease
disorders and injuries. It also paves the way
or other neurodegenerative disorders. It
for better long-term studies with patients.
promises to be an extremely useful tool in
RainbowVisions
Sources:
Haacke, E. Mark. 2007. A New MRI Protocol
for Acquired Brain Injury: Perfusion Weighted
Imaging (PWI), Susceptibility Weighted Imaging
(SWI), and Diffusion Tensor Imaging (DTI)
Presented at the annual BIA of Michigan
Conference, September 28, 2007.
Haacke, E. Mark. 2006. Susceptibility Weighted
Imaging. http://www.mrimaging.com/images/
website/File/5th_Edition_English.pdf. (Accessed
October 31, 2007.)
Bartzokis, G., Tishler, T.A. 2000. MRI
evaluation of basal ganglia ferritin iron and
neurotoxicity in Alzheimer’s and Huntingon’s
disease. Cellular and Molecular Biology
46, no. 4, http://www.ncbi.nlm.nih.gov/
sites/entrez?cmd=Retrieve&db=PubMed&li
st_uids=10875443&dopt=AbstractPlus (accessed
October 26, 2007.)
WIN T E R
2007 / 2008
Employee of the Season - Spring 2007
Rehabilitation Assistants
Ann Arbor Apts: Heather Morgan, William
Weems & Lamont Miller
After School Program: LaShaundra Little
APFK I: Vivienne Shaw
APFK II: Raquel Johnson
Arbor: Kristi Vaupel
Bell Creek: Andrella Moore
Belleville: Lisa Coleman
Bemis:  Felisa Rowsey
Briarhill:  Diane Evans
Carpenter: Francis Nzau
OC Townhouse: Michelle Nelson
Elwell: Mario Harvey
Page: Yinka Egbeleye
Garden City Apts:  Marocca Davis
Parkview: Tami Brooking
Gill:  Elnora Bobbitt
Shady Lane: Bridget Miller
Glenmuer:  Whitney Perry
Southbrook: Candice Nelson
Highmeadow: Andre Morgan
Talladay: Amy Hall & Sonia Pate
Hillside: Brooke Burba
Woodside I:  Carrie Farmer
Home Health: Tina Milligan & Sandy Haygood
Woodside II:  Judie Hull
Maple: Cynthia Woods
NRC: Laura Sarten & Kelila Hawkins
Brookside:  Justin Wargo & Sandy Saxton
House Managers
Tresa Ellis
Administration/
OEI / RehabTransport
Professional / Therapy Staff
Chris Herdell
Congratulations to our Outstanding Staff! 
Lisa Hildebrandt Brian Hatfield
Bill Carlton
Celeste Mullins
Kristian Powell
After School
& Saturday Day
Programs
To register or for more information call
1.800.968.6644
E-mail: [email protected] • www.rainbowrehab.com
RainbowVisions
10
to Therapy – Tom Chadwick
Continued from page 4
In 1994, his mother passed away
and Tom’s father became the primary
caregiver. In June of 1998, Tom was
admitted to Rainbow. It was the first
formal therapy he had received in more
than 10 years following his brain injury.
During this time, Tom suffered from
seizures almost every other day. He
Occupational Therapy
Pictured above: Occupational therapist Kathy (right) working with Tom
Tom’s current therapies at a glance …
The overall goal of Tom’s treatment team is to help him achieve the greatest degree of
independence possible given his current physical, behavioral and cognitive abilities.
Mental Health Therapy
Tom and his mental health specialist are seeking to improve his mood stability, lower
anxiety, and maintain proper behaviors. Through Rainbow’s behavioral programs and
his sister’s follow through at home, Tom’s outbursts have decreased as he’s learning
to manage his emotions.
was extremely thin and had very little
stamina. In February of 1999, he was
sent for a Wada test, which examines
language and memory on one side of
the brain at a time. This was done to
assess his candidacy for surgical relief
for his seizure disorder. Deemed a
good candidate in June of 2000, Tom
underwent a right anterior temporal
lobectomy. This surgery was successful
and substantially reduced his seizure
activity.
After his surgery, Tom began to make
great strides in therapy and rehabilitation
as a whole. He was better able to focus,
The focus of Tom’s occupational therapy is building residential independent-living
pay attention and voice his needs. He
skills. Tom is working on activities that include bank transactions, creating grocery
had increased learning retention, memory
lists, going grocery shopping and following recipes cards while cooking.
and physical tolerance. Unfortunately,
Tom and his recreational therapist have been working to increase his strength and
stamina while exercising. Tom is becoming more flexible to changes in the order of
his exercise routine. He is also learning to operate the equipment – treadmill, bike and
strengthening machines. He enjoys swimming on a weekly basis as well.
Rainbow Group Activities
his increased awareness had a negative
side effect – Tom easily became agitated
and irritable. There was a noticeable
decline in his emotional tolerance and an
increase in verbal outbursts. Sometimes,
he would become extremely angry, and
it was difficult to identify the triggers of
Tom attends many group activities while he is at Rainbow. These activities include
these episodes. Rainbow’s mental health
woodshop, mat group (for physical therapy) and community outings. These groups
specialists discovered that with Tom’s
are designed to help Tom and other clients discover new activities they enjoy and
newly acquired awareness, he perceived
experience a sense of accomplishment.
many circumstances as injustices and felt
Speech Language Pathology
Reading comprehension and interpretation of information printed on maps and home
care products has been one component of Tom’s speech therapy over the past
months. He and his speech language pathologist practice listening and informationgathering skills during phone conversations. They are also working to help Tom
establish eye contact with others during face-to-face conversations.
he deserved to be the center of attention
at all times. If he wasn’t, he acted out.
According to Kathleen Sobczak, Tom’s
former case manager at Rainbow, “Tom
was overwhelmed by too much auditory
and visual stimulation, causing him to
become distracted by his own thoughts.
Tom couldn’t figure out why he had such
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RainbowVisions
WIN T E R
negative emotions – he couldn’t put his
Lines of communication
finger on what was making him upset.”
The communication between the
In addition to his behaviors, Tom was
treatment team and family is critical
not receiving the support he needed
to success and is handled formally
at home. Living with his father, he was
through focus meetings – but
given little opportunity to work on his
there is also a tremendous amount
newly acquired skills. According to Tom’s
of informal communication.
neuropsychological evaluation, his father
Depending on what therapies are
stated, “I just don’t have the patience …
planned daily, Tom’s therapists pass
it’s easier to do it myself.” Tom’s father
along critical information to make
was also struggling with health issues.
sure each session is successful. He
With increased awareness and lack of
also has a rehabilitation assistant
consistency from therapy to home, Tom
(Raena) that personally works
found it very difficult to control his temper.
with him. She knows when Tom
It became essential that the therapy team
is heading toward an outburst
work together to help him overcome his
or when Tom needs additional
negative behaviors and bring his family on
assistance. In addition, Tom’s family
board so he had consistency.
wants the therapy team to call
whenever something happens so
How Tom, his therapy team and family
that his rewards and restrictions are
put it all together …
reinforced at home. “The family
In January 2007, Tom’s sister Lori
has been phenomenal in trying
assumed responsibility for his care. She
to reinforce the reward system at
moved in with Tom after their father passed
home that we use during therapy,”
away. This caused a great disruption
said Kathleen Sobczak. “This has
in his daily routine. Rainbow’s mental
been crucial to Tom’s success.”
health specialists implemented anger
One of Tom’s biggest gains has
management sessions and worked with
been to follow his own schedule,
Tom to accurately identify signs of anger
which he worked on with speech
along with appropriate coping skills. In
language pathologists (SLPs).
addition, Tom’s sister began to restrict TV
“Prior to his surgery, Tom was on
and video games when he had outbursts.
complete and utter autopilot,” said
One technique his therapists used was to
Angie McCalla, SLP. “When he first
play to Tom’s strengths – since he found
came to Rainbow, he would not
satisfaction in helping others, his team
even enter a room by himself. He
realized that asking him to assist with a
would stand at the threshold near
task would also help him cope with anger.
the door and rock back and forth
2007 / 2008
k
c
i
w
d
a
h
C
m
To
Tom Chadwick’s warm and friendly
personality has made him a joy for therapists
to work with. During the course of his
treatment, his therapists introduced him to
several activities that he enjoys including
cooking, woodshop, swimming and bowling.
Bowling has quickly become one of his
favorite pastimes, and he eagerly anticipates
weekly outings with Rainbow’s recreational
therapy group.
In his free time, Tom watchs TV and listens
to music. Among his favorites TV shows are
“Wheel of Fortune” and “MASH. “
Tom lives with his aunt, his sister Lori and
her boyfriend, Steve. The family has two
miniature Schnauzers named Mia and
Hannah that Tom adores. Tom’s sister has
worked closely with Tom’s treatment team
to reinforce what he is learning in therapy
at home. Her involvement and support have
greatly added to his success.
“The family has been phenomenal in trying to reinforce the
reward system at home that we use during therapy ... this has
been crucial to Tom’s success.”
RainbowVisions
12
CARF
Accreditation
A MEASUREMENT OF
Rehabilitation Quality
T
By Pawan
Galhotra, LPT, ASQ CSSBB, CBIS Program Director
he Commission on Accreditation of
• Input from stakeholders – The organization’s primary focus is to meet and exceed the Rehabilitation Facilities (CARF), a private
expectations/needs of the persons served and other stakeholders
not-for-profit organization, celebrated
• Accessibility – The removal of barriers to provide access to services
its 40 anniversary in 2006. CARF is
• Information management & performance improvement – Continuous improvement the premier internationally recognized
is an objective, data driven process
organization for the accreditation
• Rights of persons served – The organization protects and promotes the rights of of rehabilitation service providers –
individuals
accrediting providers across the United
• Health and Safety – The organization provides services in an accessible, healthy, safe States, Canada, Western Europe and South
and clean environment accomplished by on-going internal and external safety audits as America. The organization is comprised of
well as education of the persons served, personnel and other stakeholders
three sub-entities:
• Human Services – The success of the organization and clinical/financial outcomes are - CARF International in Tucson, Arizona
dependent on the efficient utilization of well-qualified, competent, licensed personnel
- CARF Canada in Edmonton, Alberta
• Leadership – The organizational leadership is committed to diversity, corporate - CARF-CCAC in Washington, D.C.
responsibility and compliance, and focused on the organization’s mission statement
All three units work toward their mission,
• Legal Requirements – The organization is in compliance with all federal, state, “to promote the quality, value, and optimal
provincial and local requirements
outcomes of services through a consultative
• Financial Planning & Management – The organization is financially responsible and accreditation process that centers on
solvent, operating in an effective and efficient manner while addressing organizational enhancing the lives of the persons served.”
mission and values
They accomplish this task by reviewing
• Rehabilitation Process for the Persons Served – The rehabilitation process is focused organizational performance and compare
on achieving predicted outcomes and reintegration of the persons served into his or her it to established quality standards. These
community of choice in an efficient and effective manner
standards are developed with input from
• Measurement of Organizational Performance as compared to the specific CARF numerous stakeholders and are specific to
standards of excellence – Specific areas covered under the medical rehabilitation the needs of the individuals served. With
standards include:
advances in rehabilitation medicine, CARF
- Comprehensive Integrated Inpatient Rehabilitation Programs
standards are reviewed and amended
- Spinal Cord System of Care
to meet evolving needs and therefore
- Interdisciplinary Pain Rehabilitation Programs
continuously improve the quality of
- Brain Injury Programs
accredited rehabilitation organizations.
- Outpatient Medical Rehabilitation Programs
Organizations accredited by CARF
- Home and Community-Based Rehabilitation Programs
are committed to providing quality
- Medical Rehabilitation Case Management
rehabilitation services. The comprehensive
- Health Enhancement Programs
accreditation process focuses on the
- Pediatric Family-Centered Rehabilitation Programs
following areas of organizational
- Health Enhancement Programs
performance:
- Occupational Rehabilitation Programs
- Stroke Specialty Programs
th
13
RainbowVisions
WIN T E R
2007 / 2008
The following brain injury programs at Rainbow Rehabilitation
Centers are currently accredited under CARF’s Medical
Rehabilitation Standards (2004 manual):
• Outpatient Rehabilitation Programs (Adults and Children)
• Home and Community-Based Rehabilitation Programs (Adults)
• Residential Rehabilitation Programs (Adults)
• Long-Term Residential Services (Adults)
• Vocational Services
• Pediatric Family-Centered Residential Rehabilitation Programs
• Pediatric Family-Centered Long-Term Residential Services
The CARF “seal of quality” indicates that Rainbow has met
the rigorous internationally recognized standards established
and is considered to be consistent with the provision of quality
rehabilitation services. Rainbow has consistently received a threeyear accreditation outcome since 1989, indicating substantial
conformance of the applicable standards – the highest level of
outcome possible following a survey.
Rainbow is looking forward to its seventh CARF survey scheduled
in January of 2008. During the survey process, CARF surveyors will
observe the environment and interactions among staff members,
management and clients; review policies and procedures; conduct
interviews with clients, personnel and other stakeholders; observe
ABOUT THE AUTHOR ...
Pawan Galhotra, LPT, ASQ CSSBB, CBIS
Education: Pawan Galhotra has a Bachelor
of Science from Wayne State University in Detroit,
Michigan. He majored in physical therapy and is a
licensed physical therapist.
Experience/Specialty: Pawan has extensive clinical
experience in acute, sub-acute, long-term care and
inpatient rehabilitation settings. His special interests
include clinical education of students, staff, patients
and family. Pawan also has significant experience
in continuous quality improvement and program
management at various facilities. In November of 2007,
he officially received ASQ-Certified Six Sigma Black Belt
Recognition (ASQ CSSBB), which is formal recognition
of individuals who demonstrate a commitment to
quality techniques in their career. Mr. Galhotra has been
a CARF surveyor since 2004. He has had the privilege
of surveying programs in the United States, Canada,
and Europe.
practices and service provisions and review documentation. The
surveyors not only gather information regarding the provision of
services but also provide consultation to improve the programs
and the organization overall. We here at Rainbow look forward to
this accreditation process as it provides an opportunity to not only
display our excellent programs and organization but also to better
serve our clients.
This article will be concluded in the next edition of Visions with an
overview of benefits of CARF to patients and organizations. 
As a consumer of products and
services, we all search for quality
and value. When it comes to seeking
quality in the rehabilitation service
arena, look for the recognized CARF
seal of a quality.
RainbowVisions
14
2008
Conference & Event Schedule
February
January – March
MBIPC Michigan Brain Injury Provider Council
February 1 - 2, 2008
Total No-Fault seminar for case managers and medical
professionals at the Hotel Baronette in Novi, MI
For info log on to: www.cmsadetroit.org
February 6, 2008
CMAA Vendor’s Night at the Holiday Inn South in
Lansing, MI
For info e-mail: [email protected]
February 12, 2008
MIARN Evening Meeting location TBA
For info log on to: www.miarn.org
February 26 - 27, 2008
Michigan CMH Winter Conference at the Radisson Hotel/
Lansing Center in Lansing, MI
For info log on to: www.macmhb.org
Learn over Lunch
Scheduled meeting times are 12:00 - 2:00 p.m.
(Registration at 11:30 a.m.)
Cost: MBIPC Member $20 / Non-member $50
March
For information e-mail: [email protected]
March 6 - 7, 2008
BIA of Iowa Annual Brain Injury Conference at the Hotel
Fort Des Moines in Des Moines, Iowa
For info call: 1.800.444.6443
For 2008 dates, locations and topics, please log on to
Select Education & Publications / Conferences & Events
Select the “Learn Over Lunch Series 2007” link
March 11 - 12, 2008
Illinois Workers’ Comp Forum critical updates and
proven cost-containment solutions at the Westin
Northshore in Chicago, IL
For info log on to: www.ilwcforum.com
March 17 - 18, 2008
North Carolina Workers’ Comp Forum in Raleigh, North
Carolina
For info log on to: www.ncwc-conf.com
2008 dates and times will be added as they become available
December 11, 2007
Topic: TBI Outcome Measurement
Location: Applause, Grand Rapids
Speaker information available online at www.rainbowrehab.com
January 8, 2008
Topic: TBA
Location: Radisson Hotel, Livonia
For up-to-date additions, changes &
2008 conference dates log on to:
Select Education & Publications >
Conferences & Events
15
RainbowVisions
February 12, 2008
Topic: Biofeedback Outcomes & Case Studies
Location: Applause, Grand Rapids
Speaker information available online at www.rainbowrehab.com
March, 2008
Topic: TBA
Location: Holiday Inn South, Lansing
TBI
Community
Education Series
February 2008
2007 / 2008
RINC
WIN T E R
Rehabilitation & Insurance Nursing Council
Meetings
Members Only
Registration begins at 11:30 a.m.
Followed by lunch / presentation at 12:45 p.m.
For the 2008 Winter schedule contact
Adrienne Shepperd: (248) 656-6681
or log on to www.rainbowrehab.com for current updates
Presentation on:
Memory, Retention, Recall
& Rehabilitation
Speakers:
Julie Blasko
Pam Boykin
Angie McCalla
Christine Ryckman
Angie Spears
Kerri Torzewski
2008 International Conferences ...
APRIL 9 - 12: The International Brain Injury Association’s
7th World Congress on Brain Injury
Pestana Palace Hotel, Lisbon, Portugal.
Contact: [email protected]
www.internationalbrain.org.
JUNE 4 - 7: European Congress on Physical Medicine &
Coming
Spring 2008
Accessible Home Modifications
Covering clinical evaluations, the building
process and new available accessible
home products.
Rehabilitation
Brugge, Belgium
www.medicongress.com
SEPTEMBER 18 - 21: 7th Mediterranean Congress of
Physical Medicine & Rehabilitation Medicine
Potorose, Slovenia
Rainbow Rehabilitation Centers offers quarterly community education
seminars that cover topics related to brain injury rehabilitation.
For up-to-date information on our
quarterly Community Education
out a registration form, log on to
presentations, log on to
For up-to-date information on our Community Education events and to fill
SEPTEMBER 24 - 27: 5th World Congress for
NeuroRehabilitation
Rio de Janeiro, Brazil
RainbowVisions
16
THE RAINBOW TEAM APPROACH TO
Nutrition & Meal Planning
By
I
n the world of medicine, hospitals may
Kirstin Olmstead, Staff Writer
that has clients with very specific dietary
planned. Portion control becomes crucial.
be known for their quality of care, but
needs. In an effort to achieve this delicate
Sometimes, the options already available
typically not for their quality of food.
balance, Cynthia has become a master of
on the menu are more than sufficient to
But a new trend is beginning to surface
substitution
meet a client’s needs. When they are not,
in medical facilities nationwide – more
“We try to have low-carbohydrate,
Cynthia provides alternatives.
balanced menu offerings featuring
low-fat, low-sodium menu items. Instead
“I had someone who was on a high-
healthier, more flavorful food, and Rainbow
of using butter, we use olive oil or a less-
fiber diet,” said Cynthia. “So we increased
is not exempt from this increasingly
saturated fat choice,” said Cynthia. “I
their portions of vegetables and fruit. I had
popular movement. In an effort to offer
am able to offer a variety of foods that
someone on a renal diet where potassium
better meal options to clients, Cynthia
may appear high in fat, but are lower-
intake was restricted, preventing them from
Jeffrey was hired to fill the role of executive
calorie options that taste good.” The
eating potatoes and oranges.”
chef at its NeuroRehab Campus (NRC).
right seasonings coupled with cooking
Most food is made from scratch at the
Cynthia is a firm believer that meals
technique is key. Roasting vegetables, for
NRC including the soups, vegetables dishes
should not only be delicious but also
example, instead of blanching them and
and salads. Sugar-free desserts are often
nutritious. At the NRC, Cynthia works
grilling or searing meats rather than using
purchased because of how time consuming
collaboratively with Rainbow’s dietitian
heavy gravy reduce total fat and calories.
they can be to create. Menus are seasonal
to ensure clients are receiving the proper
But even creating a well-rounded
and run on a two-week rotation, but to
mix of nutrients. But striking a balance
menu still requires careful monitoring of
keep things exciting, Cynthia plans at least
between taste and nutrition isn’t as easy
clients with restricted diets. For diabetics,
one themed meal each month. She and her
as it may sound, especially in a facility
carbohydrates must be counted and
staff will even dress for the occasion and
decorate to reflect the theme.
“We just hosted A Taste of the
Orient, and I brought in almond
cookies and fortune cookies,” said
Cynthia. “We made shrimp siewmai
with hoisin, chicken tempura, beef
lo mien, fried rice, plum sauce and
egg-drop soup. We had goodie bags
filled with fortune cookies, fans,
dragons and balloons. The clients
loved it.”
Although it’s not always easy
to marry taste and nutrition, the
coordinated efforts of Rainbow’s
dietitian and executive chef have
enabled Rainbow clients at the NRC
to enjoy the harmony of a truly
balanced, flavorful diet. 
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WIN T E R
2007 / 2008
Taste of the Orient
Menus &
Nutrition
At the NeuroRehab Campus (NRC),
menus are printed daily with each
client’s name, room number and diet
restrictions. Clients receive assistance
making menu selections prior to each
meal – choices that best fit their specific
nutritional needs as directed by a
doctor and/or dietitian.
If a modified diet is required, it is
prepared and plated in the kitchen
by NRC cooks. Pureed, chopped and
ground menu items are available for
individuals requiring textured diets.
Even with these restrictions, plate
Sample Menu
Breakfast
Assorted Cereals • Fresh Fruit • Waffles to Order • Sausage Links
Lunch
Soup of the Day • Salad Bar • Steak Fajitas
Roasted Apples w/Caramel & Cream
presentation is important – The
Dinner
executive chef and staff often use food
Soup of the Day • Greek Tomato Salad
Stuffed Pork Chops or Grilled Thai Swordfish w/Lime & Cilantro
Whipped Sweet Potato • Capri Vegetables
molds for presentation, ensuring that
individuals with special dietary needs
receive the same tasty menu options as
Dessert: Melon Cup or Whole Fruit
other clients. 
RainbowVisions
18
Interview with Trisha Meili
Pictured below: Trisha, in sunglasses, running across the finish line of the 1995 NYC Marathon.
At some point, you were asked to do a
presentation in front of noninvestment
bankers at work and that helped to
boost your confidence. But then you also
mentioned that certain aspects of your
work brought up moments of self-doubt.
What advice can you give to others with
a brain injury that have re-entered the
workforce and are facing emotions of
self-doubt?
Before my injury, I had moments of selfdoubt at work, too. After my injury, that old
demon of self-doubt was multiplied about
a thousand times.
At speaking engagements, I try to tell
survivors to concentrate on what you can
do post-injury. Not to say that individuals
should ignore challenges, but first, take
stock of where you are and how far you
have come. Feel good about those gains
and how they relate to the present moment.
By assessing what you can do right
now, the challenges ahead are not so
overwhelming. If I worry that, “I’m not as
Figure 3
good as I used to be” then I’m not going
to be any good. It’s more important that
of nonprofit organizations. My message
I concentrate and focus on making my
is of hope, possibility, resilience and
current situation better. It’s tough because
overcoming adversity. I currently speak to
thoughts of self-doubt do come. When I
all kinds of groups including businesses,
have those frustrating moments, I take a
universities, brain injury associations,
deep breath and try to remove myself from
sexual assault centers and hospitals. I use
the situation. If I get too caught up in self-
my personal experience to let people know
doubt, it can become a downward spiral.
that they can accomplish so much more
If I get too down, nothing seems to help.
than they ever thought possible – they can
It’s better to take a step back and say, “Hey,
reclaim their lives.
wait a minute. Look at what I have done
I like to give the message: “Yes, with
and look at what I can do.” Feel proud of
brain injury, there are deficits, but instead
that; feel proud of how far you’ve come.
of looking at the negative, look at what you
can do.” Survivors can do so much more
What are you doing today and what future
than most people think is possible. I try to
plans do you have?
spread the word that there is hope.
Currently, I speak around the country
In addition to my speaking engagements,
and work very closely with a number
I am the chairman of the Achilles Track
19
RainbowVisions
WIN T E R
2007 / 2008
Club, an organization that encourages
people are not going to make it happen
individuals with disabilities to participate in
for them. At the same time, I think it is
running. At Achilles, I founded the annual
important that survivors realize they are not
Hope and Possibility 5 Mile Race in Central
alone. It was important for me to feel like
Park. It is a wonderful event bringing the
my rehabilitation team was working with
able bodied and those with disabilities
me – that we were in this together.
together to set goals and compete. The best
Also, I saw myself as a survivor rather
news is that we are expanding this race to
than a victim, and that was very important.
other cities! I am on the board of directors
In part, that view came because of the
of Gaylord Hospital (the rehabilitation
support I received. The message was loud
hospital where I recovered), and I am also
and clear: I had done nothing wrong
running. She also enjoys
getting more involved in speaking to VA
and I wasn’t to blame. Seeing myself as a
dance performances and
hospital brain injury programs.
survivor was a mind-set, and it helped me
several genres of music from
heal. It also helped me take responsibility
classical to rock ’n’ role.
What responsibility do you think brain
for my recovery and helped me muster the
injury survivors have in order to meet
energy needed to move forward. Taking
their rehabilitation goals?
back control of a situation where I was
I believe survivors need to take
completely out of control was an integral
responsibility for their recovery. Other
part of the recovery. t
About Trisha
Married for 11 years to
Jim Schwarz
Trisha loves to be out in
nature kayaking, hiking and
A Specialty Transportation Company We offer personalized,
attentive and expert transportation services for individuals with
special needs throughout Southeastern Michigan.
Call: 1.800.306.6406
asier!
e
t
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Getting aro
RainbowVisions
20
to Therapy – Tom Chadwick
had a completely different
focus, no longer concentrating
until you physically moved him forward.
Now, Tom can handle his own schedule.”
Tom has made huge gains in handling
social situations and is now able to initiate
quality interactions with his peers.
Tom still gets frustrated but is better able
to control his outbursts. Transition and
flexibility are still difficult concepts for him
to grasp and his therapy team continuously
makes minor adjustments so he slowly
becomes accustomed to change. As he
faces new challenges, the support of his
therapy team and his family’s consistency
at home will continue to be vital. For
now, Tom’s active therapy is continuing,
and with consistent programming,
he is continuing to make substantial
rehabilitation gains.
on wound care and medical
treatment. He needed a very
structured program to move
forward with rehabilitation.
The structured environment in
Rainbow’s Residential Program
was very different from what
Jake was accustomed to, and he
wasn’t ready to commit. After
only two months, he signed out
against medical advice.
Again, Jake kept in touch
with his Rainbow mental health
counselor and reported having
problems related to his brain
injury. He couldn’t multi-task or
concentrate and was surprised
at how hard it was to perform
in his work environment. In
2006, Jake received information
Case Study #3 - Jake Kepler
Jake Kepler
about Rainbow’s Garden City
Apartment Program and wanted
Twenty-two-year-old Jake Kepler is a
young man with a bright future. After readmitting to Rainbow in March 2007, Jake
was determined to become an independent
young adult. “I relied on my mom and dad and
grandma to support me,” he said. “I don’t want to
do that anymore. Rainbow is helping me become
independent.”
August 2004 – Jake Kepler was 19
to come back to Rainbow. This
years old when he was involved in a
program is structured to support
rollover car accident. For two days, he
individuals with brain injuries
was suspended by his seat belt upside
while living with their family or
down until he was found and transported
loved one. Jake liked the idea
to the hospital. He had trauma to the head
of receiving supports while
and a soft-tissue injury across his entire
living with his girlfriend, but
abdomen.
the Rainbow team did not think
Jake was admitted to Rainbow after
he was ready for this level of
a two-week hospital stay to receive
independence. They told him he
occupational, physical, speech and
needed to learn how to maintain
mental health services. Rainbow’s mental
a job and appropriately structure free time before he could handle
health specialists thought he had ability to
this level of independent living. In March of 2007, Jake re-admitted
successfully rehabilitate, but Jake was not
to Rainbow. This time, he was committed to advancing through the
committed to treatment – he just wanted
rehabilitation process.
his physical wounds to heal. After three
Jake’s original neuropsychological evaluation documented
months of therapies and medical treatment,
cognitive deficiencies, especially memory. Joe Welch, a Rainbow
Jake left Rainbow’s program.
behavioral analyst assigned to Jake’s therapy team, didn’t think
Jake kept in touch with his mental health
that assessment matched what Jake demonstrated during therapy.
counselor at Rainbow and decided to
He thought Jake could be successful in advancing to independent-
again try rehabilitation for a second time.
living skills. According to Joe, “He [Jake] didn’t think he was
Jake admitted to Rainbow and his therapy
skilled. But, bottom line, Mr. Kepler stepped up to every challenge
Jake has successfully maintained a job at a
local grocery store and recently moved to
Rainbow’s apartment program. He enjoys
nature and taking walks in the woods. He
aspires to one day become a landscape
designer and has plans to take classes in the
future.
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RainbowVisions
WIN T E R
2007 / 2008
Ann Arbor Apartments
Jake’s current therapies at a glance …
Jake recently moved from a residential home into a Rainbow apartment, another step forward in his goal to achieve
independent living. Jake has performed well at Rainbow and is enjoying more freedom and more responsibility. He requires
minimal supervision and is working toward independently accessing the community and Rainbow’s programming.
Levels Program / Mental Health Therapy
Jake has successfully completed the second stage of Rainbow’s Levels Program, which helps clients graduate to more
independent environments as they progress in their rehabilitation. By continuing to cooperate fully with rehabilitation staff, follow
residential rules and appropriately manage himself socially, Jake graduated to level three and paved the way for his therapist to
recommend his transition to the less-structured apartment environment.
Currently, budgeting and money management are Jake’s primary focus in occupational therapy. He and his therapist have
set savings goals, and Jake has consistently paid his personal bills. Because of the level of independence he has achieved in
meal preparation, planning and grocery shopping, his therapist has discontinued this area of his therapy. He will continue to
participate in the cooking group at the apartments.
Jake and his speech language pathologist are working to improve his memory and his written, verbal and auditory
comprehension skills. During sessions, Jake will practice reading passages from a magazine and answer questions afterward.
They also work on math story problems based on time and money management. Jake also developed a budget plan to open a
savings account.
Vocational Therapy
Jake recently began working at a grocery store four days a week, organizing and maintaining the shelves. His vocational
therapist is mentoring him on many work-related skills including overall consistency, communication, attention to task, following
guidelines and appropriate work interactions. His therapist notes that he is doing very well managing this new role.
RainbowVisions
22
to Therapy – Jake Kepler
skill-building sessions. According to Kerri
good goals. I believe that he will continue
this therapist put in front of him, building
Torzewski, speech language pathologist,
to excel, but he needs a lot of support,
his confidence on his own.”
“Jake learns through repetition. He was
praise and reassurance that he is doing
Jake worked on anxiety issues, memory
really worried about starting his job at the
a good job. We, his therapy team, have
problems and scheduling in his speech-
grocery store, so we visited the store before
become his supportive family.”
therapy sessions. Since he never kept any
his start date and went through various
His interdisciplinary team feels it will
kind of schedule, it was very hard for him
tasks such as how to read tags and what to
take additional structured counseling
to plan his days. But with a lot of tenacity
expect. We did this to decrease his anxiety.”
and programming along with speech,
and hard work, Jake is now able to hold
According to Julie Slauterbeck, Rainbow
occupational and vocational therapy
down a job at a local grocery store. He
vocational specialist, “I told Jake that
before Jake is ready for his next step toward
secured this position with the help of
he is smarter than he thinks. He suffers
independence. In the meantime, his goal to
vocational and occupational therapists.
from a lack of confidence, so working
live with his girlfriend is alive and well, and
Before he was offered the job, Jake went to
at job where he’s able to excel is a real
he is working hard along with the support
two interviews. During therapy sessions, he
confidence builder. Jake still needs to learn
of his interdisciplinary team to build
practiced interview questions followed by
how to reduce his anxiety and set some
independent-living skills.
al
c
i
g
o
l
o
ch
y
s
p
o
r
u
Ne
nt
e
m
s
s
e
s
As
A neuropsychological assessment attempts to evaluate the
cognition, mood, personality and behavior of an individual.
The evaluation usually includes a formal interview; a
review of medical, educational and vocational records;
Understanding brainbehavior relationships for
individuals with traumatic
brain injury
interviews of significant others and testing using standardized
neuropsychological instruments.
Aspects of cognitive functioning that are tested typically
include:
• Perception – the process of acquiring, interpreting, selecting 23
There are three broad goals of a neuropsychological
and organizing sensory information
assessment: first, to diagnose and determine the nature of
• Attention – selectively concentrating on one aspect of the underlying problems; second, to understand the nature
environment
of the brain injury along with the resulting cognitive
• Orientation – awareness of time, place and person
problems and the impact on the survivor (This is important
• Memory – the ability to store, retain and retrieve so a rehabilitation program can be formed and a therapy
information
protocol selected); third, the assessment can help measure
• Executive functions – processes such as planning, abstract change in functioning over time and aid in determining the
thinking, selecting relevant sensory information, initiating impact of a rehabilitation program.
appropriate actions and inhibiting inappropriate behaviors 
RainbowVisions
WIN T E R
2007 / 2008
eR nee Darga
Case Study #4 - Renee Darga
November 2002 – Renee was a high school senior living in Rogers City,
Michigan, when she was involved in a serious motor vehicle accident.
During the collision, Renee was thrown from the backseat into the front of
the car. She was extricated from under the dashboard by rescue workers
and taken to Alpena General Hospital. Her Glasgow Coma Scale measured
just four, indicating she had incurred a severe traumatic brain injury. After a
total of five months in three different hospital settings, Renee was admitted
to Rainbow in March of 2003.
When Renee began her rehabilitation, she was completely dependent
on staff for all her needs. She could not sit or hold her head straight, and
her right arm and leg were essentially nonfunctional. She had limited
muscle control, was unable to feed herself and could not communicate.
Renee’s prognosis was bleak – her treating physician said she would not
rehabilitate. She would not go to college, live independently or even be
able to care for her own basic needs. According to her neuropsychological
evaluation, Renee had severe cognitive deficits.
That was a very difficult time for her parents, and the prognosis was a big
hurdle for her interdisciplinary therapy team. Though doctors must provide
a realistic picture, nobody can accurately predict the future. Renee’s
treatment team immediately began intensive physical, occupational and
speech therapy.
It didn’t take long for Renee to become the perfect example of
interdisciplinary team success. Initially, she received co-treatments, which
are simultaneous treatments by two therapy disciplines used to optimize
therapy outcomes. There was carryover between therapies to produce
consistency throughout her regimen. Renee thrived with this structure.
How Renee progressed ...
Since her arrival at Rainbow almost five year ago, Renee’s therapy
gains have been substantial. When she began physical therapy (PT), her
therapists began with rolling and fully supported sitting, then independent
sitting. About three months after her admission to Rainbow, Renee had
tendon-release surgery. This was an important step in her recovery because
she could now progress to standing during her therapy sessions. Another
surgery would later follow to provide her with increased ankle movement.
Renee also received neuro-dynamic therapy (NDT) from occupational
and physical therapists. One of the basic concepts of NDT is the idea that
all aspects of the person – sensory/perceptual, emotional, psychological
Renee Darga’s therapists describe her as a
motivated young woman who has overcome
incredible challenges and a very hard worker
in her therapy sessions.
Renee and her family are very close. Each
weekend, her parents drive over 260 miles
one way from Rogers City to visit her. Her
therapists note that her parents are delighted
by Renee’s progress and want to see her
continue to achieve new milestones in her
independence. She has one sibling, her sister
Felicia, a student at Lake Superior State
University, with whom she is also close. She
enjoys shopping when her parents come to
visit and frequenting her favorite restaurant,
the Texas Roadhouse.
“Rainbow has been everything to me,” said
Renee. “When I first came, I was in a wheelchair,
and the therapists helped me start walking again.
I’m glad there is a Rainbow. It’s really helped me.”
and physical – must be considered during recovery and treatment. The
therapists used NDT techniques to obtain normalization of tone on her
right side along with normal movement patterns, which they integrated
into her daily functional activities. One of Renee’s biggest challenges was
using her right side symmetrically with her stronger left side. The therapists
took advantage of their NDT training and facilitated use of both sides of
her body in a symmetrical manner during daily activities such as transfers,
standing and walking.
RainbowVisions
24
to Therapy – Renee Darga
Aquatics is an extremely effective
sessions. She would get up at 5:30 a.m.,
therapy for impaired individuals because
go to school, come to Rainbow’s treatment
Renee received intensive speech therapy,
swimming is a full-body activity, and water
center for therapy and then do her
focused on bringing her from a nonverbal
buoyancy makes exercising an almost non-
homework. It was amazing to see someone
state to speaking and from not being
weight-bearing activity. Renee progressed
with a severe traumatic brain injury able to
able to eat to consuming a regular diet.
from simple movements to nearly
handle that workload.”
When she was first admitted, she was
independent swimming and currently is
Renee now lives at Rainbow’s Garden
unable to consistently follow commands
working on integrating breath skills to her
City Apartments and works at RipCo, a
and responded to pain with simple
stroke.
sheltered workshop. She has progressed
vocalizations. Now, she can effectively
to working with recreational therapists on
communicate not only her needs but
Strong gains in rehabilitation ...
using public transportation and identifying
her opinions and feelings as well, as she
During her rehabilitation, Renee earned
some leisure interests.
continues to work on clarity and inflection.
her high school diploma and is continuing
While Renee has shown vast
Aquatic therapy was added to Renee’s
to working on coping strategies. “Renee
rehabilitation gains, she continues to
rehabilitation when she was ready. Again,
is an incredibly hard worker,” stated Jenny
require the services of a guardian and
co-treatments were implemented with an
Auty, Rainbow kinesiologist. “Renee went
must be monitored in her apartment.
occupational therapist and kinesiologist.
to school while receiving full therapy
Garden City Apartments
Family & Pet Friendly
Garden City Apartments offer a unique and supportive family environment where
residents with traumatic brain injury are empowered to work toward therapy and recovery goals.
At Rainbow’s Garden City Apartments, adults can reside as a single, as part of a family,
or as parents caring for their children – Rainbow’s Staff provides the necessary support.
To download a brochure log on to:
For a tour or more information call...
1.800.968.6644
Select Education & Publications
Rainbow Literature
25
RainbowVisions
WIN T E R
2007 / 2008
Renee’s current therapies
at a glance …
Renee recently moved from a residential home to
Rainbow’s Garden City Apartments, a living environment
that affords her greater independence.
Her case manager notes that, overall, she has done well
managing herself and her new home.
Fitness
Renee participates in aquatic therapy weekly to
improve her overall walking skills and coordination. Her
swimming goals coincide with her occupational and
physical therapy objectives to help increase stability and
endurance. In addition, she attends fitness sessions two
times a week to build endurance and strength.
Mental Health Therapy
Mental health therapists help Renee practice
assertiveness skills and non-aggressive communication
skills. They practice safety and problem-solving skills in
business and community settings and work on behavior
control, which has been successful.
Nursing
Renee is actively working with the nursing staff to
manage her own medication. To assist her, the
staff packages her medication for the next day
and distributes it to her the night before. Renee is
Pictured above: Physical therapist Payal (left) and occupational therapist
Carole (right) utilize neuro-dynamic therapy (NDT) therapy with Renee in a
co-treatment session. This was done early in her rehabilitation to help
maximize her rehabilitation gains.
responsible for keeping her medications for the day and
calling in after she takes them. Her nurse comments
that she has been successfully and consistently
executing this task.
Renee and her recreational therapist have been working on developing
hobbies and outside interests. She is also learning how to access public
transportation.
The main focus of Renee’s occupational therapy
has been domestic responsibilities such as cooking
and cleaning. She has done well in her new semi-
Renee no longer needs to meet with her speech language pathologist on
independent living environment at Garden City
a regular basis and currently only receives support when needed.
Apartments and utilizes a planner to keep track of
appointments.
Vocational Therapy
Renee works part-time at Rainbow’s Corner Café and at Rainbow
Physical Therapy
Industries Production Company (RipCo) assembling Adirondack furniture.
Walking longer distances with a cane has been
She is working on completing tasks independently with minimal cueing.
challenging for Renee, but she now practices walking
over uneven surfaces. She meets with her therapist(s)
four times a week.
RainbowVisions
26
to Therapy – Renee Darga
Often, individuals with severe TBIs make
substantial rehabilitation gains but still
will require a lifetime of supports. Until
her gains level off, she will continue to
pursue her long-term goals, which include
working in the community, attending
college and living as independently as
Individualized Treatment
Combining therapy needs with personal goals and interests
Individuals are always more responsive and successful when they work on goals that are
personally interesting. Renee’s therapy gains were substantial. Much of that success can
be attributed to her treatment team taking a personal interest in her life and building around
her interests and goals.
possible.
When Renee began her rehabilitation program, she was heavily involved in regaining
“In the last few years Renee has
basic skills such as swallowing, eating, standing and basic movements. Once Renee
grown into an adult and regained so
recuperated enough, her treatment team built her therapies around Renee’s goal to finish
many functions,” stated Jenny D’Angela,
high school and earn her diploma. While living at a Rainbow residential community home,
Rainbow mental health counselor. “She
Renee enrolled at the local high school and her interdisciplinary therapy team focused
has learned to speak again and has gone
sessions and skill building around her high school classes.
from a wheelchair to using a walker
independently. Her treatment team thinks
she’s pretty amazing.”
Renee had a heavy class and therapy load for an individual recovering from a severe
traumatic brain injury. Some of the skill sets she worked on during this time were:
• Organizing and scheduling – Renee had to relearn how to prioritize and complete
homework assignments on time.
• Mobility – Renee used her wheelchair effectively in the community and practiced walking
for short distances.
• Speed – Occupational therapists concentrated on speeding up basic living tasks such as
showering and getting ready for school. Renee’s challenge was to get showered and fully
dressed in only twenty minutes, which she accomplished.
Renee also wanted to attend her prom, so her team provided dance lessons (with her
date) during occupational and physical therapy sessions. Prior to the prom, Renee’s
Putting it all together ...
As these four case studies illustrate,
Rainbow’s team approach to rehabilitation
is pivotal to individual therapy successes.
By taking a “big-picture” approach to
rehabilitation and bringing every therapy
discipline together working toward
common rehabilitation goals, the patient
benefits by receiving streamlined care,
tailored to his or her specific needs. As the
team helps the individual rehabilitate, they
work together as a group to build skill sets,
reinforce behaviors, identify deficits and
implement compensatory strategies – all
to help individuals reach the highest level
of independence possible based on their
unique situation and abilities.
To learn more about Rainbow’s
professional therapy disciplines, log
on to www.rainbowrehab.com and
select Rainbow Benefits > Rainbow
Professionals.
27
RainbowVisions
therapists took her to the prom location to run through skills needed for that evening. They
selected an appropriate area for her and her date to sit and practiced walking onto the
dance floor; they helped her select her dress and shoes – all in preparation for the evening.
This was done to promote therapy success by working on skills combined with goals
important to Renee.
R
’s
enee
m
Pro
High School Graduation
Rainbow New Hires
WIN T E R
2007 / 2008
Summer 2007
Julie Tiberia – Residential Program Manager at the Ann Arbor Apartment Program
Julie is a graduate of Eastern Michigan University with a Bachelor of Science
concentrating on psychology and social work. Julie comes to us with over 11
years of experience with special needs and adolescents.
Julie Tiberia
Elizabeth Stahl – Activities Coordinator at Rainbow’s NeuroRehab Campus
Elizabeth has a Bachelor of Science from the University of Toledo in recreational
therapy.
Fall 2007
Adriane Corlew, OT – Occupational Therapist
Elizabeth Stahl
Adriane is a graduate of Western Michigan University with a Bachelor of Science
in occupational therapy with three years of experience in post-acute rehabilitation.
Donna Lee, RN – Nurse at Rainbow’s NeuroRehab Campus
Donna joins Rainbow with her associates degree in nursing from Highland Park
Community College. Donna worked in a hospital setting for over 17 years before
returning to school for her RN. She brings with her six years of experience in
occupation as well as long-term care nursing.
Adriane Corlew
Nancy Wybo – Case Manager at the Oakland Center working with pediatric
clients. Nancy is a graduate of Northern Michigan University with a Bachelor of
Science in health education and psychology. She is currently working on her
master’s from the University of Arkansas in rehabilitation counseling. Nancy brings
with her seven years of experience in vocational and medical case management.
Nancy Wybo
Jennifer Dobkin, PT – Physical Therapist at Rainbow’s NeuroRehab Campus
Jennifer is a graduate of the University of Rhode Island with a Master of Science
in physical therapy. She has over 12 years of experience as a physical therapist in
rehabilitation.
Lamar Habern – Behavioral Analyst
Lamar returns to Rainbow with his Master of Science from Eastern Michigan
University with a concentration in clinical behavioral psychology. Lamar worked
Jennifer Dobkin
for Rainbow while in college as a rehabilitation assistant in 1998/1999 and now
returns with over six years of experience in behavioral psychology.
Marcia Lester – Registered Dietitian for Rainbow treatment facilities and
residential locations. Marcia has her Bachelor of Science from Michigan State
University and her master’s degree in nutrition and food science from Wayne
State University. Marcia has worked as a registered dietitian for over 20 years in a
variety of settings, most recently in long-term care. 
Marcia Lester
RainbowVisions
28
The
Last Word
What needs to be done…
First, raise my taxes. Governor Granholm
MY BELOVED STATE OF
(who regularly converses with Governor
MICHIGAN
I
Written by
Milliken even in the current political climate
of polarization) had to raise regressive taxes
Buzz Wilson, CEO
to balance the state budget, mandated by
law. We should at least restore the Engler
tax cuts. We need a thriving Michigan
t’s been a year since my mother passed.
where, in times of need, help is offered.
I wrote about her in The Last Word (2007
Second, empty the vast, horribly
winter edition of RainbowVisions) titled,
Buccalo, on Michigan’s auto no-fault
expensive, growing network of state prisons
“Ina’s Beauty Shop.” In that article I
decline are directly traced to the Engler
where the nonviolent are crowding the
described her influence on Rainbow’s
majority on the Supreme Court. Bill has
prisons. Jail is not the answer to drug
origins, and her lessons are still valid,
enumerated how Engler’s appointees are
issues and we all know it. Why listen to the
not only for Rainbow, but for my beloved
slowly undermining the no-fault act, which
hysterical few who are building a gulag of
Michigan.
resulted from a compromise brokered by
incredible and lucrative proportions.
There is a reason that Michigan has auto
Governor Milliken. This is not a Republican
Third, deal with the redlining issue
no-fault, great universities, well-paid public
or Democrat issue; this is classic economic
straight up. This is obviously racist in nature
employees and perhaps one of the finest
warfare being waged on the poor and
and we all know it. If you are born into
medical delivery systems. I take pride in
defenseless by the super powerful.
poverty in Detroit, having to pay higher
knowing that Rainbow fits well into this
Whereas, once upon a time, the well-to-
rates is unconscionable. Certainly, in the
mold of excellence.
do in Michigan progressively set up public
short run, it would seem to make sense that
During my lifetime, I have witnessed the
programs and policies benefiting everyone.
those who make the rates go up should pay
highs and lows of life in the peninsula state.
Now these forces are being marshaled to
more – fine and dandy. Follow this logic:
My mom was one of those enlightened
wage open warfare on those very citizens
why not make 83 separate regions in the
souls who made life exciting and fun.
who need effective government the most.
state? Or 183? Why not an infinite number?
We must return to that way of life and
Governor Milliken makes the point that
The answer is obvious. No one chooses
overcome the internal conflicts that are
Michigan’s economy has historically been
to live in dangerous areas. The politics of
turning my beloved home state into a
cyclical, and it’s the role of government to
reason, promulgated by Governor Milliken,
series of unrelated bad experiences that are
be there when its citizens need support.
did not foster the every-man-for-him/
making life miserable for too many citizens.
Yet, Engler cut the taxes of those who could
herself attitude. He recognized that solving
Forget political party (that is an irrelevant
most afford it and decreased spending
problems required reason, not hysteria,
side issue), I am talking about entrenched
for those who most needed it in times of
and called for compromise wherein each
positions that make it impossible to find
economic hardship, such as now. This is
respected and tried to understand the
common ground.
shameful. The destruction of Michigan’s
position of the other. Thus, redlining is
I ask myself, what would Governor
economy makes me furious. My generation
recognized as fostering the problem of
Milliken do? His stewardship of Michigan
is allowing the progressive state engineered
body shop rip-offs, carjacking, car thefts
was our high watermark. His own party
by the generation of my mother and
and chop shop operations driving up
represents the low point as well – the
governor Milliken to decline precipitously.
the cost of auto insurance. This, in turn,
1990s when the Republican governor
I won’t take it any longer and I will do
leads to the poor (Detroit) having no auto
nearly destroyed the state. In fact, Governor
my part to restore balance and civility. I
insurance, and in one of the complete
Engler’s extremism in the name of freedom
have always considered myself a Milliken
ironies of Michigan life today, making them
lingers on in the Michigan Supreme Court,
Republican, and now is the time for me
ineligible to be covered under the medical
making a mockery of the institutions
to step up to honor my mother, Governor
coverage provisions of auto no-fault. Thus,
installed by his predecessor Milliken, which
Milliken and those who believe that
the rich are again stomping on the poor –
made Michigan great.
government is there to help, not hurt.
all in the name of economic freedom. No
Articles written by our President, Bill
29
RainbowVisions
wonder that my generation is screwing
things up. I choose to spend my remaining
requires understanding others’ differences
it difficult, if not impossible, for us to
time on this planet exposing this for what it
as well as similarities.
operate in residential neighborhoods.
really is – economic warfare.
Fifth, continue to focus on reason:
We will oppose this. We will also try to
Fourth, invest in Detroit. Rainbow, under
Reasonable compromises with
foster a sense of urgency in containing
my leadership, has avoided Detroit because
our clients and their family needs,
rehabilitation costs. It is important that we
of a perceived danger to employees
reasonable compromises on the needs
do not make auto insurance unaffordable.
and juries who ignore the rules long
of our employees, and yes, reasonable
In fact, despite what some say, Michigan’s
promulgated by the powerful. Under my
compromises on the needs of insurance
experience with no-fault has been positive.
leadership, we will change that. There is
companies. They are not the enemy. Early
Our citizens get the best care available
no reason why we can’t find rehabilitation
on, I turned Bill Buccalo loose on forging
anywhere. We have preserved one of
locations that create a thriving, well-
reasonable communication with the payor
the gifts given to us from those voices of
maintained and safe working environment.
community. This is what Governor Milliken
reason.
I will challenge the executive committee to
would have done and would do today.
We are in this journey together. We can
do just that. A third of my workforce is from
Sixth, do our part. We will take on the
continue on the road to mutual repression
Detroit. It is an insult to them, as well as
forces that try to prevent our population
and stagnation, or we can listen to the
to the memory of my mom, to perpetuate
from living in residential communities.
voices of reason in our collective recent
this economic regression. What would
The part of the state often referred to as
past. My mom and governor Milliken have
governor Milliken do? He was a close
the home of the Reagan Democrats is
given us a guide map for improving the
friend of Coleman Young. To be progressive
trying to redline our population by making
lives of our fellow citizens. We can seize
the moment. t
NeuroRehab Campus
The NeuroRehab Campus for adults with brain & spinal cord injuries offers Rainbow’s full Continuum of Care
including active therapy, community outings and supported living for individuals with medical needs. Some of
the unique features offered through the residential portion of the campus include...
• Two 20-bed facilities with private bedrooms and private baths. Each room offers optional cable TV, internet access, telephone access and call light/intercom system access.
• Physician visits on-site • Nursing services available on-site 24/7
• Executive chef
• Professional treatment team on-site
2008 Silver Anniversary
RainbowVisions
30
Rainbow Rehabilitation Center
Locations:
Ypsilanti Treatment Center
5570 Whittaker - PO Box 970230
Ypsilanti, MI 48197
734.482.1200
Oakland Treatment Center
32715 Grand River Avenue
Farmington, MI 48336
248.427.1310
NeuroRehab Campus
25911 Middlebelt Road
Farmington Hills, MI 48336
248.471.9580
For more information call toll free...
1.800.968.6644
E-mail: [email protected]
P.O. Box 970230
Ypsilanti, Michigan 48197
If you do not wish to receive copies of RainbowVisions, please e-mail:
Presorted Standard
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Permit 991
Ypsilanti, MI
[email protected]

Trisha Meili speaks about Hope and Possibilities

Transcription

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