Stroke

Contessa's Story

Contessa "Tess" Siders suffered a stroke at home on Sept. 25, 2014. In just six weeks at Madonna, she regained movement in her arm, passed her driving evaluation and transitioned from using a wheelchair to using a cane. She has returned to her community and founded a local stroke support group.

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Contessa Siders

Contessa Siders

Overview

Madonna's Stroke Rehabilitation Program provides comprehensive programming for adults and children with all types of strokes in each stage of recovery while establishing a lifelong partnership for the patient and family to turn to when needed. Our goal is to help patients become as independent as possible.

On-Site Care

Patients in the acute rehabilitation level of care will be seen daily by a physiatrist, a physician who specializes in rehabilitation, and as needed by physicians with other medical specialties, such as internal medicine and pulmonology. Patients in the Madonna Rehabilitation Specialty Hospital (also known as LTCH) will be seen daily by an internal medicine physician, and as needed by physicians with other medical specialties such as pulmonology, neurology and physiatry.

Registered nurses with rehabilitation training and experience are on staff at all times to care for patients. Madonna’s rehabilitation nursing model supports a 24/7 rehabilitation approach allowing patients additional opportunities to practice daily skills learned and supported by therapy throughout their rehabilitation stay

Madonna staffs licensed respiratory care practitioners at all times. Our respiratory therapists are able to provide arterial blood gas (ABG) services. Pulmonologists can perform bronchoscopies on-site with help from the respiratory team.

A stroke can cause complications or lead to additional conditions. Our patients are assessed and receive treatment that meets their individual needs.  The risk for recurrent stroke is also addressed

Patients and their family members or caregivers learn how to prevent strokes, the signs and symptoms of a stroke and risk factors for recurrent stroke.

Rehabilitation is not just about regaining basic skills of self-care and mobility. The ability to resume one’s life role and reintegrate back into the community is a very important component. Madonna integrates a variety of community re-entry, recreational, leisure, and adaptive sports and recreation opportunities into the rehabilitation process. Patients may also work on specific goals related to returning to work, school or driving during their rehabilitation stay.

Madonna provides a full range of inpatient pharmacy services, including medication distribution, patient education, and clinical/dosing services.

Madonna is able to provide radiology services that include X-ray, ultrasound, echocardiogram, venous doppler, arterial doppler, Holter monitor, sleep study and electroencephalogram (EEG).

Madonna's in-house laboratory provides anticoagulation, hematology, chemistry, therapeutic drug level testing and urine analysis services with results available the same day in most cases.

Madonna has registered dietitians and licensed medical nutrition therapists who are part of the care team and ensure the patient's individualized nutrition plan is met.

Neuropsychologists and rehabilitation counselors are an integral part of rehabilitation at Madonna. They provide a variety of services, including neuropsychological assessment, adjustment counseling, pain management, family therapy, concussion or mild brain injury evaluation, memory testing, dementia evaluation, neurofeedback, biofeedback, behavioral management and psychoeducation.

Assistive Technology Professional certified therapists provide seating and positioning evaluations for patients who require the use of a wheelchair for mobility.

Madonna is committed to meet all the needs of its patients--physical, spiritual and emotional. A spiritual care professional is a member of and consults with the care team. The chapel, the heart and soul of Madonna, is there to nurture faith and hope during times of crisis.

Madonna’s stroke patients and their caregivers are provided with a self-care training program based upon principles of self-advocacy and self-direction. Patients are taught how to direct their care and what to do if emergencies arise. They are provided opportunities to practice these skills during their stay, ending with a two-night stay in Madonna’s transitional living apartment. This apartment is located on the unit, with easy access to medical staff if needed, with the expectation that a family member or caregiver will assist with personal care required during their stay. The patient will direct his or her care and independently follow a therapy schedule. In addition, Madonna provides a two-week, daily stroke education class that covers a variety of stroke-related topics for all patients, family members and caregivers.

Madonna Rehabilitation Hospital offers comprehensive programming for individuals’ ages 0-100 with all types of strokes, from those still in the early stages of recovery following a very severe stroke to those who have had a mild stroke that doesn’t require inpatient care. Our program is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), as an inpatient and outpatient Stroke Specialty Program, hospital level, for adults and pediatric family centered care. Madonna’s multiple levels of inpatient care, as well as outpatient services, at both of our campus locations, ensures we are able to offer each stroke patient the right type of care at the right time. 

In fiscal year 2017, Madonna admitted 38 percent of patients from outside the Lincoln area to the Lincoln campus and 20 percent from outside the Omaha area to the Omaha campus. We admitted a total of 765 patients with stroke across inpatient and outpatient services at both hospital locations. Outpatients are referred to our services from a variety of physician specialties. A referral from a physician is required to access Madonna’s continuum of care.

Scope of services

Madonna’s goal is to help the people we serve become as independent as possible, while establishing a partnership for life that the patient and family can turn to when needed. Programming is highly individualized and dependent upon each person’s needs. Family members are encouraged to be actively involved in the patient’s care and to attend therapy sessions whenever possible so they may reinforce new techniques being taught. Research shows a correlation between family involvement and the rate in which patients return home. Madonna’s Stroke Program provides interventions in the following areas:

  • Assessment and Treatment: Patients and families are taught prevention, how to recognize the signs/symptoms of stroke, and receive treatment for conditions related to stroke and its complications.
  • Addressing Risk Factors: Risk for recurrent stroke is assessed and addressed. Patients and their families are taught about these risk factors.
  • Functional independence: The overall goal of the program is to gain functional independence. This is accomplished with skilled rehabilitation interventions, training, and use of adaptive equipment and/or techniques.
  • Coping Skills: Rehabilitation psychologists, other clinicians and peer volunteers assist patients and their family members/support system with learning techniques for coping and adapting to life after stroke.
  • Community Integration: The ability to resume one's life role and reintegrate back into the community is another goal of the Stroke Program at Madonna. Community integration skills are taught as part of therapy and activities relating to a patient's life roles simulated and practiced during the rehabilitation process.
  • Services for Families: Stroke affects the whole family and involvement of spouses, children, and others in the patient's support system is a vital part of recovery. Madonna's Stroke Program encourages family members and caregivers to be involved in education, training, peer support, support groups and counseling.

Clinical Expertise: Each patient's care is directed by a physician who specializes in physical medicine and rehabilitation and/or a physician with specialization in internal medicine. For individuals who are 18 years or younger, a pediatrician is involved in their care on a daily basis. All Madonna nurses are specially trained in providing care for patients with stroke, and several Madonna nurses have specialty training as a Certified Rehabilitation Registered Nurse (CRRN).

Rehabilitation: Madonna has a dedicated team of professionals who have completed special competency training in the treatment of persons with stroke. Each individual's treatment team is made up of physical, occupational, speech, recreational and respiratory therapists, social worker, rehabilitation nurses and case manager, as well as staff from neuropsychology as appropriate. They work together with the patient and their family/caregiver to meet the unique physical, cognitive, social and emotional needs of the patient. 

Days and Hours of Service: Therapy services are provided Monday through Friday, 7 a.m. to 5 p.m. Patients receive on average, three hours of therapy per day, five days per week in acute rehabilitation and are seen on average, 2-3 times per week on an outpatient basis as appropriate. Saturday and Sunday therapies are provided on an as needed basis for inpatients. 

Fees:  Cost of care is determined by diagnosis, level of care, medical acuity and length of stay. 

Madonna accepts patients with a variety of funding, including Medicare, Nebraska Medicaid, commercial insurances such as Blue Cross Blue Shield, worker’s compensation, and will consider out-of-state Medicaid and non-funded patients on a case by case basis. For more information, click here

Environment:  Madonna's environment affords individuals with stroke many opportunities to interact and support one another, whether it is in the spacious gym area during therapy, sharing a meal in the congregate dining area, or participating in a leisure activity outside in one of many garden areas. Madonna is the only facility in the region to have a simulated community, called Independence Square, where patients may engage in real-life skills training, such as grocery shopping, cooking a meal, transferring in and out of a car or getting in and out of bed. 

Community Re-entry:  Rehabilitation does not end when the patient gains basic skills of self-care and mobility. Participation in a variety of community re-entry and adaptive sports and recreational outings can be integrated into therapy or just for fun. Patients may also work on specific goals related to return to driving, school re-entry, or visit with a vocational rehabilitation counselor about work re-entry. 

Preparation for Home:  Madonna's stroke patients and their caregivers are provided with a self-care training program based upon principles of self-advocacy and self-direction. Patients, with or without their caregivers, are taught how to direct their care and what to do if emergencies arise. They are provided with opportunities to practice these skills during their stay, frequently ending with a stay in Madonna's transitional living apartment. This apartment is located on the unit, with easy access to medical staff if needed, with the expectation that a family member or other caregiver will assist with the personal care required during their stay. The patient will direct his/her care and independently follow his/her therapy schedule. In addition, a 2-week daily stroke education class is provided for all patients and family members/caregivers on a variety of stroke related topics. 

Home Assessment:  Another way to prepare the patient for a successful transition to home is by offering the opportunity for patients to return home for the day to practice skills in their home setting while evaluating the home for accessibility and any adaptations or modifications that may be required. For patients and families who live outside Lincoln and Omaha and the surrounding communities, a paper/pencil home assessment form is provided for the family member or caregiver to complete. 

Long-term Follow-Up:  Madonna offers many ways to help individuals with stroke and their family members continue to improve and maintain their functional gains, therefore maximizing their participation throughout the rest of their life. 

  • It is important that individuals completing rehabilitation stay active and exercise safely. We promote success by teaching how and what to do in a community based fitness environment, featuring trained staff and specially adapted equipment.
  • After you experience a stroke you may be confronted with a wide range of challenges throughout your lifetime. Because these challenges and limitations may not be evident until later, focusing on maintaining health long-term, including preventing secondary complications, is an important part of lifelong care planning. 
  • A representative from Madonna will contact you 6-12 months after discharge to see how you are doing and to gather outcome information.

Program Highlights

Rehabilitation for stroke patients includes other specialized services that promote regaining the highest level of independence: 

Additional Programs and Services

Madonna offers specialized services that focus on real-life skills to help people achieve their greatest level of independence and get back to their families, work, community and activities.

Awards and Accreditations

View a list of awards and accreditations that demonstrate our commitment to providing the best quality of care for our patients.  

State-of-the-art Technology

As a nationally recognized rehabilitation leader, Madonna has some of the most advanced rehabilitation technology available.

Stroke Online Resources

The amount of information available about stroke can be overwhelming.  Madonna coordinates with local, regional and national organizations to help patients find the most helpful online resources.

Patient Stories

Retired Navy officer overcomes stroke in time for Veterans Day (KOLN)

11/11/2017 1:10 PM | In the News

Laurence "Gunner" James shared his story with KOLN in time for Veterans Day. After a Sept. 12 stroke, Laurence “Gunner” James channeled the discipline from his 28 years in the Navy into his recovery at the Lincoln Campus. The long-time employee of Duncan Aviation participated in the Work Re-Entry program to refine his cognition and multi-tasking skills.

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Stroke won’t stopy Army vet from walking again (WOWT)

11/8/2017 1:17 PM | In the News

In advance of Veterans Day, WOWT featured Victor Cabriales who served two tours in Iraq, retiring in 2010 as a Sergeant First Class (SFC) after serving 34 years in the U.S. Army. Now, at 66, the war veteran is battling for independence after suffering a stroke in mid-September.

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Stroke survivor dresses as clown as part of therapy

10/31/2017 1:27 PM | Patient Stories

Stroke survivor Alice Gewecke recently brought only laughs and smiles to other patients as she performed her clown routine as part of her occupational and speech therapy at Madonna’s Omaha Campus. 

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Iowa mom writes thank you to Madonna staff for son’s care after stroke

10/9/2017 3:33 PM | Patient Stories

An Iowa mom says her family “made the right and best decision in bringing” her son, 31-year-old Cameron Hernandez, to Madonna’s Omaha Campus for recovery from a tragic incident at the gym. Lori Hernandez expresses her gratitude to Madonna staff in the form of a thank you letter.

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Amid recovery, surpris opera brings smiles (KOLN)

9/27/2017 8:31 AM | In the News

Ann Marie Snook, the director of music at Washburn University, enjoyed a special opera performance on her last day of therapy at Madonna's Lincoln Campus.

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