Addressing The Whole Person In Rehabilitation
Rehabilitation is a highly individualized process. What motivates one patient doesn’t necessarily motivate another. At Crotched Mountain Specialty Hospital we take the time to understand what makes our patients tick to get them moving, doing and progressing in recovery.
For Pat Mahoney, a 27 year old man who was working on a Master’s degree in fine arts prior to his accident, having physical, occupational and cognitive rehabilitation professionals tapping into his creative side during therapy sessions made all the difference.
Pat came to Crotched Mountain after being struck by a car last October while riding his bike near the UNH campus where he was working on a Master’s degree in fine arts.
Diagnosed with a serious brain injury, he was airlifted to Massachusetts General Hospital where he lay in a coma for a week. After regaining consciousness and starting rehabilitation, a very serious setback in January put him back in the ICU reversing any progress he had made.
“When Pat first arrived, he couldn’t walk by himself,” recalls Jen Forkey, Pat’s physical therapist. “He couldn’t climb steps and was very quiet. He didn’t communicate during therapy. It was hard at first to know how he felt about what was happening.”
Shortly after his arrival, Pat started cognitive rehabilitation therapy. According to program coordinator and speech pathologist, David Hajjar, M.S., CCC-SLP, Pat was a good candidate for the program as he met all the criteria for participation in group and individual therapies.
His low initiation was addressed largely through cognitive activities in a group setting. “Pat is a quiet guy with great things to share and the group therapy allowed him to practice sharing and socialization,” David recalls. “Every week we looked at his goals, strategies and progress, and readjusted the plan as necessary.”
Because Pat had been studying poetry in his MFA program and was clearly motivated by the arts, David encouraged him to write a poem as part of his cognitive rehabilitation therapy. “Pat crafted a compelling and layered poem about his experiences in rehabilitation, using the campus’ resident chickens as a metaphor,” said David.
Pat’s cognitive therapies also focused on sustained attention and learning compensatory strategies for memory. “He made good use of the iPad to stimulate recall, improve reading and comprehension, take notes, and plan and schedule activities. He also used it to research a personal scheduling system and choose a word processing program for his writing,” explains David.
All the while, Jen and Pat focused on building core strength in the therapy pool and on balance and lower extremity strength using foam beams and the BAPS Board (Biomechanical Ankle Platform System). He also participated in a regular yoga practice.
“Shortly after Pat began cognitive rehabilitation, I noticed a rapid improvement in his overall response time and the quality of his attention,” recalls Jen. “He communicated more readily which improved the overall effectiveness of his physical therapy.”
Occupational therapist, Dave Kontak, met regularly with Pat for cognitive and physical rehab that tapped many passions. “The content of rehabilitation is a huge consideration. For Pat, using art to stimulate his higher cognitive functions enriched his day and stimulated healing. Having to remember a piano phrase and play with both hands has profound healing implications.” According to Dave, a challenging creative project can boost morale and have significant rehabilitation potential because it incorporates cognitive, motor and sensory skills in an enjoyable activity.
To support Pat’s progress in all areas, Jen, David and Dave met regularly to plan strategies that complemented and reinforced each other’s treatment plans.
During the weeks prior to discharge from Crotched Mountain, Pat jogged with his brother, played tennis, hiked CM’s accessible trails, played the piano at a patient photography show, and gave a witty and informative presentation to his peers in cognitive rehabilitation group.
In June, Pat moved on to an outpatient cognitive rehabilitation program closer to home in New Jersey. He has been very busy running races, taking a sign-language class, practicing guitar and piano and using his iPad to complete his cognitive rehabilitation homework. Patrick independently made his way through a hectic Newark airport to visit his girlfriend in Boston this summer. And he is looking forward to a trip to San Francisco in November. His long-range plans include returning to school in New Hampshire.
According to Pat’s mom, Mary, “We are extremely proud of the progress Patrick has made over the past year. His determination has been truly inspiring to his family, friends, and all who have followed him along this journey.”