How to Choose a Rehabilitation Facility for a Brain or Spinal Cord Injury
It's important to be confident about the quality of care you or a loved one will receive when entering a rehabilitation program.
There are certain things to look for and questions to ask when narrowing down your list of options.
A specialized rehabilitation facility like Shepherd Center offers distinct advantages for people who need rehabilitation for a spinal cord or brain injury.
Advantages include staff expertise, a comprehensive continuum of care, a younger patient population and ongoing research.
Listen in as Donald P. Leslie, M.D., discusses the rehabilitation facility at Shepherd Center, so you can make the right decision for your brain or spinal cord injury rehabilitation.
Donald P. Leslie, M.D.
Donald Peck Leslie, M.D., is the Medical Director of Shepherd Center. Prior to this appointment, he served for ten years as Associate Medical Director of Shepherd Center and Medical Director for Brain Injury Services.
A graduate of Vanderbilt University in Nashville, Tenn., with a Bachelor's of Arts and Science degree, Dr. Leslie attended medical school at the University of Tennessee in Memphis. He completed his postgraduate residency training in internal medicine at the Mayo Clinic in Rochester, Minnesota. He then practiced at the Florence Clinic in Florence, Ala. His second residency was completed at the Emory School of Medicine in Neurology and Physical Medicine and Rehabilitation. His last stop before joining Shepherd Center in 1986 was at Stanford University PM&R in California, where he worked with Dr. Conal Wilmot. Learn more about Donald Peck Leslie, M.D
Melanie Cole (Host): A specialized rehabilitation facility like Shepherd Center offers distinct advantages for people who need rehab for spinal cord or brain injury. My guest today is Dr. Donald Peck Leslie. He’s the medical director of Shepherd Center. Welcome to the show, Dr. Leslie. Tell us a little bit at the beginning here of what’s involved in brain and spinal cord injury rehabilitation.
Dr. Donald Peck Leslie (Guest): Thank you. I appreciate being here with you today. Brain and spinal cord rehabilitation is very complex, and it is very broad. We have a continuum of care here at Shepherd, 152 beds and about 1,600 employees who are taking care of the patients and their families. One of the things that I feel is best about what we do here is that we have a family residence center, so when a patient is admitted with a brain or spinal cord injury, their family comes with them and they are housed here adjacent to the center with complimentary housing for the first 30 days, which helps them help their loved one, helps them further their education about the process of rehabilitation as well as being there for support and love. We have been doing this since 1975. We are the largest of the model centers funded by the NIDRR, the National Institute of Disability Rehabilitation Research, and we have a very comprehensive program beginning with our own intensive care unit and going all the way to post-acute services with Shepherd Pathways for brain injury and the Shepherd Day Program and Beyond Therapy for brain and spinal cord injury. Our facility, in my estimation, is second to none, and I’ve been to many, many rehabilitation centers around the globe. We house an Olympics indoor pool. We have four gymnasiums. We have 17 sports teams. We have the largest recreation therapy department in the world in that we have 42 full-time persons who help spinal and brain injured patients and their families re-enter their lives and get back into doing things that they did pre-injury. Brain and spinal cord injury are very, very life-changing, depending on the severity of the brain injury and the level of injury of the spinal cord. I go on, maybe I better come up for air and see if there’s anything specific that I might answer for you.
Melanie: Then if listeners are looking to choose a rehab center for their loved ones, what do you think are the most important aspects of a center for them to look for right when they’re beginning? Because it’s a scary, confusing time. What should they be looking for?
Dr. Leslie: You’re very correct. It is a very scary, very confusing time, and the injuries occurred, and it looks as if what looked like a potential catastrophic or a fatal injury is now -- the patient is going to make it. Well, how are we going to rehabilitate them? What do they need to look for the services that are provided? Obviously, it’s multidisciplinary. We have specialized nurses. We have a staff of 173 physicians. We have all kinds of therapists, including physical therapists, occupational therapists, speech language therapists, recreation therapists, nutritionists, chaplaincy. We have the entire gamut here at Shepherd, and we are very proud of the fact that we can provide every aspect of rehabilitation for the brain and spinal injured person.
Melanie: What do you think is the first question somebody should ask before they sign their loved one into a center?
Dr. Leslie: I think the first question that needs to be asked is what are my goals that the person who wants to come to Shepherd needs to decide what it is that he or she is looking for in the way of rehabilitation. I have said many times I’m a physician, not a magician. I wish I could make things always better or things go back to where they were, but rarely can we get 100 percent recovery. Our outcomes are second to none, but the outcomes are probably never as good as we would like for them to be. We’d like for there to be complete recovery, but realistically, we need to be sure that the goals and the expectations of the patient and of the family are realistic. And if they realize that there is a finite amount of time that can be spent, we have a finite number of beds, we need to move people through our continuum, not rush them through the continuum of care, but hopefully build on each day, each week, and each month. The average length of stay here is probably about five or six weeks as an inpatient, and then, as I said earlier, we have post-acute services like Shepherd Pathways for the brain injured population and Shepherd Day Program and Beyond Therapy for the spinal cord and brain injury. I think that it is very important in choosing a center for the rehabilitation of a loved one that the person who is making the referral, the physician, the family, whomever, will look at what we have to offer and what it is that they want from Shepherd Center and we can hopefully provide that with a great deal of expertise.
Melanie: Tell us a little bit about after inpatient, then you have a day rehab program and outpatient therapy services. Tell us what someone can expect from these services. Obviously, you can’t tell us whether they’re going to make that full recovery, but what do those services entail? What are they like?
Dr. Leslie: Good question. What we have after the inpatient stay here affords the person a hospital bed with 24/7 nurses, a doctor and therapist seeing them every day, typically six days a week. On Sunday, we have activities planned, but there is no formal therapy on the weekends—on Sunday, at least. After a person has reached a certain degree of recovery and they are deemed appropriate to go to the post-acute services to Shepherd Pathways, as I said, which is outpatient, or to Shepherd Beyond Therapy or Day Program, they then are housed outside of the hospital in our family resident with their family, and they are treated. During the day, they come at 8:30 or 9:00 in the morning and they stay all day until late afternoon, and then they go home to the family residence center at night. Those services are five days a week, Monday through Friday. That program typically lasts about four to six weeks, at an average. It may last longer. It may last shorter. But the typical person is here about six weeks in the post-acute or outpatient or day program. After that, depending on whether or not they need multiple services, do they need PT, OT, and speech, do they need nursing, do they need rec therapy -- I don’t think I’ve said anything about psychology. I should add that’s one of the cores of Shepherd. Everyone sees a psychologist. We have 16 full-time PhD psychologists and other specialists in psychology who see the patients, inpatient and outpatient. That’s very important for adjustment to disability, and that’s a big part of the program as well. These programs entail after they’ve been inpatient, which is typically all of the services, it may well be that a patient get to a certain point with one or two or more of the disciplines and they may not need daily services from each of these types of therapist. They will have decided with them and for them who do they need and what specifically is the focus of the day program or the outpatient therapy. This is done on an individual basis. We don’t have a cookie cutter approach. Each patient is treated individually and with a customized program.
Melanie: Give your best advice in just the last few minutes here, Dr. Leslie, for people considering a rehab facility for their loved one and why they should come to Shepherd Center for their brain and spinal cord injury rehabilitation.
Dr. Leslie: Well, I think that that’s a very good question and a difficult one to answer, but I’ll take a stab in saying that I don’t believe that geography should be the final factor for decision as to where to get rehabilitation. That’s way we built the family residence center, so that the families can come and not incur expense in staying here while the person is having the rehabilitation. We treat more patients from outside of the state of Georgia. Shepherd’s here in Atlanta, Georgia, but for the last probably eight or 10 years, we’ve treated more people from outside the state of Georgia and actually outside of the United States. We have multiple international patients as well than we do people just within, say, a hundred-mile radius or in the state of Georgia. It is a big consideration. There are rehab centers all over the nation, and I welcome anyone to look at a rehab center in their locale and look at what they offer. Look at what their physical plan is. Look at what their staff is like. Look at their fee, their full-time equivalent ratio. We have 1,600 staff members here and we have 150 beds. Do the math. That’s 10:1. There’s a lot of people here for each patient and their family.
Melanie: Thank you so much, Dr. Donald Leslie, the medical director of Shepherd Center. For more information, you can go to shepherd.org. That’s shepherd.org. You’re listening to Shepherd Center Radio. Thanks so much for listening. This is Melanie Cole. Have a great day.