Spinal Cord Injury and Disorder (SCI/D) Program

Spinal Cord Injury and Disorder (SCI/D) Program

At Providence St. Elias Specialty Hospital Inpatient Rehabilitation, we’re on a mission to help Alaskans with spinal cord injury and disorder (SCI/D) regain the best possible health and function. From your physiatrist – a physical medicine and rehabilitation-trained physician – to your nurse, case manager and therapists, you’re partnered with a whole team trained in the management and rehabilitation of SCI/D.

We use rehabilitation management techniques backed by scientific evidence and harness assistive technology to help you restore optimal function, prevent complications from physical disability and adapt to an altered lifestyle. Further, a primary care physician is integral to your team, ensuring that all your medical needs are closely monitored and optimally managed while you are hospitalized.

Based on your needs, we provide a personalized plan to reach your goals – and thrive in your home community.

Treatments and Services

Our rehabilitation program is tailored to your needs, personal and environmental resources, cultural values and goals.

Our treatments and services include:

  • Case management and social work
  • Diagnostic testing, such as X-rays, CT scans, laboratory tests, electrodiagnostic testing of nerve function and specialized bladder scanning to check bladder storage and emptying
  • Education and training for you and your caregivers
  • Medical management and rehabilitation of SCI/D
  • Mental health and cognitive support
  • Occupational therapy
  • Physical therapy
  • Preparation for life after inpatient rehabilitation
  • Speech therapy
  • Therapeutic recreation
  • Ventilator training and care

Spinal Cord Injury and Disorder (SCI/D) Rehabilitation

SCI/D rehabilitation can look different for each patient. You may need support in one or more of these areas:

doctor-patient-consultation

SCI/D may affect the nerves that connect your brain and spinal cord with your bowels and bladder. You might not know when you need to go or are able to actively void.

Our rehabilitation program includes bowel management, which may involve diet, exercise, fluid intake, medication and a scheduled bowel program. We also help with bladder emptying techniques, catheters and medications for bladder management.

Adjusting to life with SCI/D can be challenging. While each person reacts to life-changing events differently, shifts in mood are often part of this adjustment. Some of the most common symptoms include grief, anxiety or worry, sadness, frustration or feeling overwhelmed. Sometimes, you need help processing these emotions – especially if they get in the way of daily living.

During rehabilitation, we have specialists who help with mindfulness, strategies for problem-solving and self-management and addressing other mental health needs.

A big part of inpatient rehabilitation is helping prepare you to rejoin your community and resume your desired roles and activities. We offer help and resources for transportation and recreation. Transportation may mean returning to driving with a disabled parking permit, finding public transportation options or requesting accommodations on other transit. When appropriate, we may refer you to outpatient training for an adapted driver’s training program.

Your care team helps you get back to the activities that bring you joy. That might mean adjusting certain aspects of the recreation and leisure you prefer, learning about new passions and/or connecting with community resources.

A person with SCI/D may experience weight loss soon after injury and need to learn to manage fluid intake for bowel and bladder self-care. Over their lifetime, people living with SCI/D are at risk for weight gain, unhealthy lipid levels and a reduction in muscle and bone mass.

Healthy eating can help maintain muscle mass and a healthy weight. It can also reduce your risk of developing chronic illnesses, such as diabetes and heart disease. Our rehabilitation program makes sure you consume proper nutrients while staying hydrated. We also offer education on how to continue proper nutrition and manage fluids appropriately for your needs at home or in your community.

Our bodies are designed to move. After SCI/D, people often have limited ability to move their body on their own. If we don’t move our bodies, the joints, ligaments, tendons and muscles can get tighter and weaker.

Rehabilitation addresses any range of motion or musculoskeletal issues to help you complete daily activities, such as dressing, grooming or hygiene and walking or using a wheelchair. We teach you strategies to preserve your bone and joint health over your lifetime.

SCI/D usually leads to altered or absent sensation, poor temperature regulation and impaired skin blood flow. This leads to a higher risk of skin breakdown. During inpatient rehabilitation, we focus on preventing skin injuries from pressure, friction or moisture. We optimize nutrition with the help of a dietitian, and our nurses are attentive to daily skin checks and care to protect the skin. Our specially trained wound care nurses are available to provide a broad range of wound and ostomy care.

Recognition

Commission on Accreditation of Rehabilitation Facilities (CARF) - Accredited

Joint Commission - Gold Seal of Approval

Frequently Asked Questions

SCI/D can result from many causes:

  • A traumatic spinal cord injury (SCI) is damage to the spinal cord due to trauma like a car accident or a fall. While a fracture of the spine around the spinal cord often causes cord injury, SCI may develop without a fracture, such as a fall in the setting of a narrowed or arthritic spinal canal.
  • A spinal cord disorder is dysfunction of the spinal cord that results from nontraumatic conditions – for example, a tumor, herniated disc, congenital disorder such as spina bifida, inflammation, infection or altered blood supply leading to a spinal cord stroke.

Inpatient rehabilitation is a program for people who are medically and surgically stable and ready to begin an intensive, goal-oriented rehabilitation program in a hospital setting.

The spinal cord communicates with the brain and body, so any spinal cord dysfunction often means permanent changes in how you move, feel and use your body and how your body functions. You may also experience mental and emotional changes. Inpatient rehabilitation provides a setting where you can get specialized care from a team of experts around the clock.

Through rehabilitation, our goal is to help you recover faster and adjust to these changes, so you can return to living your full life.

The effects of your SCI/D will vary based on the location and severity of the spinal cord damage. You may need help with different changes.

Long-term medical changes we address in our rehabilitation program include:

  • Abnormal muscle tone
  • Autonomic dysreflexia
  • Bladder function
  • Body composition
  • Bowel dysfunction
  • Circulation
  • Dysphagia
  • Infection management
  • Medications
  • Men’s health issues
  • Musculoskeletal complications
  • Neurological changes
  • Nutrition
  • Pain
  • Sexual function
  • Skin integrity
  • Respiratory support
  • Women’s health issues

Yes. Functional and life changes we help with include:

  • Activities of daily living
  • Assistive technology
  • Behavioral health
  • Cognition
  • Communication
  • Community integration
  • Driving – partner with community services
  • Durable medical equipment needs
  • Emergency preparedness
  • Environmental modification
  • Family or support system counseling
  • Leisure and recreational activities
  • Occupation
    • Accomodations for returning to work and referrals to ongoing outpatient vocational rehabilitation resources
  • Orthotic and preparatory prosthetic needs
  • Peer support
  • Personal care assistance
  • Seating and mobility
  • Sexual function education
  • Substance abuse screening

We’re ready to support your needs, along with your health and wellness, independent living and community integration.

We’ve expanded our services every year. Typically, we have more men than women, with nearly half of patients between ages 66–85.

Almost 75% of all SCI/D cases at Providence St. Elias are due to a non-traumatic spinal cord injury.

At the hospital, we serve people with SCI/D who are referred by other community or regional providers, health care clinicians or loved ones.

You can also refer yourself to the program.

Your care team includes different specialists based on your specific needs. Everyone on your team has training in rehabilitation. Your rehabilitation medicine physician leads the team and manages your care.

You may also work with:

  • Case managers and social workers who help you and your family prepare for what’s next after inpatient rehabilitation
  • Rehabilitation psychologists and neuropsychologists
  • Specialty trained nurses certified in rehabilitation and wound/ostomy care
  • Therapists, including speech therapists, occupational therapists and physical therapists
  • Peer support volunteers
  • Prosthetics and orthotics consultants
  • Recreational therapy

The first step of inpatient rehabilitation is being admitted to our Acute Inpatient Rehabilitation Unit.

Shortly after admission, you meet with your rehabilitation care team for evaluation and to define your initial goals. We incorporate your and your caregiver’s goals into a plan of care and set a tentative discharge date. How long you stay in the program depends on your specific needs and goals – and is different for everyone.

During rehabilitation, your care will be managed by a primary care physician and a rehabilitation medicine physician, along with a team of therapists, nurses and care managers. You may work with other specialists such as dieticians, medical consultants such as urologists, wheelchair seating specialists and more. Your team ensures that you get the best care while in our inpatient program and when you go home or to your community.

We encourage friends and family who will be helping once you’re discharged to attend and participate in therapy sessions.

Most patients have private rooms, as well as access to a day room and laundry services.

Your time at the hospital is one step in your SCI/D recovery. We want to help you return home and continue to heal.

Before you’re discharged, we’ll recommend services that support you, such as outpatient therapies, home health therapies or nursing, and personal care assistant (PCA) services.

We can also help determine if you need an extended care facility, assisted living facility or skilled nursing facility as a bridge to your home or community.

Your case manager helps you schedule required follow-up appointments. We also make sure you understand any medications you need.

There are many organizations to support you and your loved ones with SCI/D recovery. Some examples include:

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