Family Information Guide

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1 Your Rehab Team Department Name Phone # Program Manager: Chris Richards Chief of Service: Dr. Limcangco Your Physician: Reception: Unit Manager: Unit: Clinical Coordinator: Speech Language: SAMM: Psychology: Occupational Therapy: Physical Therapy: Recreational Therapy: Social Worker: Dietician: Kendra MacPherson Shirley York Revised May Family Information Guide HALVAR JONSON CENTRE FOR BRAIN INJURY INPATIENT PROGRAM THE CENTENNIAL CENTRE FOR MENTAL HEALTH AND BRAIN INJURY

2 Table of Contents Welcome... 1 Patient and Family Information... 3 Communication... 3 Family Involvement... 3 Family Support... 4 Concerns Resolution Process... 5 Understanding the Rehab Process... 5 Admission Guidelines... 6 Rehabilitation Resources... 8 Therapeutic Relationships... 8 Discharge Planning... 8 Confidentiality... 9 Admission to the Program... 9 Personal Items to Bring on Admission Medication Room Assignments Keys Visiting Guidelines Legal and Financial Information Passes/Leaves of Absence Equipment Loans Maintenance of Private Wheelchairs Adaptive Equipment, Supplies & Services External Consultations Heart Smart Diet Donations/Gifts Use of Prohibited Substance Halvar Jonson Centre for Brain Injury Page 24

3 Fire Exits Table of Contents Facility Information Infection Prevention and Control Good Hand Hygiene Respiratory Etiquette Notice of Outbreak Scented Products Smoking Facility Services Boutique Cafeteria/Kiosk Computer Use Hairdressing Laundry Library Mail Volunteer Services Parking Pastoral/Spiritual Care Patient s Accounts Office Phone Maps Map of Brain Injury Map of Units Fire Exits Your Rehab Team Page 23 Halvar Jonson Centre for Brain Injury

4 Map of Brain Injury Units Hall to Reception Offices and Storage Unit Clerk WELCOME Snack Bar Patient Rooms Welcome to the Halvar Jonson Centre for Brain Injury (HJCBI). We are located in the Centennial Centre for Mental Health and Brain Injury in Ponoka, Alberta. Our program provides a safe, supportive environment for patients and family members during their rehabilitation. Dining Room Patient Rooms Lounge HJCBI is a long-term rehabilitation service that assists persons with complex brain injury, including both traumatic and non-traumatic injury such as stroke. We have received provincial and national recognition for our specialized services. Patio Our Mission The Halvar Jonson Centre for Brain Injury is committed to optimizing the functional potential of persons with acquired brain injury. We Value Respect, Accountability, Transparency, Engagement, Innovation/Creativity Page 1 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 22

5 Map of Brain Injury Contact: Brain Injury Reception (403) Hours: 7:30 am 4:30 pm Monday to Friday Mailing Address: Halvar Jonson Centre for Brain Injury Box 1000, Ponoka, Alberta T4J 1R8 Physical Address: 2km S of Hwy 53 on 46 St Ponoka, AB Brain Injury Units and phone numbers Navarre (403) Waterton (403) Ferintosh (403) Hours: 24hours/day 7 days/week Admission to hospital can be an emotional time for patients and families. Our goal is to make the rehabilitation experience positive. With this in mind, we offer this family information booklet to provide facility information, rehabilitation principles and to reinforce our commitment to effective communication and mutual respect. Page 21 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 2

6 Patient and Family Information Communication We value: Respect Dignity Care Fairness and concern for all patients, family members, visitors and staff Communication between patients, families and staff is one of the most critical factors in developing a healthy therapeutic working relationship. There is an expectation that staff, patients, family members and visitors will communicate in a respectful manner. Abusive behaviour will not be tolerated from staff, patients, family members or visitors: It is understood that patients may have challenging behavior as a result of their brain injury and this will be addressed through a treatment plan. Family Involvement Family involvement in rehabilitation is encouraged and welcomed. Your input and involvement in goal planning and discharge planning is very important.. You are encouraged to learn and participate in providing care as these are the skills that will be needed for Leave of Absences (LOA s) and ultimately for discharge. When families wish to be involved in the patients day to day care on the unit it is best to discuss this role with the Clinical Coordinator. This communication link is vital for the nursing team. There will be times when we ask the family to decrease their level of involvement so that the staff can Parking There are a few visitor parking stalls in front of the HJCBI entrance. Visitor stalls are also available by the front entrance of the Adult Inpatient program. A daily visitor parking pass must be obtained from the main reception Pastoral/Spiritual Care A chapel is located in the Town Centre. Arrangements can be made for visitation from a person of your faith. Please ask for assistance from the Social Worker Patient s Accounts Office (Banking Services) There is an internal banking system for patients at the Town Centre. The office is open 9:00 am to 3:00 pm Monday through Friday. Banking services include: deposits, cash withdrawals, payment of bills, money orders, and storage of personal effects. You are encouraged to deposit money directly with Patient s Accounts. During the evening or weekend, money for deposit should be given to the Nurse-in- Charge who will give you a receipt and will make sure that the money is safely locked away to be deposited when the bank opens. Phone Patients have limited access to unit telephones. A pay phone is located in the hall outside the Waterton unit. We suggest the use of a phone card. Some rooms are equipped with the capacity for private telephones. Hook-up and monthly charges are the responsibility of the patient/family and need to be arranged through a service provider. Personal cell phones are also an option but cell phone use during treatment sessions is prohibited. Page 3 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 20

7 There are several computers in the Crafts and Hobbies area in the Activity and Treatment Centre that have high speed internet. These computers are available to all patients in the facility. The hours of operation are posted on the door. Patients can also bring their own computer for their room. Caution must be exercised when using a web cam to ensure confidentiality of others in the area. Publicly located computers cannot be used to access adult websites. Hairdressing Full-service professional hair dressing is available at the Town Centre on a fee-for-service basis. The Unit Clerk can assist in booking an appointment Laundry A laundry service is available for patients. Personal items must be labeled Each unit has a washer and dryer for patient use. Library Learning Resource Centre (library) is located in the Dave Russell Education Complex Mail Letters and packages will be delivered to the patients unit Monday through Friday. Mail received after discharge will be forwarded to the discharge location or to the family. If a patient wishes to mail a letter it can be given to the staff at Brain Injury reception. Stamps can be purchased at main reception. Volunteer Services Volunteer services are available to offer companionship to patients. The unit social worker can discuss this with you. Page 19 Halvar Jonson Centre for Brain Injury assess what the patient can do for his or herself. The patient will also need to practice the skills they are learning in rehabilitation. There are many opportunities for families to be partners in care development of rehabilitation goals and priorities for discharge education/training related to day to day care and care needed for LOA s home and discharge attending out of hospital appointments family meetings discharge planning evening and weekend homework (extra practice exercises) observing programs visiting and quality of life activities Family Support When a person has had a brain injury it has a significant impact on the entire family. Family members may experience an increase in emotional stress and demands on their time as they deal with changes in roles and relationships. Recovery from a moderate to severe brain injury can be a long and difficult process and there can be much uncertainty and frustration. It is normal to experience grief and loss but there should be hope for the future as well. Psychology and Social Work staff are available to provide education, counseling and emotional support to family members. Please let us know how we can help. Halvar Jonson Centre for Brain Injury Page 4

8 Patient/Family Feedback Process If a family member has a concern with any hospital personnel we suggest that they first speak directly to the staff member involved to try to resolve the problem. If this is not possible or does not result in a satisfactory resolution we suggest that the family member follow the progressive steps listed below. To resolve concerns with nursing staff 1. Speak to the Clinical Coordinator 2. Speak to the Unit Manager 3. Speak to the Program Manager To resolve concerns with therapy staff 1. Speak to the Unit Manager 2. Speak to the Program Manager The family also has the option to have a concern addressed by staff outside of the program through the following avenues Central Services Office (after hours manager) (403) Director, CCMHBI (403) Submit a Patient Feedback Form Contact the Patient Relations Department Telephone: Fax: Mail: Patient Concerns Officer Mail Slot #57, Jasper Ave Edmonton, AB T5K 0L4 Positive feedback is appreciated and can be provided directly to the staff, program or through the Patient Feedback options noted above Understanding the Rehabilitation Process Patients are admitted to the program based on the following Admission Guidelines: Staff are not permitted to escort the patient or assist the patient to smoke in any way Smoking cessation and Nicotine Replacement Therapy is available. Please discuss with your physician. Staff, students, families, and visitors are not allowed to smoke anywhere on the site. This includes parking areas, sidewalks or any outdoor area Facility Services Boutique There is a boutique where donated clothing and accessories can be selected for personal use for those patients who do not have the means or are unable to purchase items on their own. Cafeteria/Kiosk (Food) Harvest Café Hours of Operation Monday Friday 7:00 am 1:30 pm Weekends closed Café du Monde - Hours of Operation Monday Friday 9:30 am 7:00 pm (Closed 11:30 12:30) Weekends 9:00 am 4:00 pm Vending machines available throughout the facility. Computer Use There are computers for patient use on each unit. High speed internet access is available for patient use on each unit. The unit clerk will provide the password. Page 5 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 18

9 Facility Information Infection prevention and control Good hand hygiene is the single most important way for all staff, patients and visitors to control the spread of germs. Please wash hands thoroughly with soap and water and use the hand sanitizer supplies available throughout the facility. Respiratory Etiquette when you cough or sneeze be sure to cover your mouth and nose. Use disposable tissues if possible. Cough or sneeze into your upper sleeve if you do not have a tissue available. Be sure to perform hand hygiene. Notice of an Outbreak if an outbreak of an illness happens in the facility, an outbreak sign will be posted on the door of the unit. An outbreak may impact visiting, rehabilitation programming and scheduled appointments/outings. Please do not visit if you feel you have any Influenza like symptoms: fever, cough, sore throat, runny nose and/or general body aches. Scented Products The facility has a scent free policy and we ask patients/family/visitors to refrain from wearing perfumes, after-shave or other scented products and not to bring in highly scented flowers. Admission Guidelines ~ Diagnosis confirming non-progressive acquired brain injury. ~ Medically stable A clear diagnosis and co-morbidities have been established; co-morbidities/health issues are managed. Acute medical issues have been addressed (consultations completed, follow-ups arranged) Disease process and/or impairments do not preclude participation in a rehabilitation program. ~ Age years ~ Able to participate Demonstrate physical tolerance and cooperation sufficient to engage in programs. Able to communicate (verbally or non-verbally) Able to carry out one step commands ~ Able to learn Demonstrate ability to retain information/carry over from session to session in order to benefit from rehabilitation and achieve goals. ~ Require services of an interdisciplinary treatment team Needs are not able to be met with out-patient programming or short stay inpatient rehabilitation ~ Capacity and consent addressed Person must be informed regarding the rehabilitation program at Halvar Jonson Centre for Brain Injury and must have consented to participate. Smoking Patients are allowed to smoke only in the designated area outside the Rendezvous Page 17 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 6

10 If person appears to lack or have impaired capacity, capacity must be addressed and a substitute decision maker in place if required. ~ Anticipated discharge location has been considered. Letter of repatriation may be required Each brain injury is unique and following admission our therapists will assess the patient and develop an individual treatment plan. The program uses an outcome measurement tool called the FIM + FAM (Functional Independence Measure and Functional Assessment Measure) to measure progress in rehabilitation. The patients level of ability is rated in physical, communication, emotional and cognitive domains. This measure is scored on admission, at regular intervals and at discharge. Your Social Worker will review this form when discussing the Treatment Conference Summaries. Rehabilitation initially works toward restoration of function and secondly towards compensation. Stage 1 - Restoration of function involves practice and relearning of previous abilities. The brain is capable of change (neural plasticity) and sometimes functions can be relearned. When restoration is not fully successful the therapist will initiate the use of compensation strategies. Stage 2 - Compensation involves using strategies or external aids to gain independence in a particular task (e.g. using a cane for walking, using a dressing strategy to allow independence when one arm is not functional, using a memory journal). The patients, family members and treatment team work together as an interdisciplinary team to set goals and priorities for the patient s rehabilitation. The family s involvement is important. The most effective rehabilitation occurs when everyone works together to achieve the identified goals. Heart Smart Diet The program supports a Heart Smart (cardiac) diet as a component of rehabilitation as it contributes to overall good health and weight control. Dieticians are willing to discuss specific likes or dislikes with patients and will substitute items on the menu as needed. Use of Prohibited Substance The use of illicit drugs or alcohol while participating in a rehabilitation program is prohibited. These type of substances interact negatively with regular medication and therapy activities. The use/possession of illicit drugs or alcohol will be reported to the Physician and may be reported to Protective Services (security) and/or RCMP. It may also result in discharge from the program. If you are aware of the use or distribution of illicit substances please notify a member of your treatment team immediately. Donations/Gifts Patients/families who wish to express appreciation can donate to a specific unit or to the program. This recognition is appreciated and can be accepted. Professional boundaries and ethics prohibit staff from accepting personal gifts from patients/families at any time during a patient s stay. Please ask the Unit Manager for information regarding donations that will be directed to the program. Page 7 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 16

11 Wheelchairs or other equipment being transported in the back of an open truck must be securely tied down. A family member is required to sign a waiver and assume responsibility prior to borrowing equipment. Maintenance of Private Wheelchairs Patients who bring in their own wheelchair or purchase a wheelchair while in the program are required to pay for the cost of parts and labor (other than noted below) to maintain the wheelchair. Maintenance staff will only inspect and adjust wheelchairs (brakes, tightening of components). If replacement parts are required the family will be billed directly by the retailer for the inventory at replacement cost. Adaptive Equipment, Supplies and Services The Program can arrange for the purchase of equipment, therapeutic supplies and/or services on behalf of patients. Examples include visits to the dentist, optometrist or orthotic equipment (splints). Patients/guardians are responsible for payment of services/equipment not covered by Alberta Health and Wellness or insurance. External Consultations A patient may need to attend follow-up appointments or consultations with specialists. We encourage family members to attend with the patient and when possible provide transportation of the patient to the appointment. Appointment dates and transportation arrangements will be confirmed with the Clinical Coordinator or Social Worker. Rehabilitation Resources It is important for patients and families to understand the limitations of our program so that we do not create unrealistic expectations. As a program, we do not have casual staff to cover-off for the therapists when they are away due to illness, vacation, educational workshops, family meetings or other commitments. While all efforts are made to cover programs affected by staff absences there will be times when programs are cancelled. Patient therapy time is dependant upon the patient s ability to benefit and the therapist s caseload. A decrease in therapy time may occur when a patient s progress has slowed or a patient has achieved their identified goals. Patients are tracked for level of participation in rehabilitation and if they do not attend sufficient programs they may be discharged before all rehabilitation goals have been met. Therapeutic Relationships A therapeutic relationship is one in which the professional uses their skills and knowledge to benefit the patient in their rehabilitation. A positive therapeutic relationship is one in which all parties; patients, therapists, and family members, are working toward the same goal. Rehabilitation can be a lengthy process and requires hard work and commitment from all participants. We fully support a cooperative and professional relationship as this will produce the best results. Our professionals are required to maintain their professional boundaries. Discharge Planning Your Social Worker will discuss expectations for discharge with you at the time of admission. Discharge planning can be a long and complex process. Based on rehabilitation Page 15 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 8

12 progress the Social Worker will facilitate ongoing planning. You will receive a Family Guide for Discharge Planning from the Social Worker, which provides more detailed information. Confidentiality The confidentiality of your information is important to us. All staff, students, and volunteers sign an Oath of Confidentiality and are required to respect and protect your privacy as specified under applicable legislation Privacy is important to you and your family as it is to other patients and their families. We ask that you, your family and visitors respect the confidentiality of others by not disclosing information you may have access to or inadvertently have seen or overheard while at the facility. In order to preserve patient confidentiality, digital cameras, cell phones, social networking sites and other wireless communication devices may not be used to photograph, take video images or record the conversations of any patient, family, or staff member without consent. Admission to the Program Admissions are typically Monday to Thursdays between 10:00 a.m. to 2:00 p.m. On the day of admission the patient will be seen by the doctor for a physical examination, nursing staff for general assessment, a physical therapist for transfer assessment and a speech therapist to review swallowing and eating concerns. At that time patient information will be entered into the Health Records system and an admission photo will be taken. Legal and Financial Information - Alternate Decision Making If you have a guardian/agent or trustee/power of attorney you will be asked to bring a copy of the legal documents for the health record. The unit Social Worker will follow-up on legal and financial information and assist with any questions. Please try to bring two pieces of government issued identification, one needs to have your picture. This is required for external appointments at other facilities. Passes/Leave of Absence (LOA s) Home visits are encouraged on the weekend after patient safety is assessed and education on patient care is provided to family. LOA s provide an opportunity to reconnect with friends and family and to practice skills learned in therapy. The feedback to the treatment team on successes and challenges in the home or community is important for future treatment. Leaves that impact scheduled rehabilitation appointments are discouraged. The treatment team will review leave requests. Equipment Loans The program will provide patients with the loan of a wheelchair following admission if they do not have their own. Please take care of the wheelchair as seating equipment is very expensive and will be used again for future patients. The program can loan other pieces of equipment (e.g. bed, transfer pole) to be used in the family home for LOA s. The equipment may not be available for loan if it is required for use in the program. Other options for equipment loans can be discussed with your occupational therapist or social worker. Page 9 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 14

13 Visiting Guidelines Visiting hours are 9:00 am to 9:00 pm except under special circumstances. This facilitates the completion of personal care and promotes good sleep patterns. Visitors should schedule their visits around therapy and rest times Children must be supervised at all times while in the facility Families that would like to bring in their pet must receive permission from the unit manager. As well the pet must be registered through Volunteer Services. All pets must be kept on a leash and supervised by their owner. Families and friends should check with nursing staff before bringing gifts of food or drink for patients. There may be safety precautions regarding eating and swallowing or food allergy concerns. Families and friends visiting the centre need to be aware that some patients may have behavioural and emotional challenges. We ask for your understanding, tolerance and respect. If you have any concerns please bring them forward to any staff member Do not visit if you have a cold, influenza, or gastrointestinal type symptoms We encourage prevention of infections please use hand sanitizers located throughout the facility. If the patient is on isolation please contact the nursing staff for instructions before entering the room The Glass Lounge is available as a quiet area for visiting off the unit. The area is frequently used for therapies during program hours and is unavailable during these times. Family members who accompany the patient will be asked to meet with the Social Worker to assist in providing history and patient information. Personal Items to bring on Admission Comfortable, easy wash, loose fitting clothing - Clothing will be labeled ~ Sweat pants or pants with elastic waistbands one size larger than normal if using a wheelchair or need wheelchair assistance in dressing ~ Loose fitting T-shirts, sweat shirts or zipped hoodies long in length for comfort ~ Loose comfortable underwear, sports bras for women ~ Diabetic or Comfort Top Socks - long enough to pad the lower leg if splint required ~ Shoes lightweight shoes that fasten securely and have a good grip on the sole ~ Sleepwear 2 to 3 changes ~ Seasonally appropriate outdoor wear ~ Bring a minimum of 2 weeks of change in clothing - Laundry service is available but it takes time for the clean laundry to be returned to the unit Toiletries as required throughout admission - please write your name on all items. Glasses, hearing aides and dentures - please label them with your name. You can have this done by an optometrist, hearing aide company or dentist. Page 13 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 10

14 Rehabilitation equipment e.g. wheelchair, splints, brace, communication device Items to personalize your room - communication or entertainment devices (All electronic items must be CSA approved and will be checked by Hospital Maintenance). We recommend you LABEL all items for identification purposes. ~ Pictures, cards, quilt etc. ~ Watch ~ Stereo, CD player, ipods ~ Electronic games, computer ~ Television, DVD player and DVD s ~ Cell phone, Blackberry Approximately $ $ in spending money, which will be deposited at the Patient s Account Office (bank) RESPONSIBILITY WAIVER HJCBI does not assume responsibility for the replacement of, or reimbursement for, lost or damaged property. We recommend that you keep valuable items locked in the top drawer of your dresser. DO NOT BRING ~ Expensive jewelry/watches or items of sentimental value ~ Unsafe objects - straight razors, penknives, matches or lighters ~ Prescription medication, vitamins or supplements Medication Our medication policy states that a persons own medication will not be used during hospitalization and must be sent home. When that is not possible it will be sent to pharmacy for storage. Nurses are not allowed to administer or assist in administering non-prescription medication such as vitamins and supplements Patients interested in taking vitamins or supplements must receive approval from the physician Room Assignments Rooms are assigned based on patient need There are 16 beds on each unit, 8 private rooms and 4 semi-private There are times when patients are required to change rooms to accommodate the needs of new admissions or the changing needs of patient s (eg due to illness). We will try to minimize disruption and provide as much notice as possible if a move is required. Keys Unit doors are locked for safety reasons. A key is required to open the door to leave the unit Patients are assessed for safety and orientation prior to receiving their own key One family member can be provided with a key. There may be a charge for lost keys. Unit door keys also open the glass lounge (a quiet visiting area off the unit) A key can also be provided to lock the top drawer in the patient s room for safe keeping of small items All keys must be returned at time of discharge Page 11 Halvar Jonson Centre for Brain Injury Halvar Jonson Centre for Brain Injury Page 12

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