Programs

Amputee Rehabilitation Program

 
Please note: Max Gomez went to our Outpatient Division for his rehab.

Amputee Rehabilitation Program Description

The goal of Burke's Amputee Rehabilitation Program is to speed your healing, restore your confidence and provide you with the skills to return home and live as independently as possible after an amputation.

Burke's two-phase program begins immediately following surgery. The first phase focuses on pain control, healing, emotional support and preparing the limb for prosthesis. A prosthetist—a professional who assesses, designs, measures, fabricates and fits various types of upper and lower extremity prostheses—is available at Burke through the program. The prosthetist may be involved in the second phase, the education and training regarding the use, care and function of the prosthesis. Phase two can be done in an inpatient or outpatient setting depending on the patient's level of function.

Within a safe, secure and structured environment, Burke offers intensive therapy seven days a week. Your schedule will be determined by your individual needs and goals. As a patient in any of Burke's inpatient programs, you will receive a minimum of 3 hours of therapy a day, 5 days per week, generally Monday through Friday, and additional therapy on Saturday and/or Sunday for at least 1.5-2 hours. Skilled therapy will be provided in a combination of physical therapy and occupational therapy and/or speech therapy as needed.  Rehabilitation nursing and access to a physician are available 24 hours a day, seven days a week.

 

Scope of Services
The Amputee Team is committed to ensuring that each individual patient’s needs are addressed by:

  • Providing rehabilitation through an interdisciplinary approach that emphasizes communication, collaboration and cooperation
  • Lessening limitations of activities by focusing on the individual’s capabilities and utilizing compensatory strategies and devices
  • Providing the highest quality, patient-focused rehabilitation
  • Removing or lessening restrictions to participation in life situations to the fullest extent possible
  • Providing counseling to the individual and family and/or caregiver on alternative possibilities for life participation when necessary
  • Preparing the individual, family and/or caregiver to make the transition to the next stage of the rehabilitation process

Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training.

The Amputee Program serves patient populations from adolescence through geriatric. Over the past two years, the ages for the persons served has ranged from 26 to 91. Diagnoses of patients served include Above Knee Amputations (bilateral and unilateral), Below Knee Amputations (bilateral and unilateral), and Toe Amputations.

In 2016 and 2017, the amputee team served 41 patients ranging in age from 26 to 91 years old. Our patients were discharged to the following settings:

  • 61% (25) of the patients returned home with outpatient or home care services.
  • 29% (12) of the patients continued therapy at a sub-acute rehabilitation or skilled nursing facility.
  • 10% (4) of the patients returned to the acute care hospital.
  • 0% of the patients entered a long term care facility.

At the time of discharge, the patient is provided with a summary of all recommendations for continued care and follow-up services including, but not limited, to therapy services, assistance required, medical appointments, summary of applications for transportation or parking permits, etc.

Within the scope of the amputee program, patient evaluation and care planning are designed around traditional medical disablement models. These models assess three levels of dysfunction which stem from the patient’s admitting diagnosis (pathology). 

Impairments: Weakening, damage, or deterioration of function within a specific component of the musculoskeletal system, especially as a result of injury or disease.

Examples: Decreases in strength, active range of motion, passive range of motion, cognition, balance, and/or activity tolerance along with increases in pain and/or edema. 

Activity Limitations: The inability to perform a specific task as a consequence of the impairments mentioned above. 

Examples: Difficulty with ambulation, stair negotiation, dressing, grooming or self-care.

Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles. 

Examples:  Inability to perform duties as a parent, caregiver, employee or participant in social and leisure activities

Team Description
Under the direction of Karen Pechman, M.D., a specialist in physical medicine and rehabilitation, the professionals on your interdisciplinary care team will assess your medical and rehabilitation needs and work with you to establish your individual goals. In close collaboration, the team designs and implements your treatment program. Throughout your treatment, the entire team meets formally once per week to discuss your progress. Family members and caregivers are encouraged to attend and participate in treatment sessions and patient care as appropriate.The philosophy of the Amputee Program is that the program’s mission can best be accomplished by providing rehabilitative care through an interdisciplinary team approach.

The team consists of the following:

  • Individual with an amputation
  • Individual’s family and/or caregiver(s)
  • Physician
  • Rehabilitation Nursing
  • Occupational Therapy
  • Physical Therapy
  • Recreation Therapy
  • Social Work/Case Management
  • Nutrition

 Additional services available to meet the needs of each individual patient include:

  • Orthotic/Prosthetic Services
  • Medical consultations (Podiatry, Urology, Plastics, ENT, Dermatology, etc.)
  • Pastoral Care
  • Pharmacy
  • Psychiatry
  • Radiology
  • Laboratory Services
  • Complimentary Therapy
  • Wheelchair seating/positioning
  • Peer support

From admission through the discharge planning process, team members work collaboratively with each other, the individual with amputee diagnoses and the family and/or caregiver(s) to ensure that the specific needs of each individual are addressed. Patient and family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.

Based on the results of the initial assessment, goals are determined with the individual and/or family, and a treatment plan is implemented. The individual’s progress is discussed formally once per week at team conference/medical rounds. Team consultation and collaboration occur throughout the treatment program. In addition to speaking directly with members of the team regarding the patient’s medical condition, progress, functional status, participation in therapy, achievement of established goals, family members and/or caregivers are strongly encouraged to attend and participate in treatment sessions and patient care as appropriate.

Patient and Family/Caregiver Education
Ongoing patient and family/caregiver education is the first priority for all of Burke's programs. Each interaction with therapy and social work should serve as educational, and additional education classes and materials may be provided. In order to maximize the benefit, education will be diagnosis-specific with a focus on functional independence, adherence to precautions, progress and well-being. Dependent upon need, individual sessions may be dedicated to family training, during which a therapist will train family members in the appropriate provision of care and assistance for mobility, self care or exercise performance.  

Diagnostically exclusive educational classes will be held for all patients. These sessions will be used to provide educational materials, encourage group discussion and group problem solving and serve as support sessions. In addition, there is a monthly support group that meets on campus for amputees.  

Admission Criteria
Every potential patient who may benefit from our care is discussed with the screening staff, physician, and/or program director. The rehabilitation potential for every patient is evaluated prior to admission. In 2017, 28 patients were admitted to the Amputee Program.

Screening Process
Referrals to Burke are usually made by physicians, social workers, discharge planners or case managers. A reasonable medical and functional profile must be provided and appropriate sections of the medical record from the acute care process are included. A rehabilitation nurse may also perform a detailed evaluation at the referring institution. Recommendations are then made to the appropriate member of the medical staff who renders a final decision with regard to admission.

Discharge Planning
The discharge planning process begins when the patient is first admitted to the program. The social worker/case manager leads the planning process, coordinating information from all members of the interdisciplinary team and acting as the primary liaison between the team and the patient and family. Based on the individual’s functional status for self-care, mobility and other daily life skills, family/caregiver support, medical needs, pre-morbid living situation and level of function, and available health insurance, the team, in collaboration with the patient and family, makes recommendations for the most appropriate and suitable discharge plan for the patient. At the team or family’s request, a meeting with the team and patient/family is scheduled to discuss available discharge options. The patient’s and family’s preferences are of primary concern and the team will make recommendations for a safe discharge when options for continued care and rehabilitation are considered. 

Recommendations may include, but are not limited to:

  • Home with home care services
  • Home with outpatient services
  • Sub-acute rehabilitation services
  • Long term care services
  • Hospice services

Financial Information
For information regarding fees and insurance, please click here.

Location
Located in White Plains, New York, Burke Rehabilitation Hospital's Amputee Rehabilitation Program attracts amputation patients from Westchester County, New York City, Long Island, Northern New Jersey, and Connecticut. Burke also welcomes amputees from across the country and around the world.

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What Our Amputee Rehabilitation Patients Are Saying

Read about the experiences of former amputee rehab patients.

Ray Calore