UNION HOSPITAL SERVICES

Medical Rehabilitation Center

Program Manager/Social Worker

At Union Hospital Medical Rehabilitation, we believe that the people we serve, our patients and their families, hold the key to successful outcomes. Your participation and active support of the rehabilitation process will help to guarantee success.

Upon admission, you will meet/talk with the Program Manager/Social Worker. This person will assist you in becoming oriented to your program and guide you in becoming an active member of the team. To help ensure the most positive outcomes, it is important that you discuss your progress in the program and any needs, concerns or expectations you may have about your return home. The Program Manager/Social Worker will actively participate in conferences to communicate your needs, preferences or concerns to other team members.

The Program Manager/Social Worker will arrange an interview with you and/or your family to obtain background information important to the team in planning a treatment program and discharge planning. The Program Manager/Social Worker will

• encourage you and your family to participate in conferences and the patient/family education program.
• ask that your family arrange to work with you in therapy and on the patient care unit.
• find meeting information on various support groups if requested by you or your family.
• assist with obtaining information about Social Security benefits, vocational rehabilitation services or other financial information.
• give information on health care resources such as home health care, outpatient therapy, assisted living and skilled and/or extended care facilities.
  

The Program Manager/Social Worker will contact you and/or your family to arrange a time to discuss team conferences, if needed. Some of the information that is discussed in those conferences includes:

• therapy evaluations,
• goals for therapy,
• tentative discharge dates,
• strengths and barriers to meeting goals, and
• needs related to returning to your home and community.

If you and/or your family would like to schedule a formal meeting with the team to discuss concerns and expectations for discharge, please ask the Program Manager/Social Worker. The team might also want to meet with you and/or your family. We encourage you, the primary caregivers and/or the primary support person to attend these meetings. You can help make the conferences meaningful by preparing in advance to discuss such topics as:

• activities you enjoyed prior to hospitalization,
• activities or functions needed to go home again,
• your thoughts and ideas concerning needs at discharge and what routines may need to be modified to successfully get you home, and
• the use of services in the home, equipment needed and possible modification to your home to make it more accessible for you and/or your family.