Continuity of services in SCI Centres for East and West Quebec
Following an accident that affects the spinal cord, a person is immediately taken to the nearest hospital, then stabilized and directed to an SCI Centre. They will start by being treated for trauma, and will end on the path towards rehabilitation, before returning to the community. This process manifests itself in the four phases of rehabilitation.
Phase I rehabilitation immediately follows the accident. This is the moment where the injured person, whose spine was affected, is taken to the Trauma unit at the Sacré-Cœur Hospital in Montreal or at the Enfant-Jesus Hospital in Quebec. The medical team must initially stabilize the condition of the person and do everything possible to ensure that the consequences of the trauma are as minimal as possible. A preliminary diagnosis may be announced immediately following the SCI, but generally it will be completed during Phase II, when experts can better determine the severity of the injury.
Phase II is characterized by an intensive period of rehabilitation at the Gingras-Lindsay Institute of Montreal or at the Institut de réadaptation en déficience physique de Québec. Some objectives of this phase include learning how to transfer and working on strength and balance with a physiotherapist, and learning about the different tools and options available for returning home with an occupational therapist. The person with the SCI is supported by a multidisciplinary team of specialists such as occupational therapist, physical therapist, physiatrist, social worker, psychologist, sexologist, urologist, etc. The length of stay varies depending on several factors that differ from person to person.
With the objectives of Phase II met, the patient will either go back in the community or they will be admitted to Phase III centre for further rehabilitation. At this stage, it often happens that the achievements of Phase II of the rehabilitation are still fragile. The patient must rebuild his self-esteem and maximize his or her potential. They must also learn to function in daily activities. These are the main objectives of Phase III rehabilitation. At this critical stage the patient often has to face his new reality and we note the intensification of the grieving process. This process can take several years, well beyond their stay at the rehabilitation centre, as the limitations of their spinal cord injury become evident in their everyday lives.
The health system has its limitations. Sometimes when the patient leaves the rehabilitation network and returns to their regular environment, it doesn’t necessarily mean that all their needs are met. At this stage we can realize obvious problems that will confront some patients who have received the continuum of services through the rehabilitation network. For many, the process will be very well in place and they can finish their grieving process, and therefore be able to realize a new life with new projects, both personal and professional. For others, the situation can be much more complicated. Difficulties in returning to the regular living environment and physical health problems can increase the frustrations inherent to their new reality of being disabled.
Role of social integration services at MEMO-Qc
MEMO-Qc provides support services for the rehabilitation and social integration, and throughout all of the phases of rehabilitation. It goes without saying that professional services and psychological support are essential to withstand the test of trauma and better equip the new spinal cord injured patient in their reintegration.