Rehab Without Walls® was founded over 30 years ago as an alternative to traditional neurological rehabilitation programs. This unique service is delivered where patients need it most; in their own surroundings. Rehab Without Walls is focused on providing patients with the functional skills necessary to participate in practical daily activities at home, school, work or in the community where they live.
A Whole New Kind of Care
Rehab Without Walls is dedicated to removing walls — including physical, emotional and geographical — that can slow recovery. The advantage of this comprehensive service is that a skilled clinical team, which can include physical therapists, occupational therapists, recreational therapists, speech pathologists, clinical social workers, nutritionists and neuropsychologists, is able to teach relevant skills in the patient's environment as opposed to a staged setting. Instead of just learning to prepare a meal, patients learn to shop in their local grocery store and use their own kitchen. Rather than simply focusing on grooming skills, patients learn to navigate their own bathrooms, safely.
The ultimate goal of Rehab Without Walls is to provide care in a comfortable, familiar environment, help patients experience better outcomes. Our home & community based expertise reduces re-admissions, increases participation and provides tangible proven clincial and financial results.
We maintain the largest post-acute home & community database in the U.S. at over 8,000 patients, which we use as both a predictor and measure of postive clinical and financial outcomes. We have 6 peer reviewed and medical journal published research articles based on our findings. We have TRUE outcomes driven, verifiable data.
How Rehab Without Walls Works
Our expert team will create a customized treatment plan based on the physician's orders and the patient's goals. For example, if a patient wants to play the piano again, that will become part of the rehabilitation routine. When patients have a realistic goal — like returning to a beloved pastime or going back to work — rehabilitation becomes real.
- Traumatic Brain Injury
- Spinal Cord Injury
- Cerebrovascular Accident (Stroke)
- Central Nervous System Tumors
- Complex Orthopedic Trauma
- Post-Concussion Syndrome
The Rehab Without Walls® Approach to Stroke Treatment
The Rehab Without Walls® Difference
As a company focused on durable, functional outcomes, Rehab Without Walls® is uniquely suited for working with clients who have sustained a stroke. And because stroke can occur in people of all ages—not just the elderly, as the stereotype would have you believe—our approach is particularly beneficial in returning younger clients with families to raise, households to run, and careers to pursue to productive and fulfilling lives. What we bring to each case includes:
The Home and Community Setting
Rehab Without Walls® performs rehabilitation wherever life occurs—in the home, at the workplace, in schools or within the client’s own community. This concept, which serves as the foundation of our approach to care, comes from the belief that clients learn better and can better maintain gains in their own environment. This results in more durable outcomes, fewer re-hospitalizations and a fuller return to independence. For example, often following stroke individuals must learn to walk again. What do you think will serve them better—practicing in an artificial setting, such as a hospital corridor or outpatient gym, or learning in the environment that they will eventually return to and have to live in again? Navigating their gravel driveway, bumpy lawn, uneven front steps, rug- and furniture-filled home from the start ensures that they will be able to function effectively in their own lives. It also eliminates the barriers that clients who had therapy in other settings face when returning home, as well as saves time and money if subsequent retraining is required.
A Team Approach
Our interdisciplinary clinical treatment teams are comprised of all the specialties of the rehabilitation spectrum. Team members can work one-on-one with clients. However, Rehab Without Walls® also offers the added advantage of co-treatments to ensure the most comprehensive treatment possible. This allows us to treat the client as a whole and address cognitive and physical components at the same time. “Coordinated knowledge is key,” says Susan Matthews, physical therapist at the Sacramento location. “When we work closely as a team, we can ensure that fewer things fall through the cracks and that we can reinforce each other’s’ work. Often I’ll do co-treats with the OT or speech therapist. For example, if we are taking a client out in the community for a walk, the OT will help the client focus on pathfinding and comprehension while I’ll focus on gait and balance.”
A Strong Neuropsychology Component
Rehab Without Walls® provides comprehensive neuropsychological testing to assess cognitive, behavioral, and emotional strengths and weaknesses. Based on the evaluation results, the neuropsychologist assists with the development and implementation of a cognitive remediation plan and provides education on the cognitive, emotional and behavioral sequelae of stroke. “Helping the client adjust psychologically to the impairments and changes following a stroke, while often overlooked in more traditional approaches to rehabilitation, is one of the hallmarks of Rehab Without Walls®,” says Susanne Griffin, Psy.D., at the Phoenix location. “Frequently clients experience anxiety and depression which, if left undiagnosed and untreated, can interfere with rehabilitation. Neuropsychologists can address these issues upfront, give clients tools to understand and manage their emotions, and help them transition to their new reality.”
High Intensity and Low Intensity
The Rehab Without Walls® approach to stroke is flexible to accommodate diverse rehabilitation needs physical, cognitive, emotional, behavioral, communicative) and at just the right level of intensity. For example, if needed, the treatment can parallel what is offered in an acute, inpatient rehabilitation setting. Our clinical expertise and the number of treatment hours per week we can provide clients— as many as 18 to 30 hours a week of therapy, with longer treatment days and possible weekend availability—brings an intensity to treatment that was once not available in the home. Not only does this mean that clients can have shorter hospital stays—which translates to significant cost savings—but that they can begin comprehensive treatment sooner. This allows us to maximize limited insurance benefits and help clients attain long-term goals faster. In contrast, when needed, Rehab Without Walls® also can deliver a diverse range of rehabilitation services at a low level of intensity, again achieving clinical efficacy and cost efficiency.
An Emphasis on Functional Goals.
We’ve learned from experience that once a client has had a stroke, he or she wants only one thing: to get their life back. Yet often, clients have difficulty understanding how they will get from A to Z. Our emphasis on functional goals not only breaks down treatment into Our emphasis on functional goals not only breaks down treatment into manageable steps, but it also makes therapy purposeful and meaningful, manageable steps, but it also makes therapy purposeful and meaningful. For example, say a client who needs to rebuild his strength once spent his spare time tinkering in his garage workshop. We might plan his therapy around cleaning the garage. The goal may always have been to lift 10 pound weights. Whether he lifts weights in an exercise program or with paint cans in the garage makes no difference to his body. Both give the same result. But if the client is doing something with relevance to his life, motivation increases. This, in turn, affects compliance, as well as helps clients return to their lives more quickly.
“It takes more creativity on our part to make therapy relevant,” says Matthews, “but time and time again we’ve seen how the payoff is greater for the client.” The ability to help clients transition from hospital to home. Following a stroke, clients may be discharged from the hospital once they are medically stable. Often, however, they may be too weak to begin outpatient rehabilitation, may require 24-hour supervision and may not understand the implications of their disability on their daily lives. Bringing Rehab Without Walls® in at this time can jumpstart recovery and prevent further deterioration of the client’s health.
“This is a critical stage in the rehabilitation process, especially from a safety perspective” says Matthews. “Also, it is important to keep the client moving forward, otherwise weakness or bad habits may set it, which will only lengthen the treatment time later. We also can go into the house ahead of time, make a safety assessment, do some teaching with the family and support people, and help make sure the client is appropriately prepared to begin treatment.”
A focus on family education. Like all catastrophic illnesses and injuries, stroke has a ripple effect on the client’s family. The family dynamic may have changed. There may be worries if the main breadwinner is unable to work. Expectations for recovery may not be in line with reality. “These kinds of changes are challenging for clients and their families,” notes Dr. Griffin. “We educate the client and family members, and help them develop the coping resources and compensatory strategies to adjust to their new reality. The health of the family and the health of the client are so interconnected that both need to be a part of the treatment process.”
According to the American Heart Association*, about 700,000 people nationwide sustain a stroke annually—a statistic that translates into a stroke occurring every 45 seconds. In 2006 alone, this resulted in a staggering $58 billion in medical costs. Clearly, it is imperative that we find ways to reduce the incidence of stroke, control costs and return those who sustained impairments as a result of stroke back to their productive lives. And while Rehab Without Walls® can do little about prevention, it can address the latter—cost reduction and functional rehabilitation—in innovative and effective ways that can make a real difference for the people we serve.
Who We Are
While all of our team members are focused and dedicated, there are many who go above and beyond the requirements of their jobs by serving on boards, advocating in the community, participating in professional organizations, connecting with other leaders in the field and gaining additional professional certifications. To them, it means that their profession is more than just a job, it’s a way of life. To us, this means our workforce is second to none when it comes to activism, advocacy and staying current in the profession. And to our clients, it quite simply means the world.
Southern California Rehab Without Walls®
Kim Gully, Executive Director
Chairman of the Medical Speech-Language Pathology Council of California, which is an organization made up of over 500 medical speech pathologists with the purpose of providing affordable continuing education to medical SLPs . She also became a newly certified Certified Brain Injury Specialist Trainer (CBIST), along with the following staffers: Jeno Oehler, RN, Clinical Coordinator; Norma Caloca, Clinical Coordinator; Dina Shorey, TR, DCM; and Beverly Workmon, OT, DCM.
Phoenix Rehab Without Walls® Day Treatment
Lana Susskind-Wilder, PhD. D., Neuropsychologist
Vice President and Event Coordinator for Western States Karate Championship Association charity tournament, with proceeds benefiting Cystic Fibrosis Foundation of Arizona.
Karen Schwarz, OT/L
Works with the Brain Injury Association of Arizona Camp Can Do survivors camp and serves as volunteer therapist to assist campers as needed in ADLs and all activities.
Diane Hendrix, MA, Clinical Coordinator
Works with The American Heart Association—coordinates Rehab Without Walls® Team participation in the annual Heart/Stroke Walk each February. The team of walkers includes RWW staff and family members, persons served and their family members, as well as past stroke survivors who return annually to participate in this fundraising event.
The monthly Rehab Without Walls® Spanish Support Group
This group is for Spanish-speaking individuals with brain and spinal cord injuries and their family members. Diane created and facilitates this group; there is no other TBI/SCI support group for Spanish speakers in the state.
Maribeth Hirte, Speech-Language Pathologist
Coordinator of Arizona Rehab Without Walls® Committee for Community Involvement (CCI). She facilitates staff involvement in events, nominates persons served for community recognition, and serves as Coordinator for Rehab Without Walls® ’ annual Farmer’s Market fundraiser for the Brain Injury Association of Arizona and Arizona Spinal Cord Injury Association’s survivor camps. Participates in the walk for Southwest Autism Research Center each year.
National RWW Leadership
Shannon Swick, MA, LLP and Paul Folkert, MBA have had the opportunity over the last 10 years to be amongst the leadership at RWW. The following is a portion of the projects they commit their time to on behalf of all TBI, ABI, SCI, CVA communitites across the country:
Past & Present Chairs, Boards, Committees, Projects
- ACBIS, National BIAA Professional Council, National BIAA, Outcomes Chair, Analytics Chair, Marketing Chair, Professional College, publications, Political Activisim raising awareness and funds for; awareness, education, research, political change in healthcare policy coverage of neurorehabilitation.
While we work on change that can be slow at a national level, the REAL change comes with every single patient & family our teams serve face to face. Where it matters most, in the patient's own home and own community.