CARE AND SERVICES PROVIDED
Amputations and severe orthopedic injuries
Amputations and severe orthopedic injuries
Within the framework of the Amputation and severe orthopedic injury program, the Institut de réadaptation Gingras-Lindsay-de-Montréal (IRGLM) provides specialized rehabilitation services:
The program was allocated 31 permanent beds (4 of which are for severe orthopedic injuries).
➢ Clientele
Within the Amputation and severe orthopedic injuries program, the IRGLM provides services to a clientele essentially from the Montreal area.
The Institut has also been given the mandate to provide services to upper limb amputees from all of Quebec. It can also provide services, upon request, to a clientele from other regions who present with a lower limb amputation associated with complex conditions (hip disarticulation, other related lesions, difficulties with appliances and devices, etc.).
➢ Objectives
Rehabilitation objectives are:
➢ Approaches and techniques
The rehabilitation process at the IRGLM is based on four principles.
The client-centred approach
The client-centred (or personalized) approach is the foundation of the IRGLM's rehabilitation process. The client and his significant others are active members of the rehabilitation team, ensuring the smooth provision of the adaptation / rehabilitation process.
Interdisciplinary approach
The daily interventions of the clinicians are concerted, complementary and global.
Many activities designed to promote rehabilitation objectives are offered:
These activities require the integrated action and contribution of all health care professionals. The same is required from the client and his significant others.
Intensive functional rehabilitation can be organized in different ways for the clients of the program:
• Rehabilitation without a prosthesis
If the wearing of a prosthesis is not possible, the client will follow a rehabilitation program designed to increase his level of independence-- eventually with the use of a wheelchair -- and improve his quality of life.
• Rehabilitation with a prosthesis
If wearing a prosthesis is considered, the team will recommend the best equipment in terms of ruggedness, performance, comfort, safety and appearance.
Prosthetics and orthotics are made by the Technical aids services whose expertise is unique and well known for complex cases such as upper limb amputations, double amputations or sports prosthetics.
It is crucial that the patient be at his best in order to receive the prosthesis. The amputated limb must be prepared and the physical and psychological conditions of the patient must be optimized.
• Follow-up
Following rehabilitation, a follow-up is done to validate the maintenance of the acquired assets as well as to identify eventual needs, evaluate client satisfaction and, as needed, fine tune certain learned skills.
An environmentally-friendly approach
Clinicians prefer an environmentally-friendly approach. This approach encourages imitation as closely as possible of the client's own home environment of clients. Evaluations and treatments are done both at the IRGLM and in the client's familiar or significant environment.
An educational approach
The objectives of the educational approach are to promote, generalize and consolidate the learning experiences acquired through therapy at the IRGLM and in the home.
➢ The team
The team is under the supervision of a program manager, an assistant and a head of medical services. Coordination is ensured by an assistant to the supervisor in the case of nursing and by a clinical coordinator. The team is composed of various health care professionals and physicians, depending on the needs of each clinet, such as:
The program team works closely with the Technical aids services, in particular, the orthotics / prosthetics mechanics and technicians.
Other interveners can be added to the team according to patient needs – a speech therapist, sexologist or medical specialists.
The team can also depend on the services of a remedial teacher from the Commission scolaire de Montréal, as well as on the contribution of our faithful volunteers.
All interveners work closely together. They maintain their professional proficiency through the use of best practices and by getting involved in research projects.
➢ Partners
➢ Causes for admission
Amputations, in particular, those resulting from:
- To adults presenting with one or more upper and / or lower limb amputations;
- To persons presenting with hip disarticulations (hemipelvectomy);
- To persons presenting with severe orthopedic injuries.
The program was allocated 31 permanent beds (4 of which are for severe orthopedic injuries).
➢ Clientele
Within the Amputation and severe orthopedic injuries program, the IRGLM provides services to a clientele essentially from the Montreal area.
The Institut has also been given the mandate to provide services to upper limb amputees from all of Quebec. It can also provide services, upon request, to a clientele from other regions who present with a lower limb amputation associated with complex conditions (hip disarticulation, other related lesions, difficulties with appliances and devices, etc.).
➢ Objectives
Rehabilitation objectives are:
- the development of capabilities that will allow a return to life habits and social roles;
- the knowledge and mastery of those elements, essential to the new life conditions of the client;
- the development of independence, with or without a prosthesis;
- the adjustment of the client and his significant others to the new situation;
- the adaptation of the environment;
- the safe return to the home environment.
➢ Approaches and techniques
The rehabilitation process at the IRGLM is based on four principles.
The client-centred approach
The client-centred (or personalized) approach is the foundation of the IRGLM's rehabilitation process. The client and his significant others are active members of the rehabilitation team, ensuring the smooth provision of the adaptation / rehabilitation process.
Interdisciplinary approach
The daily interventions of the clinicians are concerted, complementary and global.
Many activities designed to promote rehabilitation objectives are offered:
- daily life activities in a clinical and life settings;
- individual, spousal and family support activities;
- exercise programs;
- pain management;
- educational and training programs;
- integration outings and weekends at home prior to discharge;
These activities require the integrated action and contribution of all health care professionals. The same is required from the client and his significant others.
Intensive functional rehabilitation can be organized in different ways for the clients of the program:
• Rehabilitation without a prosthesis
If the wearing of a prosthesis is not possible, the client will follow a rehabilitation program designed to increase his level of independence-- eventually with the use of a wheelchair -- and improve his quality of life.
• Rehabilitation with a prosthesis
If wearing a prosthesis is considered, the team will recommend the best equipment in terms of ruggedness, performance, comfort, safety and appearance.
Prosthetics and orthotics are made by the Technical aids services whose expertise is unique and well known for complex cases such as upper limb amputations, double amputations or sports prosthetics.
It is crucial that the patient be at his best in order to receive the prosthesis. The amputated limb must be prepared and the physical and psychological conditions of the patient must be optimized.
• Follow-up
Following rehabilitation, a follow-up is done to validate the maintenance of the acquired assets as well as to identify eventual needs, evaluate client satisfaction and, as needed, fine tune certain learned skills.
An environmentally-friendly approach
Clinicians prefer an environmentally-friendly approach. This approach encourages imitation as closely as possible of the client's own home environment of clients. Evaluations and treatments are done both at the IRGLM and in the client's familiar or significant environment.
An educational approach
The objectives of the educational approach are to promote, generalize and consolidate the learning experiences acquired through therapy at the IRGLM and in the home.
➢ The team
The team is under the supervision of a program manager, an assistant and a head of medical services. Coordination is ensured by an assistant to the supervisor in the case of nursing and by a clinical coordinator. The team is composed of various health care professionals and physicians, depending on the needs of each clinet, such as:
- occupational therapist;
- pharmacian;
- physiotherapist;
- psychologist;
- ocial worker;
- nurse;
- nursing assistant;
- neuropsychologist;
- nutritionist;
- general practitioner;
- beneficiary attendant;
- occupational therapy / physiotherapy attendants;
- physiatrist;
- leisure technician.
The program team works closely with the Technical aids services, in particular, the orthotics / prosthetics mechanics and technicians.
Other interveners can be added to the team according to patient needs – a speech therapist, sexologist or medical specialists.
The team can also depend on the services of a remedial teacher from the Commission scolaire de Montréal, as well as on the contribution of our faithful volunteers.
All interveners work closely together. They maintain their professional proficiency through the use of best practices and by getting involved in research projects.
➢ Partners
- The Association québécoise des intervenants auprès des personnes amputées (AQIPA): it implements actions designed to improve the quality of care provided to amputees by, among other things, promoting complementary and continuous development programs for interveners;
- The Amputee Coalition of Canada (ACC): provides many activities among which the Peer Visitor program for new clients. The program provides support, comfort care, information, as well as the opportunity to interact with a specially trained peer who has lived through the same type of experience;
- The Société de l’assurance automobile du Québec (SAAQ);The Commission de la santé et de la sécurité du travail (CSST);
- The Indemnisation des victimes d’actes criminelles (IVAC).
➢ Causes for admission
Amputations, in particular, those resulting from:
- vascular problems (over 60% of cases);
- trauma;
- tumours.
- trauma.