SummaryFalls are the major cause of spinal cord injuries in older people. The pattern of injury seen most frequently is that of a central cord syndrome due to cervical hy perextension. The medical records of 58 patients over 50 years of age who sustained a spinal cord injury in a fall were reviewed for circumstances of onset, length of stay and outcomes of rehabilitation.The study identified elderly single or widowed men, and those who use alcohol, as high risk groups.
This article describes how the Education for All Handicapped Children Act of 1975, Public Law 94-142, assists in achieving the rehabilitation goal of school reintegration for spinal cord injured (SCI) adolescents. It also describes how subordinate goals are achieved during the inpatient rehabilitation phase. Comments from a survey of 13 SCI adolescents who returned to school demonstrate the need to prepare SCI adolescents for the services to which they are entitled, to acquaint them with ways of resolving possible problems they may encounter, and, when they return for follow-up care, to encourage them to continue in school.
Most spinal cord injured (SCI) patients are discharged to their homes and families after they complete their initial rehabilitation program. Nursing homes, however, were the discharge destinations for 3.9% of all SCI patients nationally. When a nursing home is the only discharge option for a young SCI adult, certain economic, medical and psychosocial incongruencies make this placement poten tially stressful for both the nursing home staff and the young patient. This study of the rehospitalization of 12 SCI patients under the age of 50 who were discharged to nursing homes explores the issues of cost, care and outcome during their first year following nursing home admission. Nine of the 12 patients were rehospitalized a total of 21 times, mainly for urinary tract infections and decubiti. Charges for 18 of these 21 rehospitalizations amounted to over $423, 110 for 599 days of care. Four of these 9 patients died before the end of the first year. Although this is a retrospective study of the medical records and follow up data for a small key group of SCI patients, it calls attention to the need for continued investigation into the outcomes of a minimally visible population that lacks advocacy for change.
SummaryThe problem of teenage spinal cord injury (SCI) secondary to gunshot wounds was observed in a model SCI system. By identifying one factor, 'risk taking', in which the system could intervene, a SCI prevention program was developed that has had major community attention. Hopefully, it will also meet the needs of other communities experiencing interpersonal violence among adolescents.
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