T10 – L1 Levels Expected Functional Outcomes Equipment Respiratory Bowel Independent • Elevated or standard padded toilet seat Bladder Independent Bed Mobility Independent • Full to king standard bed Transfers Independent • May need transfer board Pressure relief Independent W/C pressure-relief cushion Postural support devices as indicated Pressure-relief mattress or overlay may be indicated Eating Independent Dressing Independent Grooming Independent
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T10 – L1 LevelsExpected Functional OutcomesEquipment Respiratory BowelIndependent Elevated or standard padded toilet seat BladderIndependent Bed MobilityIndependent.
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Acute care unit (hospital) 25 days – 1974 18 days – 2004
Rehab unit 115 days – 1974 39 days – 2004
Lifetime Costs
Severity of Injury First Year
Each Subsequent Year
25 years old 50 years old
High Tetraplegia (C1-C4)
$741,425 $132,807 $2,924,513 $1,721,677
Low Tetraplegia (C5-C8)
$478,782 $54,400 $1,653,607 $1,047,189
Paraplegia $270,913 $27,568 $977,142 $666,473
Incomplete Motor Functional at Any Level
$218,504 $15,313 $561,827 $472,392
Average Yearly Expenses(in May 2006 dollars)
Estimated Lifetime Costs ByAge at Injury
Life Expectancy
Age at Injury
No SCI Para Low Tetra (C5-C8) High Tetra (C1-C4) Ventilator Dependent
20 58.4 46.3 41.7 37.9 23.3
40 39.5 28.6 24.7 21.6 11.1
60 22.2 13.5 10.8 8.8 3.1
Life Expectancy (years) post-injury by severity and age(for persons surviving at least 1 year after injury)
Social Aspects of SCI
Quality of social support has a positive relationship with adjustment & enhancing independent functioning
Psychological counseling for coping and adjustment
Patients can have difficulty maintaining relationships with friends they had before their injury Embarrassed feel their friends’ discomfort let friendships “drift away”
Socially isolated
Psychological counseling for coping and adjustment
Family effects: loss of personal space & time Financial concerns Loss of spontaneity Worry about the present & future Family member role changes/role confusion Patient’s anger - often directed at loved ones
Vocation 64% employed at time of injury
(if between 16 – 59 years old) Post-injury employment increases with time
0
10
20
30
40
50
1 2 5 10 15 20 25
paraplegia tetraplegia% Patients
Year Post-injury
Vocation
Predictors of postinjury employment: Younger age Greater functional capability
(paraplegia > tetraplegia) Able to drive Greater elapsed time since injury Physical intensity of preinjury
occupation/secondary gain considerations Social support Internal locus of control
Vocation Job assessment (VR counselor or OT)
Functional assessment Work environment/physical factors Job tasks Production needs/expectations Adaptive equipment State/community agencies, support groups,
state/county employment programs
Vocation Benefits
Economical Quality of life
Self esteem Self identity Life satisfaction/well being Psychological adjustment to disability
Pre-existing medical conditions Concomitant injuries Secondary complications Cognitive impairment (pre-existing or injury-related) Age Body type Psychological factors Social factors Availability of financial resources Cultural factors