United States Department of Veterans Affairs
 Health Care
The Path to Rehabilitation is on Independence Way
woman and man in mini-mart
Polytrauma Speech Pathologist Megan Kelly runs Veteran Jamar through an exercise in the Independence Way mini-mart.

Feeling the weight of a carton of eggs in your hand is something you have probably never taken notice of before. Just as navigating the front steps to your house or remembering to take your receipt from the ATM give you little pause. Mastering these everyday skills takes practice for the rehabilitation patients on Independence Way.

Veterans come to the Washington DC VA Medical Center’s Polytrauma team with a wide range of ability levels. Some are regaining fine motor skills after a long-term illness or getting accustomed to a new prosthetic, and then there are Traumatic Brain Injury (TBI) survivors with symptoms from limited cognitive functioning to speech impediments.

Fortunately, the Independence Way program and the doctors and therapists that run it are flexible to meet the needs of all the Veterans passing down its artificial streets.

“The beautiful thing about rehab is that all the therapists are very creative,” said Heather Malecki, Polytrauma Coordinator. “The therapists have come up with a notebook of things they can do and they’re always adding to it. It’s much more engaging to the patient and the end result will be the same [as traditional therapy methods].”

That carefully replicated carton of eggs, for example, ensures that Veterans are capable of lifting a dozen eggs — not just an empty carton. Checking the nutritional information on a box of crackers keeps patients mindful of their healthy diet. Bringing everything to the cash register, patients then have to handle the payment transaction.

man at checkout counter
Jamar is a TBI rehabilitation patient at the Washington DC VA Medical Center.

Practicing these activities get rehabilitating patients one step closer to feeling comfortable and confident in a real mini-mart. For (OEF/OIF) Veteran Jamar, that means being able to accompany his grandmother to the grocery store again.

“I have to get on with my life,” he explained. “The hard part is leaving the house.”

Jamar is a TBI patient who has been participating in the Independence Way program for the past four months. Before, he was in individual rehab for almost two years.

“The timing was pretty perfect,” said Megan Kelly, M.S. CCC-SLP, a Polytrauma Speech Pathologist. “[Jamar] has just recently been doing tasks in Independence Way. We’ve been working a lot on his processing speed and being able to locate things in the grocery store. He’s been able to manipulate his wheelchair better too.

Compared to traditional therapy sessions, Kelly says it’s a lot more enjoyable for patients to practice real life activities in Independence Way.

The Washington DC VA Medical Center rehab team is eager to expand the mini-mart’s therapeutic potential by adding a sound system.

“Being able to focus in the midst of background noises is really difficult,” said Malecki. “We’re working on basic skills that would convert to a regular shopping experience.”

Going to the bank

The challenging visit to the mini-mart over, Kelly guides Jamar over to the ATM to withdraw some money.

It takes some maneuvering to get his motorized wheelchair close enough to the donated Diebold ATM, then Jamar is able to feed his card into the machine. The computer screen follows all of the typical prompts: PIN, deposit or withdrawal, which account do you want to withdraw from?

Things get a little complicated when Jamar, with a mischievous smile on his face, adds as many zeroes as he can to the withdrawal amount. His antics have Kelly laughing as she guides him through re-entering a smaller amount.

man at ATM
Jamar practices taking money out of an ATM on Independence Way.

“He’s got a heart of gold and everyday there’s some joke he says that really lights up everyone’s day,” Kelly said. “It makes therapy easier. He doesn’t take the activities so seriously.”

Next to the ATM is a Metrorail station with a system map and fare chart. Being able to travel on the Metro alone is Jamar’s long-term goal and something that Independence Way will be able to help him with.

“Many of our patients have challenges in the community,” said Dr. Joel Scholten, Associate Chief of Staff for Rehabilitation Services. “[Independence Way] gives us an opportunity to do some background training; it’s a nice intermediate step. We’re always trying to provide activities that will be effective and maximize independence out in the community.”

Being able to control the elements of the Independence Way program keeps things unique and fresh for patients who may have a very long road to recovery before them.

Related links:
  Physical Medicine & Rehabilitation