LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

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Other diagnostic techniques s Computer tomography and magnetic resonance tomography: Christ, MD, Professor, Division of Radiology, Sana Hospital Gerresheim s Magnetic resonance tomography: U. Mödder, MD, Professor, Institute of Radiology, s University Hospital Düsseldorf s Positron Emission Tomography: K. Zilles, MD, Professor, and A. Bauer, MD, Professor, Jülich Research Centre s Sonography of the blood vessels supplying the brain as well as electromyography and electroneurography examinations are conducted at the Neurology Division of the LVR-Klinikum Düsseldorf. Therapy Units Medical Director: W, Gaebel, MD, Professor of Psychiatry and Psychotherapy Electroconvulsive therapy and repetitive transcranial magnet stimulation therapy Electroconvulsive therapy is provided at the LVR- Klinikum Düsseldorf in cooperation with the Institute for Anaesthesiology (B. Pannen, MD, Professor) of the University Hospital Düsseldorf. It is also possible to apply the innovative method of repetitive transcranial magnetic stimulation therapy. Consultation services of other specialists The LVR-Klinikum Düsseldorf is responsible for providing psychiatric advice to the Sana Hospital Gerresheim and the University Hospital Düsseldorf. Conversely, patients who receive treatment in psychiatry and psychosomatic medicine at the LVR-Klinikum Düsseldorf can also attend regular consultation hours held by board-certified specialists in internal medicine, dentistry, ophthalmology und gynaecology. Board-certified specialists of the University Hospital Düsseldorf from any other field can be readily consulted at any time. Physiotherapy, exercise therapy and kinesitherapy Physiotherapy Therapists: H. Gerrits, J. Zukowski The hospital uses a range of physiotherapy techniques. Physical education is used as an additional form of treatment for patients who require physiotherapeutic activity and a gradual improvement of their physical condition. Heat therapy is performed by applying infrared radiation, mainly before HealtHcare massages, to help the individual relax and to improve blood circulation. Fango packs also assist relaxation and may, for example, be applied before subjecting persons suffering from a hardening of the muscles – often one of the concomitant problems of depression – to an otherwise inevitably painful massage. Classic massage techniques are designed to reduce increased muscle tone and release tensions. Partial and full body massages can, for example, be applied to loosen and relax hardened muscles. Manual lymphatic drainage (MLD; also a decongestive therapy) is applied if excessive amounts of liquid have accumulated in the tissue in order to ensure or accelerate the flow of the lymphatic fluid through the lymph vessels. Lymphatic drainage serves to avoid complications that may arise as a consequence of oedema in the tissue. MLD is also used as pain relief to reduce the pressure on tissue and nerves. Exercise therapy Director: C. Luckhaus The starting point is the patient’s current movement pattern. Objectives of exercise therapy may include: s Improve communication and interactive skills s Enable the patients to better express themselves s Increase, improve and maintain their levels of overall competence s Improve self-awareness s Increase confidence and self-esteem s Teach strategies of coping with everyday challenges s Improve general well-being s Improve physical condition Exercise therapy uses elements from the Feldenkrais method, eutony, yoga, tai chi, Jacobson’s progressive muscle relaxation, concentrative exercise therapy, breathing therapy, dance therapy, chi gong, therapy of movement, stamina training and the so-called small and big games. Ergotherapy Director: Dipl.-Psych. W. Höhl Ergotherapy is a collective term for a wide range of therapeutic methods and techniques, many of which are used at the LVR-Klinikum. One particular feature of ergotherapy is the use of therapeutic tools such as design techniques – which, in turn, use different materials (clay, textiles, peddig tubes, etc.) – as well as routine everyday activities. It is crucial, however, that these tools are used with a clear purpose, which is derived from the indication 51
lVr-KlINIKUM DÜSSelDOrF – HOSPItal OF tHe HeINrIcH-HeINe UNIVerSItY DÜSSelDOrF – this is what distinguishes ergotherapy from simply doing handicrafts. The treatment aims to restore, improve or compensate for skills and functions the individual has completely or partially lost as a consequence of his illness. Nearly all units of the hospital provide such ergotherapy treatment. On top of that, occupational therapy sessions are also on offer. In contrast to the ergotherapy courses, however, occupational therapy is organised on a centralised basis for the entire hospital. Roughly one third of the approximately 25 ergotherapists work in this area. Occupational therapists instruct patients in how to complete specific tasks to achieve certain therapeutic objectives. The hospital operates five occupational therapy areas: wood, office, gardening, housekeeping and industry. Patients from different departments and units of the hospital jointly use these therapy courses, which are provided in designated central therapy facilities. Between 100 and 150 people per month are treated in this way. The occupational therapy unit also features a small number of places with day care. This programme allows patients to receive uninterrupted treatment before they return to their jobs or start a rehabilitation programme. During the past four years, about 70 day care patients per year attended these courses for an average duration of approximately five months. On top of that, a new option of “outpatient ergotherapy” was added in 2005. This new offer allows people to continue their ergotherapy treatment as outpatients after they have been discharged from the hospital. People who have had no previous contact with our hospital can also join the outpatient ergotherapy courses. One key difference to the day care occupational therapy is the wide use of all therapy tools of psychiatric ergotherapy – such as creative design and cognitive training – in addition to activities of work in the narrower sense of the word. Whereas day care occupational therapy courses are generally scheduled every day (and are also designed to occupy much of the day and structure it), outpatient ergotherapy is provided in a remedial function (much in the way of speech therapy and physiotherapy) for no more than two consecutive hours once or twice a week. Outpatient ergotherapy courses are attended by about fifteen people a month. We still have very little reliable information about the effects of occupational therapy and ergotherapy. Bachelor and other degree theses – to be written by young scientists from the unit – are about to address this deficit. 52 Creative therapy Director: F. Mecklenbeck The term “creative therapy” describes different forms of therapy, all of which encourage the patients to express themselves artistically. The LVR-Klinikum Düsseldorf offers courses in art therapy, creative social therapy, music therapy and dance therapy. In all of these courses, communication is always conducted in the language of the medium. Creative therapy is activity and experience centred. People express themselves through an activity, which is associated with an intense experience. Both therapist and patient are emotionally involved. The change takes place without taking a detour via the spoken word. Verbal reflections, however, are part of the therapy, creating another dimension for the patients in which they can question their behaviour through cognitive insights and develop new forms of conduct. Each creative therapy is characterised by different methods, techniques and objectives that may be applied depending on the individual patient’s illness and the therapist’s strategies. Creative therapy is a target-oriented form of treatment which may be used as a diagnostic tool and to achieve indicationbased, precisely defined treatment objectives. Both individual and group sessions are possible. This type of therapy is generally suitable for all patients with emotional, social, cognitive and psychomotor problems. Creative therapies are offered by all departments and divisions of the LVR- Klinikum Düsseldorf. The hospital has been certified as a teaching institution for music therapy in Germany, Austria and Switzerland, as a teaching institution for creative therapy in the Netherlands, and – as the only one among all similar institutions in Germany – as a “Clinical Training Facility” by the American Music Therapy Association. All creative therapy facilities at the Klinikum have dedicated and well-equipped therapy rooms. Publications Mecklenbeck F (2001): Musiktherapie in den Rheinischen Kliniken Düsseldorf. In: Mit allen Sinnen, video/DVD 54 Min., LVR Cologne/ Medienzentrum Düsseldorf Pirkl U (2001): Tanztherapie in den Rheinischen Kliniken Düsseldorf. In: Mit allen Sinnen, video/DVD 54 Min., LVR Cologne/Medienzentrum Düsseldorf
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2005 Baumann AE, Richter K, Belevsk
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115-121 Wölwer W, Gaebel W (2006):
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