The Many Benefits of Inpatient Rehabilitation for Stroke

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Encompass Health Rehabilitation Hospital of Harmarville

Posted on

Nov 28, 2018

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Pennsylvania - Greater Pittsburgh Area

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When a loved one suffers from a stroke, it is an unexpected and life changing event for everyone in the family. Stroke can cause paralysis or weakness on one side, visual/perceptual impairment, reduced coordination and balance, language and cognitive difficulty, bowel and bladder issues and swallowing difficulty, among many other issues.
Stroke impacts thinking, talking, and daily living skills. Luckily, stroke rehabilitation can help greatly improve a patients symptoms from a stroke and in many cases, even return them to their former independent lives. Valerie Bucek, MA CCC-SLP/L treats stroke patients regularly as a speech therapist for Encompass Health Rehabilitation Hospital and sees the positive effects rehabilitation has on these patients every day. It is important to have a treatment plan unique to the individual patient in order to address that patients specific needs and challenges while building on their strengths and preserved skills, says Bucek.No two patients are alike. Each person is affected by a stroke in different ways and every patient has their own goals and lifestyle. While there are a variety of settings where a stroke patient can receive rehabilitation services, such as a skilled nursing facility, Bucek says the inpatient route is often the most comprehensive. The benefits of inpatient rehabilitation for stroke over a skilled nursing facility include an interdisciplinary rehabilitation team led by a physiatrist, access to rehabilitation nursing specialists or CRRNs, more intense therapy sessions of at least 3 hours a day, five to seven days a week, and staff with specialized training certifications for stroke-specific treatments. The inpatient setting also includes access to a variety of rehabilitation technology that can greatly enhance traditional therapy to help improve grip, gate, swallowing, coordination and more. Furthermore, inpatient rehabilitation hospitals can be certified by the Joint Commission for rehabilitation programs such as stroke. In order to qualify for this rigorous designation, a hospitals program must follow evidence-based Clinical Practice guidelines, monitor specific performance measures to continuously improve the program and meet or exceed the Joint Commission Disease Specific Care standards.  Encompass Health Rehab Hospitals of  Harmarville and Sewickley are both Joint Commission certified. Patients and caregivers should look for this certification because it shows the commitment the hospital has to this specific patient population to provide exceptional care and services, says Bucek. 

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Springtime Nutrition: Fresh And Healthy Eating For Seniors

March is celebrated as National Nutrition Month, a period dedicated to emphasizing the importance of healthy eating and making nutritious food choices. For those caring for elderly family members, providing meals that are both nutritionally balanced and tailored to meet the unique dietary requirements of seniors is of utmost importance. As we observe this significant month, lets explore healthy habits and senior-friendly recipes designed to not only provide essential nourishment but also to please the palates of our older loved ones.Embracing Healthy Habits Seniors and CaregiversRecipe Ideas for Balanced MealsBreakfast: a nutritious start to the dayLunch: light and nourishing midday mealsDinner: comforting and wholesome evening fareSnack ideas for between mealsNutritional drinks for seniorsEmbracing Healthy Habits Seniors and CaregiversMaintaining a healthy lifestyle becomes increasingly important as we age. For seniors and their caregivers, adopting healthy habits can significantly enhance quality of life and overall well-being.  Here are some practical tips to help seniors start on the path to healthier living:Plan mealsTaking time each week to plan meals that cover all five food groups is essential. This not only ensures your loved one enjoys a nutritionally balanced diet but also makes grocery shopping more straightforward, as your meal plan doubles as an effective shopping list.Make informed choicesWhile shopping for groceries, pay close attention to the Nutrition Facts labels on food packaging. This step is key in choosing products that are higher in vitamins, minerals, and dietary fiber but lower in sodium, saturated fat, and added sugars, meeting the specific nutritional needs of seniors.Understand calorie labelingWhen dining out or ordering food, look for calorie information on menus. This can help you make healthier choices for your senior, enabling you to manage their calorie intake effectively, which is critical for maintaining their overall health.Monitor Intake and PortionsMonitoring how much and what your senior eats is vital in maintaining their health. Use the Nutrition Facts label as a guide to control portion sizes and calorie intake, ensuring they receive the nutrients they need without unnecessary excesses.Recipe Ideas for Balanced MealsBreakfast: a nutritious start to the dayBreakfast is often called the most important meal of the day, and for a good reason. It sets the tone for energy levels and nutritional intake. For seniors, starting the day with a meal thats both nutritious and easy to eat can help maintain energy levels, support cognitive function, and promote heart health. Our breakfast ideas focus on combining simple, wholesome ingredients like whole grains, lean proteins, and healthy fats to create meals that are both satisfying and senior-friendly.1. Creamy avocado and egg toastIngredients: Soft whole-grain bread, ripe avocado, poached or scrambled eggs, sprinkle of paprika.Benefits: Avocado offers a creamy texture loaded with healthy fats and fiber, ideal for senior digestion and heart health. Eggs contribute high-quality protein and choline, enhancing brain function. This combination on soft whole-grain bread provides a balanced, nutrient-rich start to the day thats also easy on the palate.Instructions: Begin by toasting the soft whole-grain bread to your desired level of crispness. Mash the ripe avocado in a bowl and spread it evenly on the toast. Prepare the eggs to your likingeither poached or scrambledand place them on top of the mashed avocado. Sprinkle a bit of paprika over the eggs for added flavor. This dish combines textures and nutrients beneficial for seniors, making breakfast both enjoyable and health-supportive.2. Berry and yogurt smoothieIngredients: Mixed berries (fresh or frozen), plain Greek yogurt, a splash of almond milk, and a teaspoon of honey for sweetness.Benefits: Berries are packed with antioxidants and vitamins, supporting immune health and providing natural sweetness. Greek yogurt is a fantastic source of protein and probiotics, aiding in digestion and bone health. The almond milk adds a smooth consistency and a dose of vitamin E, while honey brings natural sweetness and energy.Instructions: Combine the mixed berries, Greek yogurt, almond milk, and honey in a blender. Blend until smooth. If the smoothie is too thick, add a little more almond milk to reach your desired consistency. This smoothie is not only nutritious but also easy to consume, making it a perfect breakfast option for seniors who may have difficulty with solid food early in the morning.3. Oatmeal with bananas and cinnamonIngredients: Rolled oats, sliced bananas, cinnamon, and milk (or a milk alternative).Benefits: Oatmeal is a heart-healthy grain that provides a good source of fiber, aiding in digestion and keeping cholesterol levels in check. Bananas add natural sweetness and potassium, which is vital for maintaining healthy blood pressure levels. Cinnamon not only adds flavor but also has anti-inflammatory properties.Instructions: Cook the rolled oats in milk or a milk alternative according to package instructions until they are soft and creamy. Slice a banana and stir it into the cooked oatmeal. Sprinkle cinnamon on top for flavor. This warm and comforting meal is easy to prepare, gentle on the stomach, and packed with nutrients, making it an ideal breakfast for seniors.Lunch: light and nourishing midday mealsLunch offers an excellent opportunity to incorporate a variety of nutrients into a seniors diet, helping to sustain energy throughout the afternoon. Our lunch recipes are designed to be both light and nourishing, providing a balance of proteins, carbohydrates, and fats, along with essential vitamins and minerals. These meals are not only easy to prepare but also gentle on the digestive system, making them perfect for a midday boost.1. Smooth sweet potato soupIngredients: Roasted sweet potatoes blended into a smooth soup, low-sodium vegetable broth, a touch of cream for richness, and mild spices according to taste.Benefits: Sweet potatoes are a great source of beta-carotene, vitamins, and fiber. This soup is warming, easy to digest, and can be made creamy to suit different dietary needs.Instructions: Begin by roasting sweet potatoes in the oven until they are soft and tender. Once cooled, blend the sweet potatoes with low-sodium vegetable broth in a blender until smooth. Transfer the mixture to a pot, and heat over medium. Stir in a touch of cream for richness and add mild spices such as cinnamon, nutmeg, or ginger according to your taste preferences. Continue to heat the soup, stirring occasionally, until it is warm throughout. Serve the soup with a dollop of cream or a sprinkle of herbs on top for garnish.2. Chickpea salad sandwichIngredients: Canned chickpeas, mayonnaise or a healthier alternative like avocado, Dijon mustard, celery, red onion, salt, pepper, and whole-grain bread.Benefits: Chickpeas are a fantastic source of protein and fiber, contributing to muscle maintenance and digestive health. The addition of celery and red onion provides a crunch as well as essential vitamins and minerals. Using whole-grain bread adds another layer of fiber and nutrients, making this a balanced, nutritious lunch option.Instructions: Drain and rinse the chickpeas before mashing them in a bowl. Mix in mayonnaise (or mashed avocado for a healthier fat option), Dijon mustard, finely chopped celery, and red onion. Season with salt and pepper to taste. Spread the chickpea mixture onto slices of whole-grain bread and close to make a sandwich. This sandwich is not only nutritious but also soft and easy to chew, making it a senior-friendly lunch option.3. Tuna and white bean saladIngredients: Canned tuna (in water), canned white beans, olive oil, lemon juice, chopped parsley, salt, and pepper.Benefits: Tuna is a lean source of protein and provides omega-3 fatty acids, essential for heart and brain health. White beans are high in fiber and protein as well, supporting muscle health and digestion. Olive oil adds healthy fats, and lemon juice provides a boost of vitamin C.Instructions: Drain and flake the tuna into a bowl. Rinse and drain the white beans and add them to the tuna. Dress the mixture with olive oil and fresh lemon juice, then season with salt and pepper to taste. Fold in chopped parsley for a fresh flavor. Serve this salad on its own, over a bed of lettuce, or with whole-grain crackers for a crunchy texture. This salad is easy to prepare, nutritious, and provides a refreshing, light lunch option for seniors.Dinner: comforting and wholesome evening fareDinner is a time for relaxation and enjoyment, a moment to savor flavors and unwind. For seniors, its also an opportunity to ensure theyre receiving all the necessary nutrients to support their health through the night. Our dinner ideas focus on easy-to-digest foods that are rich in nutrients necessary for muscle maintenance, bone health, and good sleep. These comforting and wholesome recipes are designed to be the perfect end to the day, providing both nutrition and pleasure in every bite.1. Oven-baked chicken with soft vegetablesIngredients: Tender chicken breast, olive oil, and a variety of vegetables such as carrots, squash, and green beans, all baked to soft perfection.Benefits: Chicken provides lean protein, while the vegetables offer vitamins and minerals essential for senior health. Baking the ingredients together makes them softer and easier to chew.Instructions: To prepare Oven-Baked Chicken with Soft Vegetables, start by preheating your oven to 375F (190C). Toss tender chicken breasts and bite-sized pieces of your favorite vegetableslike carrots, squash, and green beanswith olive oil, salt, pepper, and optional herbs for flavor. Spread them in a single layer in a baking dish, ensuring vegetables are around the chicken for even cooking. Bake for about 25-30 minutes until the chicken is thoroughly cooked and the vegetables are tender. Let it rest for a few minutes before serving to ensure the chicken remains moist and flavorful. 2. Soft-cooked vegetable pastaIngredients: Whole-grain pasta, olive oil, garlic, a variety of vegetables (e.g., spinach, tomatoes, zucchini), grated Parmesan cheese, salt, and pepper.Benefits: Whole-grain pasta provides a good source of fiber, which is important for digestive health. The vegetables add vitamins and minerals, supporting overall well-being, while olive oil and Parmesan cheese offer healthy fats and calcium, respectively.Instructions: Start by cooking the pasta according to the package instructions until it is soft. In a large pan, heat olive oil over medium heat and saut garlic until fragrant. Add the chopped vegetables and cook until they are soft and tender. Mix the cooked vegetables with the drained pasta, and toss everything together with a bit of olive oil, salt, and pepper. Serve with a sprinkle of grated Parmesan cheese on top. This dish is not only nutritious but also easy to chew and swallow, making it a senior-friendly meal option.3. Quiche with spinach and mushroomsIngredients: Eggs, milk, grated cheese (such as cheddar or Gruyere), fresh spinach, mushrooms, a pre-made pie crust, salt, and pepper.Benefits: Eggs and milk provide high-quality protein and calcium, crucial for bone health. Spinach and mushrooms are excellent sources of vitamins and antioxidants, supporting immune health and providing dietary fiber for digestion.Instructions: Preheat your oven to 375F (190C). In a mixing bowl, beat the eggs and milk together, then stir in the grated cheese. Season with salt and pepper. Saut spinach and mushrooms in a pan until theyre soft and then spread them evenly over the bottom of the pie crust. Pour the egg mixture over the vegetables. Bake in the preheated oven for 35-40 minutes, until the quiche is set and the crust is golden brown. Let it cool for a few minutes before slicing and serving. This quiche is not only nutritious but also soft and easy to eat, making it a perfect dinner option for seniors.Snack ideas for between mealsKeeping hunger at bay between meals is crucial for maintaining energy levels and preventing overeating at meal times. Here are a couple of nutritious snack ideas for seniors, focusing on nutrition, ease of eating, and taste:Baked apple slices with cinnamon: Fiber-rich, naturally sweetened with a hint of cinnamon for flavor.Vegetable sticks with hummus: Crunchy vegetables with protein-packed hummus.Soft cheese and whole-grain crackers: Creamy cheese with fiber-rich crackers for a gentle crunch.Oatmeal and raisin cookies: Chewy cookies with fiber from oats and sweetness from raisins.Avocado chocolate mousse: Rich in healthy fats and antioxidants, sweetened naturally.Peach and cottage cheese bowl: Juicy peaches over protein-rich cottage cheese.Soft pearled barley salad with vegetables: Fiber-full barley with soft roasted veggies.Pumpkin seeds and cranberry trail mix: Magnesium-rich pumpkin seeds with sweet cranberries.Rice cake with ricotta and berries: Light rice cakes topped with creamy ricotta and fresh berries.Chia seed pudding: A pudding made from chia seeds, milk (or a milk alternative), and a touch of honey or maple syrup, optionally topped with soft fruits.Nutritional drinks for seniorsNutritional drinks can play a crucial role in the diet of seniors, especially for those who may find it challenging to meet their nutritional needs through solid foods alone. These beverages are designed to provide a concentrated source of vitamins, minerals, protein, and other nutrients essential for maintaining health and vitality in older adults. Heres a closer look at how nutritional drinks can benefit seniors and some options to consider incorporating into their daily regimen. Types of nutritional drinksComplete nutritional shakes: These are all-in-one solutions designed to meet a significant portion of a seniors daily nutritional requirements, including vitamins, minerals, protein, and dietary fiber.Protein shakes: Specifically formulated with high levels of protein, these shakes are beneficial for muscle maintenance and repair, especially important for seniors engaged in physical therapy or exercise programs.Homemade smoothies: Customizable and made with fresh ingredients, homemade smoothies can be tailored to meet specific nutritional needs or preferences, incorporating fruits, vegetables, yogurt, or protein powder.Meal replacement drinks: Intended to replace a meal, these drinks provide balanced nutrition with a specific calorie count and are often used for weight management or to ensure dietary needs are met when a meal isnt possible. Tips for choosing nutritional drinksCheck nutritional content: Look for drinks that offer a balance of nutrients, including protein, carbohydrates, fats, vitamins, and minerals, tailored to the specific health needs of the senior.Consider dietary restrictions: Choose drinks that comply with any dietary restrictions, such as low-sodium for heart health or gluten-free for those with celiac disease.Taste preferences: Since seniors will be more likely to consume drinks that taste good to them, consider taste preferences and potentially try out different flavors to find the most appealing options.Consult healthcare providers: Before adding nutritional drinks to a seniors diet, consult with a healthcare provider or a dietitian to ensure theyre appropriate for their health status and nutritional needs.Celebrating National Nutrition Month by preparing senior-friendly recipes is a wonderful way to show love and care for the elderly in our lives. These recipes not only meet their nutritional needs but also provide the comfort and joy that come from a delicious meal. As family caregivers, our role in nurturing through nutrition is a testament to our dedication and affection for our elderly loved ones. Lets make this month a memorable one by exploring new recipes and creating healthy, tasty meals together. 

Signs & Risk Factors for a Stroke

This May is American Stroke Month, a multi-agency effort that seeks to provide the public with more information about one of Americas most common adverse health events. Each year, nearly 800,000 people suffer a stroke, leading to 140,000 deaths. This makes it the leading cause of death in America, and a major cause of serious disability, according to the Centers for Disease Control.Luckily, a stroke is often preventable and treatable. Thats why it is crucial to know the risk factors and warning signs. Stroke StatisticsThough strokes can affect people of all ages, they are most commonly seen in those over 65. According to the Stoke Awareness Foundation, the risk of stroke doubles each decade after an adult turns 55.While treatable, the adverse health effects of a stroke can be debilitating, sometimes affecting survivors for the rest of their lives. Of the 7 million stroke survivors in the United States, more than two-thirds suffer from some sort of disability as a result of the stroke, the Stroke Awareness Foundation reports.According to the University of Maryland Medical Center, strokes are more common in men, but more deadly in women. Additionally, strokes are more common, and more deadly, in African American adults, regardless of age. Stroke Risk FactorsWhen thinking of adverse health events related to the cardiovascular system, most adults tend to think of heart attacks. But this isnt the only adverse event that can come from poor cardiovascular health, as heart health is one of the leading factors when it comes to stroke risk.According to Johns Hopkins, high blood pressure, heart disease, diabetes, smoking and high cholesterol are all risk factors for stroke. Additionally, other risk factors include age, race, gender and genetics.These risk factors mean that maintaining heart health is key to avoiding stroke. This means that adults should exercise regularly, refrain from smoking or excessive drinking, consume heart-healthy foods and regularly check in with their healthcare provider to assess cardiovascular health. Signs of a StrokeAccording to the American Stroke Association, more than 1.9 million brain cells die every minute that a stroke goes untreated. Thus, getting treatment is critical to lowering the risk of an adverse outcome. And to get treatment, one must understand the signs and symptoms of a stroke.Several health agencies have made this easier through their usage of an acronym FAST. Its meaning is as follows:F Face droopingA Arm weaknessS Speech difficulty (such as slurring)T Time to call 911 Additionally, men and women can sometimes have slightly different symptoms of a stroke. Signs of stroke in women include feeling weak, disoriented, fatigued and nauseous, in addition to vomiting. A stroke is a serious medical condition, one that can lead to poor health outcomes in both the short term and long term. Therefore, it is crucial to understand the factors behind a stroke and the symptoms of stroke.By knowing the symptoms of a stroke, you can take action quickly, and improve the chances of a positive health outcome.

Get to Know the Outreach Team at Pennsylvania Relay

Pennsylvania (PA) Relay is a free public service that provides telecommunication solutions to citizens who are deaf, hard of hearing, DeafBlind, or who have difficulty speaking. With support from PA Relay, these individuals can place and receive calls through assistive services and technology. PA Relay has a team of outreach coordinators who visit various communities throughout the state to bring more awareness to this valuable service. Outreach coordinators connect with potential PA Relay users, their loved ones, and community members and inform them about the available solutions that could help them, or someone they know, communicate more efficiently and effectively.  PA Relays outreach coordinators Jenny Pearson and Thadeus Graham took some time to answer important questions about the free public service and their roles on the outreach team to help people understand how they can benefit from PA Relay services and the educational opportunities available through the outreach program. Keep reading to get to know your outreach coordinators!What are the responsibilities of your role as an outreach coordinator?Jenny: As an outreach coordinator, my main focus is educating Pennsylvania residents and businesses about the services provided by PA Relay and how those services work. Its my pleasure to travel throughout the state educating people about PA Relays services and how businesses and organizations can benefit from using PA Relay to connect with potential clients who use accessible telecommunications to conduct business. To do this, the outreach team exhibits at community events, gives educational presentations to local organizations, and provides training to businesses and organizations.   Thadeus: I educate people about PA Relay as well as assist people in gaining access to the free public service. As an outreach coordinator my role is to both assist our relay users as well as introduce people who could benefit from the service to PA Relay. I answer questions, help with equipment installations, provide a point of contact for our users, host presentations, or attend expos and health fairs to make sure everyone is aware of the services that are available to them.  How can PA Relays services help people stay connected, and how do you help people learn more about these specific services?Jenny: In presenting this information at public and private events, the outreach team can inform people on how these services work and why they are important for accessibility and facilitation of communication for people of all abilities.   Thadeus: PA Relays services help people stay connected by returning independence and autonomy to our users. It empowers people who are deaf, DeafBlind, hard of hearing, or who have speech differences to connect to standard telephone users directly through their adaptive equipment. I help people learn about these services through a variety of methods.  What kind of events do you attend as an outreach coordinator?Jenny: Some types of events the outreach team attends could be health fairs, senior expos, state and local fairs, church groups, chamber of commerce events, conferences, and virtual presentations.   Thadeus: I will attend any event that will have me and that will have a meaningful impact for my fellow Pennsylvania residents. I attend health fairs, senior expos, and host presentations at local organizations. I also work with community leaders to schedule town hall events or even host awareness nights at local sporting events. Ive met with PA Relay users in their homes to help them with their adaptive equipment on a more personal level.  What has been one of your favorite events that youve attended as an outreach coordinator? What made it so memorable?Jenny: I have been an outreach coordinator for six years and have experienced so many amazing events and interactions. Some of my favorite events involve educating seniors and their caregivers about PA Relay and how we can help maintain connections between those who use traditional telephone services and those who use relay services. Hearing loss is a common experience among those who are aging, and to be able to provide these folks with a solution like Voice Carry-Over or Captioned Telephone is incredibly rewarding, especially when they share their experiences with me. Thadeus: My first ever presentation will always be etched into my mind. It was a cold December morning just north of Philadelphia. I had just presented to a group of seniors about PA Relay. After the presentation I helped a few of them download and set up the Hamilton Mobile CapTel App on their phones. The joy they had calling each other and using their new adaptive technology made me realize how much of a difference this can truly make for people. I was hooked on wanting to help as many people as possible after that day.Do you offer educational presentations about PA Relay to local organizations?Jenny: Yes, we do! We provide presentations throughout the state, both in person and virtually. Some of the types of organizations we educate are service providers, health professionals, retirement communities, Deaf and Hard of Hearing support groups and organizations, local businesses and agencies, sporting groups, and church gatherings. All of our presentations are always no cost and can be scheduled at the organizations convenience.   Topics discussed during our presentations are general information about PA Relay, types of services provided and how they work, and how to use the service. The topics can certainly be customized based on the organization. For example, a group may be interested in services for those who are living with hearing loss, so we can tailor our presentation to address those specific services.Thadeus: PA Relay offers a variety of training as well as educational preparations to any interested organization across the Commonwealth. We can also provide training to organizations on how to properly handle relay calls. The Relay Friendly Business Training helps organizations identify relay calls and trains staff on how to properly handle these types of calls.During these presentations we discuss everything from the history of relay services to the different types of services. We discuss PA Captioned Telephone Relay Service and how to acquire adaptive equipment either through the states equipment distribution program, TechOWL, or other means. The topics and timeframe can be customized to meet the needs of the organization.  Is there anything else about your role as an outreach coordinator that youd like people to know?Jenny: As an outreach coordinator, the most important thing I do is connect people to resources they can use to make life a bit easier. Often, I present information to people who do not need PA Relays services, but they know someone who does. When this happens, its so rewarding to hear how they will share what theyve learned from me with those who really need assistance making and receiving calls. This ensures that connections remain strong, and people are able to live life as independently as possible.   Thadeus: The biggest thing I would like people to know is just how life-changing these services are. Even if youre not someone who could use PA Relay, its likely that someone you know could greatly benefit from the service.  How can an interested individual or organization reach you?Jenny: To learn more about PA Relay, feel free to email me at Jenny.Pearson@HamiltonRelay.com or call 610-737-7205! Thadeus: The best way to get in touch would be by emailing Thadeus.Graham@HamiltonRelay.com, or I am available by phone at 412-944-7424.  FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. Advanced speech recognition software is used to process calls, and, in certain circumstances, a live communications assistant may be included on the call. There is a cost for each minute of captions generated, paid from a federally administered fund. To learn more, visit fcc.gov. Third-party charges may apply: the Hamilton CapTel phone requires high-speed internet access (Wi-Fi capable) and in some cases, may require telephone service. When using Hamilton CapTel on a smartphone or tablet and not on Wi-Fi, a data plan is required. Hamilton CapTel may be used to make 911 calls but may not function the same as traditional 911 services. For more information about the benefits and limitations of Hamilton CapTel and Emergency 911 calling, visit HamiltonCapTel.com/911. Third-party trademarks mentioned are the property of their respective owners.

Local Services By This Author

Encompass Health Rehabilitation Hospital of Harmarville

Rehabilitation Hospitals 303 Guys Run Rd, Pittsburgh, Pennsylvania, 15238