Rehabilitation for Stroke
What is rehabilitation?
Rehabilitation is the process of helping an individual achieve the highest level of independence and quality of life possible - physically, emotionally, socially, and spiritually. Rehabilitation does not reverse or undo the damage caused by a stroke, but rather helps restore the individual to optimal health, functioning, and well-being. Rehabilitate (from the Latin "habilitas") means "to make able again."
The stroke rehabilitation team:
The stroke rehabilitation team revolves around the patient and family. The team helps set short- and long-term treatment goals for recovery and is made up of many skilled professionals, including the following:
- physicians such as a neurologist (a physician who treats conditions of the nervous system such as stroke) and physiatrist (a physician who specializes in physical medicine and rehabilitation)
- internists and specialists
- critical care nurses
- rehabilitation nurses
- physical therapists
- occupational therapists
- speech and language pathologists
- dietitians
- social workers and chaplains
- psychologists, neuropsychologists, and psychiatrists
- case managers
The stroke rehabilitation program:
The outlook for stroke patients today is more hopeful than ever due to advances in both stroke treatment and rehabilitation. Stroke rehabilitation works best when the patient, family, and rehabilitation staff works together as a team. Family members must learn about impairments and disabilities caused by the stroke and how to help the patient achieve optimal function again.
Rehabilitation medicine is designed to meet each person's specific needs; thus, each program is different. Some general treatment components for stroke rehabilitation programs include the following:
- treating the basic disease and preventing complications
- treating the disability and improving function
- providing adaptive tools and altering the environment
- teaching the patient and family and helping them adapt to lifestyle changes
The success of stroke rehabilitation depends on many variables, including the following:
- the cause, location, and severity of stroke
- the type and degree of any impairments and disabilities from the stroke
- the overall health of the patient
- family and community support
Areas covered in stroke rehabilitation programs may include the following:
| Patient need: |
Example: |
| Self-care skills, including activities of daily living (ADLs) |
Feeding, grooming, bathing, dressing, toileting, and sexual functioning |
| Mobility skills |
Walking, transfers, and self-propelling a wheelchair |
| Communication skills |
Speech, writing, and alternative methods of communication |
| Cognitive skills |
Memory, concentration, judgment, problem solving, and organizational skills |
| Socialization skills |
Interacting with others at home and within the community |
| Vocational training |
Work-related skills |
| Pain management |
Medicines and alternative methods of managing pain |
| Psychological testing |
Identifying problems and solutions with thinking, behavioral, and emotional issues |
| Family support |
Assistance with adapting to life styles changes, financial concerns, and discharge planning |
| Education |
Patient and family education and training about stroke, medical care, and adaptive techniques |
Choosing a rehabilitation facility:
Rehabilitation services are provided in many different settings, including the following:
- acute care and rehabilitation hospitals
- subacute facilities
- long-term care facilities
- outpatient rehabilitation facilities
- home health agencies
When investigating rehabilitation facilities and services, some general questions to ask include the following:
- Does my insurance company have a preferred rehabilitation provider that I must use to qualify for payment of services?
- What is the cost and will my insurance company cover all or part of the cost?
- How far away is the facility and what is the family visiting policy?
- What are the admission criteria?
- What are the qualifications of the facility? Is the facility accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)?
- Has the facility handled treatment for this type of condition before?
- Is therapy scheduled every day? How many hours a day?
- What rehabilitation team members are available for treatment?
- What type of patient and family education and support is available?
- Is there a physician onsite 24 hours a day?
- How are emergencies handled?
- What type of discharge planning and assistance available?