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:
Doctors, such as a neurologist (a doctor who treats conditions of the nervous system such as stroke) and physiatrist (a doctor who specializes in physical medicine and rehabilitation)
Other specialty doctors
Critical care nurses
Speech and language pathologists
Social workers and chaplains
Psychologists, neuropsychologists, and psychiatrists
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
According to the National Institute of Neurological Disorders and Stroke, in general, there are five types of disabilities that stroke can cause: paralysis or problems controlling movement, such as walking or balance and/or swallowing; sensory (ability to feel touch, pain, temperature, or position) disturbances; difficulty using or understanding language; thinking and memory problems, and emotional disturbances. Stroke rehabilitation can help you recover from the effects of stroke, relearn skills, and develop new ways to perform tasks. The type and extent of rehabilitation goals depend 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:
Self-care skills, including activities of daily living (ADLs)
Feeding, grooming, bathing, dressing, toileting, and sexual functioning
Walking, transfers, and self-propelling in a wheelchair
Speech, writing, and alternative methods of communication
Memory, concentration, judgment, problem solving, and organizational skills
Interacting with others at home and within the community
Medicines and alternative methods of managing pain
Identifying problems and solutions with thinking, behavioral, and emotional issues
Assistance with adapting to life styles changes, financial concerns, and discharge planning
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
Long-term care facilities
Outpatient rehabilitation facilities
In the home by 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?
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 doctor on site 24 hours a day?
How are emergencies handled?
What type of discharge planning and assistance is available?