Stroke Rehabilitation

Locations for stroke rehabilitation vary depending on the needs of the stroke survivor. Rehabilitation may occur within the hospital, in a skilled nursing facility or through careful home management. In cases where the damage from a stroke is severe, rehabilitation may not be effective. In such cases, family members and the stroke survivor may have to choose between home management and the use of a nursing facility.

Inpatient Hospital Facilities

Inpatient rehabilitation facilities are available to patients while they are hospitalized. A hospitalized patient can access a wide range of therapists while receiving 24-hour medical care. Inpatient stroke rehabilitation usually lasts two to three weeks. Rehabilitation is usually scheduled for at least three hours a day, five to six days a week, and is designed to get the maximum benefit out of the available time.

Outpatient Services

Outpatient services may be accessed in combination with home management. Instead of staying at the hospital during stroke rehabilitation, stroke survivors visit outpatient facilities throughout the week (usually three days a week). Hospital therapists continue to offer quality stroke rehabilitation through outpatient clinics, but outpatient stroke rehabilitation is less intensive than inpatient care.

Nursing Facilities: Traditional or Rehabilitation?

Severe disability may require temporary, or even permanent, placement in nursing facilities. Traditional nursing facilities concentrate on residential care and often lack specialized stroke rehabilitation therapists. Specialized rehabilitation facilities offer a range of therapists, although the presence of a specific type of therapist may differ from one nursing facility to the next.

Nursing facilities vary widely in price, rehabilitation services, therapist availability, and quality of care. It is important to check the credentials of several nursing facilities when full-time care is being considered.

Assisted Living Nursing Facilities

Assisted living nursing facilities allow stroke survivors to maintain as much independence as possible in an environment that provides residential care and sometimes rehabilitation. Like traditional nursing facilities, assisted living centers vary in quality, therapist availability, and overall services.

Home Management of Stroke Rehabilitation

Home management of stroke rehabilitation is possible if the stroke survivor has minimal disability, a supportive family, or both. The goals of home management are to maintain rehabilitation benefits, continue stroke rehabilitation at home, and allow the stroke survivor maximum independence. It is often possible for a therapist to provide rehabilitation in the home.

Home Management Techniques: Grab Bars, Walkers, and Safety

Home management requires implementing strategies to maximize independence and provide a safe environment for stroke rehabilitation. The bathroom is a danger zone for people with physical disabilities. Installing grab bars around the toilet and bath make it easier for a patient to maneuver safely. Replacing the bathtub with a specialized nonskid tub or shower stall is another option to consider.

As part of home care of a stroke patient, furniture and other obstacles should be rearranged for safety and convenience. If necessary, grab bars can be installed in other areas of the house, such as the kitchen or bedroom. Grab bars in hallways should also be considered, as these aids may make it easier for the patient to walk, or rest, when necessary.

The simple act of dressing oneself can be extremely frustrating for stroke victims with weakness or paralysis. Home management of stroke may include replacing catches, zippers, and buttons with Velcro to make dressing easier. All of these devices help make independent living possible for stroke survivors.

Resources

Anderson, C., Rubenach, S., Mhurchu, C.N., Clark, M., Spencer, C., Winsor, A. (2000, May). Home or hospital for stroke rehabilitation? Results of a randomized controlled trial. Stroke, 31(5), 1024-1031. Retrieved February 18, 2004, from stroke.ahajournals.org/cgi/content/full/31/5/1024.

Chest, Heart, and Stroke Scotland. (2003). Stroke: A guide to your rehabilitation. Retrieved February 18, 2004, from www.chss.org.uk/pdf/publications/stroke/Stroke_a_guide_to_rehabilitation.pdf.

National Institute of Neurological Diseases and Stroke. (2003). Post-stroke rehabilitation fact sheet. Retrieved February 19, 2004, from www.ninds.nih.gov/health_and_medical/pubs/poststrokerehab.htm.

Pollack, M.