What rehabilitation therapies are available for stroke?
Rehabilitation often consists of three main therapies which are physical, occupational, and speech therapy. Physical therapy helps a patient with balance, standing, walking, transitional movements and regaining strength. Occupational therapy helps a stroke victim regain their ability to perform activities of daily living (ADLs) such as feeding, grooming, bathing, toileting, and dressing. Occupational therapists also work to improve overall arm function and fine motor skills so survivors are able to perform their ADLs. Speech therapy focuses on improving speech, swallowing and cognitive deficits. For more information about the specific types of exercises provided during therapy, please visit the stroke rehab exercises page.
Which type of rehab facilities are best?There are several types of facilities that offer stroke rehab. Initially, a patient will be in an acute hospital and may receive a few days of therapy while there. Once discharged from the hospital, one will have to decide what type of facility is best for them. Rehab options may include inpatient rehabilitation hospital, skilled nursing facility (SNF), long term acute care hospital (LTAC), home health, and outpatient rehab.
If a patient is having serious medical issues and needs extended medical care, they may be referred to a long term acute care hospital or LTAC. A LTAC specializes in caring for patients with serious medical problems. If a physician recommends a LTAC then the patient is not ready to transfer to other types of rehab facilities because these facilities will not be equipped to handle the serious medical issues that need to be addressed.
If a patient has poor endurance and cannot tolerate three or more hours of therapy each day, they may be referred to a skilled nursing facility (SNF). Fewer hours of therapy are offered at SNFs compared to outpatient and inpatient rehabilitation units. This may be an excellent choice for patients who have endurance issues.
The patient that has fair to good endurance but has moderate to severe physical and/or cognitive deficits will most likely be referred to an inpatient rehabilitation hospital. Patients stay in this type of facility usually for 2 to 3 weeks and participate in an intensive program of rehabilitation involving 3 hours of active therapy a day, 5-7 days a week. Inpatient rehab facilities offer a wide range of medical services, including physician supervision and therapists specializing in stroke rehabilitation.
The stroke patient with fewer physical and/or cognitive deficits may be referred to home health or outpatient rehabilitation. Home health is best for patients who are homebound and unable to travel to an outpatient facility. The therapy regimen at home may be intensive or less demanding depending on the stroke survivor's needs. Stroke therapy at an outpatient facility will involve traveling to the facility 2-3 days each week and taking part in hourly sessions with the physical therapist, occupational therapist or speech therapist as needed then returning home.
What questions should be asked when looking for a rehabilitation facility and therapist?When searching for rehab facilities or therapists, there are some important questions you will want to ask. These include:
1) How many stroke patients does the facility admit on average?
2) How many patients is each therapist assigned?
3) How long have the therapists who will be assigned to you been working and how much stroke experience do they have?
4) Does the facility have information on patient satisfaction surveys?
5) What type of equipment does the facility have for stroke rehabilitation?
6) Is the facility covered by my insurance plan?
The reason why these questions are important is that you want to make sure the facility and therapists are experienced in working with stroke victims, the therapist to patient ratio is adequate, the facility has sufficient rehabilitation equipment, and other patients have been satisfied with the stroke rehab. You have a right to choose your rehabilitation facility, and doing some homework ahead of time can prevent headaches later.
Where can one find a hospital, rehab facility or nursing home?
In the US, the government has a website where you can look up and compare hospitals. It can be found at: www.hospitalcompare.hhs.gov. They also have a website to find and compare nursing homes which can be found at: www.medicare.gov/NHCompare.
When looking for rehabilitation hospitals or outpatient rehab clinics, your physician or social worker should be able to guide you in finding local facilities. Some rehab facilities will have special accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF). These facilities will likely offer quality rehabilitation, however, there are many good rehabilitation hospitals who do not have this accreditation.
Where can one find out information about a therapist?
You can contact your state's therapy licensing board to verify a therapist's license. You can also look for or rate therapists on AllTherapist.com