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Stroke rehabilitation: What to expect as you recover
Where does stroke rehabilitation take place?
You'll probably begin stroke rehabilitation while you're still in the hospital. Before you leave, you and your family work with hospital social workers and your care team to determine the best rehabilitation setting for you depending on your needs, what insurance will cover, and what is most convenient for you and your family. These options include:
- Inpatient rehabilitation units. These facilities are either free-standing or part of a larger hospital or clinic. You may stay at the facility for several weeks as part of an intensive rehabilitation program.
- Outpatient units. These facilities are often part of a hospital or clinic. You may spend several hours a day at the unit relearning skills, but you return home each night.
- Nursing facilities. The type of care available at a nursing facility — sometimes referred to as a nursing home — varies widely. Some facilities specialize in rehabilitation, while others offer less intense therapy options.
- Home-based programs. This type of program — having therapy done in your home — allows greater flexibility than other options. One drawback is you likely won't have access to specialized rehabilitation equipment in your home. In addition, insurance strictly controls who qualifies for home-based therapy.
Talk to your doctor and family about the best option for you.
Who participates in your stroke rehabilitation team?
Stroke rehabilitation involves a variety of specialists, which include:
- Physicians range from your primary care doctor to specialists in physical medicine and rehabilitation (physiatrists) to neurologists. They help guide your care and prevent complications. They can also offer symptom-modifying medications and treatment options for managing bowel and bladder complications of stroke.
- Rehabilitation nurses specialize in caring for those with disabilities. They help incorporate skills learned in physical, occupational and speech therapy into your daily routines.
- Physical therapists help you relearn physical tasks, such as walking and keeping your balance.
- Occupational therapists work with you to relearn daily skills, such as bathing, tying your shoes or buttoning your shirt. They can also address safety issues in your home by suggesting changes or proper home equipment.
- Speech and language pathologists help improve your language skills and ability to swallow. They may also teach you how to use recovery tools to address memory and thinking problems.
- Social workers help you make financial decisions, as well as help you arrange new living arrangements if necessary.
- Psychologists work to ensure that your mental and emotional health concerns are addressed.
- Therapeutic recreation specialists help you relearn skills needed to do hobbies or other activities you enjoyed before your stroke.
- Vocational counselors help you address return-to-work issues if this is a goal.
What factors affect the outcome of stroke rehabilitation?
Because stroke recovery varies so widely from person to person, it's hard to predict how many abilities you might recover and how soon. However, in general, successful stroke rehabilitation depends on:
- The amount of damage to your brain
- The skill of your stroke rehabilitation team
- Cooperation of your friends and family — having a good support network has a big effect on your recovery
- Timing of your rehabilitation — the sooner you start, the better you'll do
Stroke rehabilitation takes time
Recovering from a stroke can be a long and — at times — frustrating experience. The difficulties you face are normal. Dedication and willingness to work toward improvement will help you gain the most benefit.
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- Post-stroke rehabilitation fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/stroke/poststrokerehab.htm. Accessed March 24, 2009.
- Ropper AH, et al. Cerebrovascular diseases. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2005. http://www.accessmedicine.com/content.aspx?aID=973845. Accessed March 24, 2009.
- Stroke rehabilitation. American Stroke Association. http://www.strokeassociation.org/presenter.jhtml?identifier=4713. Accessed March 24, 2009.
- Duncan P, et al. Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke. 2005;36:e100.
