Rehabilitation
for Stroke
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 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
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 |
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?
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