When a stroke occurs, blood flow to the brain is blocked, depriving the organ of needed oxygen. This can destroy brain cells, which in turn impairs brain function in a number of areas and each person who has a stroke may have slight to significant variation in what areas of function are affected and the degree of damage. Therefore, stroke rehabilitation is always highly individualized to the patient, but common areas of focus include improving movement, speech/language skills, thinking/reasoning skills, ability to perform daily activities, and issues like being able to swallow. People can expect to get help in any or all of these areas beginning in the rehabilitation hospital setting and continuing after discharge for possibly a few months to several years, and they may work with various specialists, including physical therapists, speech language therapists and occupational therapists.
In the hospital, doctors might do initial assessments of stroke damage to determine which stroke rehabilitation services are required, but first efforts are to make certain a patient is stable enough to begin therapy. Usually patients are transferred once they’re medically stable to a rehabilitation hospital, where they might stay for several more weeks while beginning therapy. Sometimes the rehabilitation hospital is connected to the hospital in which the patient received initial medical care, and other times it is a separate facility.
The reason for keeping the person hospitalized for the beginning part of stroke rehabilitation therapy is because it allows more intense therapeutic focus when it may be most critical. People can expect that the first goals once in rehabilitation are to draw up a treatment plan to address all areas that require retraining, relearning or support. Each person’s therapy plan will be different because of the different issues that a stroke can cause, and duration of stroke or oxygen deprivation of the brain can make each person’s degree of impairment more or less significant.
Once a plan is drawn up, people might work with physical therapists who can help them address any issues of movement impairment. Similarly, sometimes basic skills like being able to use the bathroom, writing with a pen, or others may be lost and a person may have to work hard to relearn these with an occupational therapist. Speech/language therapists are often on hand to help address damage to communication: either being able to use the spoken word, forgetting words, or being unable to pronounce language. These therapists may also work with patients who have impaired ability to swallow.
Another important aspect of this beginning stroke rehabilitation is educating family members on what to expect once a stroke victim returns home. Primary caretakers of those who had a stroke may be taught how to be most helpful and continue therapy lessons at home, and they may be counseled on what types of support the stroke victim will require in the home. They also are usually the ones with whom the rehabilitation center deals to coordinate continuing care.
After intensive in-hospital stroke rehabilitation therapy, patients may expect to return home but continue therapy, either in their homes, at a rehabilitation center in the community or at the hospital in which they stayed. This final option might be the best since it means working with the same specialists. As patients progress, therapy will continue to be assessed based on need and success. Once patients have recovered full function, which does not always happen, they may no longer require certain types of therapy and treatment plan will be adjusted accordingly.
