About Rehab

One of the first things we learned was that everyone is affected differently by stroke and that not everyone will recover completely. The purpose of Rehabilitation is to recover as much as possible AND to learn to manage (activities of daily living) with the level of recovery that is achieved.

Ideally stroke rehabilitation will begin within days of the stroke event so long as the patient is stable; sometimes rehabilitation will begin in the hospital where the patient was first treated, other times the patient will be transferred to an acute or sub-acute facility where therapy will be offered to meet the patient's needs and abilities — the doctors at the hospital will best be able to make this determination. 

"Acute rehabilitation is appropriate for patients who will benefit from an intensive, multidisciplinary rehabilitation program."
"Sub acute level care is less intensive than acute rehabilitation... a combination of physical, occupational and speech therapy may be provided in the sub acute setting"
(from Burke Rehabilitation Hospital)

Our Story:
In our case, Mark was transferred to an ACUTE facility the 3rd day after the diagnosis, the rehabilitation hospital doctor welcomed him to Rehab Bootcamp; he arrived on a Friday night and therapy began the next day. When he arrived he was totally paralyzed on one-side of his body although his level of consciousness and speech didn't appear affected.

The beginning program consisted of 6 days per week of Physical, Occupational and Speech therapy, as time progressed some therapies were reduced and others introduced; throughout the month he was there he also saw a psychiatrist, got to practice in a pseudo independent living situation, did math, learned to write (again), practiced climbing stairs, and even pretend-drove a mock-up car! Most importantly (although these are things most of us take for granted) he learned to do things for himself such as daily toiletries, feeding himself, transferring from bed to wheelchair, and even going to the bathroom without assistance. There were also several socialization opportunities such as discussion groups, entertainment and games.

Although Mark had quite a bit of practice using a walker, he was still mostly confined to a wheelchair by the end of his scheduled month, this was heartbreaking as there was no way the therapists could recommend that he return home. Although I had often thought of "growing old in place" I was dismayed to learn how inadequate our own home was for many disabilities. I cried when I was told they were transferring him to a sub-acute facility.

By previous experience I can say the sub-acute facility was better than I expected but truthfully it was nowhere near the level of the rehab hospital he had already been in. His physical therapy sessions were limited to approximately an hour to an hour-and-a-half five days a week. Since the facility had a mixed clientele the therapists didn't always distinguish the activities per patient and they didn't push if a patient didn't want to work, fortunately Mark was determined and pushed himself. He remained "confined" to the wheelchair for 3 of the 4 weeks he was there. Finally he became proficient with a walker and amidst our tears of joy, he came home.

There was the 3rd leg of therapy — Outpatient. There was very little guidance afforded us to choose a facility here so we did our best. The sub-acute doctor wrote a prescription and we searched for a physical therapist with the right equipment for Mark's needs. The therapist worked extensively with strengthening his walking ability which did enable Mark to drop the walker and rely on a quad-cane (a cane with "feet" for extra stability). Insurance coverage eventually dictated when he was "done" with therapy.

He had come a long way, walking short distances with the cane, learning to drive again, and beginning to do normal household and personal chores. Since he still needed assistance and his stamina wasn't what he needed he was classified disabled by social security.

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