Stroke rehabilitation and recovery

A stroke occurs when the flow of fresh, oxygen-filled blood from the heart and lungs to the brain is interrupted by a blockage or rupture. This cuts off the brain from vital energy and causes nerve cells to die, resulting in a loss of function in the areas controlled by the affected area of the brain.

There are a variety of indicators that someone might be having a stroke, including: 

• Loss of control of muscles or feeling of numbness on one side of the face, leaving a drooping or uneven appearance
• Weakness or numbness on one side of the body, commonly in the arms but can occur throughout the body
• Speech is suddenly slurred or hard to understand, with some cases having a sudden loss of speech
• Low vision, double vision, blurred vision, tunnel vision, or blackout within one or both eyes
• Sudden onset of vertigo, dizziness, or the inability to balance
• Sudden or intense headache
• Nausea, which can also be accompanied with vomiting

Do not hesitate to call 9-1-1 if you or someone else is experiencing these symptoms. Time is of the essence and the longer you wait, the more detrimental the outcomes can be.

Stroke rehabilitation is a program of specialized nursing care and therapies designed to help you relearn skills lost after a stroke. Depending on the parts of your brain affected by the stroke, rehabilitation can help with daily living skills, movement, speech, and cognition. Stroke rehabilitation can help you regain independence and improve your quality of life.

There’s a wide range of complications from stroke and each person’s recovery is unique. Research shows that people who participate in a designated stroke rehabilitation program perform better than people who do not participate in focused stroke rehabilitation. Therefore, stroke rehabilitation is recommended for all people affected by stroke.

Inpatient stroke rehab requires an extended hospital stay where care is available 24 hours a day, seven days a week. Conversely, outpatient rehab is session-based, typically at a rehabilitation center that a patient visits a few times per week, depending on their overall health. Inpatient stroke patients receive a minimum of three hours of intensive therapy each day, whereas outpatient patients receive a few hours per week.

Every person’s experience with stroke is different; however, the average length of stay for hospital rehabilitation at Sheltering Arms Institute post-stroke is 18 days.

It is helpful to ask how many stroke patients the center sees per year, if they have a dedicated stroke program, and what percentage of patients are discharged home. Sometimes eligibility depends on your insurance coverage, so it is important to learn what your insurance covers.

In the inpatient setting, stroke rehabilitation and recovery programs focus on assessing and improving:

• Activities of daily living such as eating, bathing, and dressing
• Mobility such as getting from a bed to a chair, walking, climbing stairs, or using a wheelchair
• Communication skills in speech and language
• Cognitive skills such as memory or problem solving
• Social skills such as interacting with other people
• Psychological functioning to improve coping skills and treatment to overcome depression, if needed

While the following schedule is only a sample, inpatient patients can expect an average of 3-5 hours of therapy each day. Individual schedules vary based on each patient’s care plan and level of injury.

7-9 a.m. – Physician Rounds

8:30-9 a.m. – Breakfast

9-12:30 p.m. – Physical / Occupational / Speech / Recreation / Therapy

12:30-1 p.m. – Lunch

1-4 p.m. – More Therapy

4-5 p.m. – Therapeutic Recreation Groups

5:30-6 p.m. – Dinner

6-7 p.m. – Therapeutic Recreation Groups

7-8 p.m. – Medications and Bedtime Preparations

Rehabilitation is a team effort rooted in interdisciplinary communication and coordination. At Sheltering Arms Institute, inpatient stroke rehabilitation teams are led by a physician and also include:

• A physiatrist is a medical doctor specializing in stroke rehab
• Focusing on walking, balance, and coordination, physical therapists work to get you as mobile and as independent as possible, helping you improve major physical and sensory deficits
• Occupational therapists help you with daily activity skills such as bathing, toileting, eating, and driving
• Rehabilitation nurses coordinate your medical support needs throughout rehab
• Speech-language pathologists help with speech and language skills and swallowing disorders
• Recreation therapists help with adapting activities that you enjoyed pre-stroke and may introduce new ones
• Medical psychologists can help you manage and adjust to the emotional and life changes a stroke may bring 

Care managers help with discharge planning and arranging follow-up care