Stroke Rehab: Choosing a Path to Recovery

If you or a loved one has suffered a stroke, choosing the best path to recovery can be a confusing process. In most cases, that path will include rehabilitation services, since stroke rehabilitation is an essential element of a successful recovery. Generally, stroke survivors are asked to choose, with the help and advice of their medical team, between options that include short term care programs, outpatient rehabilitation services, long term care facilities or home-based rehabilitation. When faced with an unfamiliar and overwhelming decision, it often helps to know where experts stand on an issue. In this post, we'll look into what the American Stroke Association recommends for stroke rehabilitation and recovery.

In May, 2016, the American Stroke Association issued Guidelines for Stroke Rehabilitation and Recovery for Adults. This publication acknowledges what many stroke survivors, their families and their healthcare providers already know, that the type of rehabilitation and support systems stroke survivors receive in the aftermath of a stroke can make a substantial difference in their level of recovery, health outcomes and quality of life. With those facts in mind, the organization's stroke experts compiled evidence-based recommendations outlining best clinical practices in the rehabilitative care of adults recovering from stroke.

When Inpatient Stroke Rehab is Indicated

These guidelines strongly recommend that stroke survivors who have experienced some level of disability in the aftermath of a stroke should, whenever possible, be treated at a short term care facility upon discharge from the hospital. That recommendation is based upon a body of evidence showing that effective stroke rehabilitation requires a sustained, coordinated and collaborative effort from a large, multidisciplinary team.

The team should consist of the patient, his or her family, friends or other caregivers, along with rehabilitation professionals, including physicians, nurses, physical, occupational and speech therapists, psychologists, social workers, nutritionists and others as indicated by the patient's individual needs. Intervention should begin early, as soon as a patient is medically stable and can tolerate rehabilitation therapy, and be intensive to promote the best possible level of functional gain. This level of care, according to these guidelines, is the best possible scenario for maximizing total functional improvement, and is the level of care provided in a short term rehab environment.

When To Consider Other Options

For stroke survivors who cannot tolerate the intensive rehabilitative therapy routines of a short term care program – which entails a minimum of three hours of therapy daily – beginning recovery in a less strenuous rehabilitation setting is more appropriate. This may be a skilled nursing facility, where rehabilitative services can be tailored to suit the needs of medically fragile stroke survivors who need 24 hour nursing care. Outpatient or in-home rehabilitation therapy can also be an option for people who cannot tolerate intensive therapy, but are healthy enough to be safely discharged to their homes – either on their own or with the assistance of in-home caregivers. Outpatient or in-home rehabilitative therapy may also be a good option for individuals who have had a mild to moderate stroke that has resulted in little or no significant disability.