Where does stroke rehabilitation take place?

You'll probably begin stroke rehabilitation while you're still in the hospital. Before you leave, you and your family will work with hospital social workers and your care team to determine the best rehabilitation setting. Factors to consider include your needs, what insurance will cover, and what is most convenient for you and your family.

The options include:

  • Inpatient rehabilitation units. These facilities are either freestanding or part of a larger hospital or clinic. You may stay at the facility for up to two to three weeks as part of an intensive rehabilitation program.
  • Outpatient units. These facilities are often part of a hospital or clinic. You may spend a few hours at the facility a couple of days a week.
  • Skilled nursing facilities. The type of care available at a nursing facility varies. Some facilities specialize in rehabilitation, while others offer less-intense therapy options.
  • Home-based programs. Having your therapy at home allows greater flexibility than other options. One drawback is you likely won't have access to specialized rehabilitation equipment. In addition, insurance strictly controls who qualifies for home-based therapy.

Talk to your doctor and family about the best option for you.

Who participates in your stroke rehabilitation team?

Stroke rehabilitation involves a variety of specialists.

Specialists who can help with physical needs include:

  • Physicians. Your primary care doctor — as well as neurologists and specialists in physical medicine and rehabilitation — can guide your care and help prevent complications. These physicians can also help you to gain and maintain healthy lifestyle behaviors to avoid another stroke.
  • Rehabilitation nurses. Nurses who specialize in caring for people with limitations to activities can help you incorporate the skills you learn into your daily routines. Rehabilitation nurses can also offer options for managing bowel and bladder complications of a stroke.
  • Physical therapists. These therapists help you relearn movements such as walking and keeping your balance.
  • Occupational therapists. These therapists help you relearn hand and arm use for daily skills such as bathing, tying your shoes or buttoning your shirt. Occupational therapists can also address swallowing and cognitive issues, and safety in your home.

Specialists who focus on cognitive, emotional and vocational skills include:

  • Speech and language pathologists. These specialists help improve your language skills and ability to swallow. Speech and language pathologists can also work with you to develop tools to address memory, thinking and communication problems.
  • Social workers. Social workers help connect you to financial resources, plan for new living arrangements if necessary and identify community resources.
  • Psychologists. These specialists assess your thinking skills and help address your mental and emotional health concerns.
  • Therapeutic recreation specialists. These specialists help you resume activities and roles you enjoyed before your stroke, including hobbies and community participation.
  • Vocational counselors. These specialists help you address return-to-work issues if that is a goal.

What factors affect the outcome of stroke rehabilitation?

Stroke recovery varies from person to person. It's hard to predict how many abilities you might recover and how soon. In general, successful stroke rehabilitation depends on:

  • Physical factors, including the severity of your stroke in terms of both cognitive and physical effects
  • Emotional factors, such as your motivation and mood, and your ability to stick with rehabilitation activities outside of therapy sessions
  • Social factors, such as the support of friends and family
  • Therapeutic factors, including an early start to your rehabilitation and the skill of your stroke rehabilitation team

The rate of recovery is generally greatest in the weeks and months after a stroke. However, there is evidence that performance can improve even 12 to 18 months after a stroke.

Stroke rehabilitation takes time

Recovering from a stroke can be a long and frustrating experience. It's normal to face difficulties along the way. Dedication and willingness to work toward improvement will help you gain the most benefit.

May 24, 2017 See more In-depth