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Rehabilitation

The aim of recovery and rehabilitation are the same—to become as independent as possible within the limitations of the stroke. The difference between them is that recovery begins immediately and goes on indefinitely.

A programme of rehabilitation may be limited by time and progress, and may involve eventually reaching an end. (This can apply to out patient therapy as well as being discharged home from a rehabilitation unit).

Types Of Rehabilitation Programmes

Organised or ‘formal’ rehabilitation may not commence immediately. Once an individual has been stabilised, assessed and investigated a decision will be made as to how to progress.

This could be through:

• hospital programmes—an acute stroke unit or a stroke rehabilitation unit or slower general rehabilitation ward
• long-term care with therapy and skilled nursing care
• outpatient programmes
• home based programmes

The aim of stroke rehabilitation is to enable an individual to become as independent as possible within the limitations of their stroke. It is centred on the individual and is carried out using a Stroke Team Approach. The focus is on finding new ways to achieve tasks as well as maximising and improving functions that are lost or impaired.

Successful rehabilitation depends on

• amount of damage to the brain
• skill on the part of the rehabilitation team
• co-operation of family and friends. A caring family can be one of the most important factors in rehabilitation.
• timing of rehabilitation—the earlier it begins the more likely a person is to regain lost abilities and skills

Cyclical Process

The conventional approach to rehabilitation is a cyclical process

• assessment—needs are identified and quantified
• goal setting—goals are defined for improvement as long/medium/short term
• intervention—to assist in the achievement of the goals
• re-assessment—progress is assessed against the agreed goals

Goals can be considered at several levels

• aims—often long term and referring to situation after discharge
• objectives—usually multi professional, at the level of disability
• targets —short term, time limited goals