Acute Care
The first stage of stroke recovery occurs in acute care. In some cases, acute care may take place at any local hospital. In other cases, stroke survivors may be transferred to a hospital that specializes in stroke care. The goal of acute care is to ensure that stroke survivors are medically stable and are not at risk for further complications. The hospital stay may be as short as one to two days, or last much longer, depending upon the medical need of the stroke survivors.
Speech, occupational and/or physical therapy may begin during the acute care phase. The type of prescribed therapy depends on the specific needs of stroke survivors, their medical condition, and the services available at the acute care hospital.
Rehabilitation
Once stroke survivors are medically stable, they may begin inpatient rehabilitation which may occur in the same hospital as the acute care. Sometimes, stroke survivors may be transferred to a rehabilitation hospital or unit. Physicians that specialize in rehabilitation are called physiatrists. They work with the nurses and therapists to create a rehabilitation program to specifically meet the needs of stroke survivors. Most stroke survivors receive a combination of speech, occupational and physical therapy.
Inpatient rehabilitation is intensive - often with a minimum of three hours of therapy per day. The goal of inpatient rehabilitation is to ensure that stroke survivors can safely return home without the risk of further injury. The length of this stage of rehabilitation varies greatly. It may be as short as a few days or as long as many weeks, depending on the facility and the needs of the survivors.
Long Term Care
Some stroke survivors do not have the stamina for intensive inpatient rehabilitation. Others may be unable to care safely for themselves at home. In these situations, stroke survivors may spend some time in a long term care facility, such as a nursing home. Therapy, at long term care facilities, is generally less intensive than at in-patient, rehabilitation programs. Once stroke survivors are able to tolerate more intensive rehabilitation, they may be transferred to an in-patient rehabilitation program. Another alternative is to release them from a long-term care facility, when they can safely care for themselves at home and/or receive outpatient therapy.
Home Care
Therapy services may also be available in a stroke survivor's home. These services may be arranged through a home health care agency. Home care and/or various therapy services may be recommended when stroke survivors do not need the 24-hour intensive care provided by a hospital or long term care facility, but need continued therapy or nursing care. These services may also be recommended when a stroke survivor lives alone or is physically unable to safely get to and from outpatient therapy.
Outpatient Therapy
Once stroke survivors are able to safely leave their home, it is time for outpatient therapy. Outpatient therapy may occur at a local hospital or outpatient therapy clinic. The goal of outpatient therapy is to assist the stroke survivor in regaining independence in a wide variety of activities, such as their hobbies, driving, and returning to work. During the outpatient phase, the duration of physical, occupational, and speech therapy may differ since these therapies are based on the needs of the stroke survivor.
Many stroke survivors and their families are informed that progress stops after six months. There is more and more research that shows that progress from the effects of a stroke can continue indefinitely. Recovery slows down but does not stop. Many people are still seeing positive changes years after their stroke.
