What To Expect In A Stroke Inpatient Rehab Unit (2024)

Recovery from a stroke can be a challenging and even frightening experience. As complications with vision, swallowing and use of limbs are just a few examples of the effects following a stroke, it's crucial to receive early treatment and rehabilitation to improve your stroke recuperation.

Sandy Lim, a physical therapist at Franciscan Health Indianapolis, explains how the stroke inpatient rehab unit at Franciscan Health can help patients regain abilities after a stroke and what patients and families should expect in the inpatient rehabilitation unit each day.

How Do You Rehabilitate A Stroke Patient?

Depending on the condition of a stroke patient, their rehabilitation and recovery can require multiple specialists to work with them to get abilities back.

"An inpatient rehab unit is overseen typically by a medical doctor, usually a physiatrist or more commonly known as a rehab doctor," Lim said. "Sometimes a nurse practitioner will also be present to help the doctor. We have case managers and social workers to help with insurance, discharge planning, as well as community resources."

Lim also said that dieticians are crucial to maintaining good nutrition for patients, which helps them heal correctly and have enough energy to participate in therapy.

Therapy For Stroke

"The bulk of therapy comes from physical therapy, occupational therapy and speech therapy," Lim said.

Physical therapists typically work on walking, balance, leg strengthening and stairs in an inpatient rehab unit, Lim said. Occupational therapists work on activities of daily living or the essential things that patients need to do to take care of themselves.

"In occupation therapy, patients will work on bathing, dressing, toileting, managing in the kitchen and laundry, alongside upper extremity or arm exercises," Lim said. "They also work on visual issues that may arise because of the stroke."

While speech therapy is what it sounds like, improving the ability to talk is only a portion of what speech therapists can assist with.

"Speech therapy also works on swallowing with patients who develop swallowing issues from external causes or internal causes like stroke or cancer," Lim said. "Additionally, they work on cognition, things like memory or attention and problem solving."

"Beyond therapy in our unit, we also have wonderful and amazing nurses that we couldn't do without," Lim said. "And because we are part of a hospital and are healthcare professionals, you also can have other healthcare professionals come on board, like neurologists, cardiologists and nephrologists depending on the patient's needs."

Why Does Inpatient Rehabilitation Matter For Stroke Recovery?

The care provided during and after a stroke is critical to a patient's recovery. This is why it's crucial for stroke patients to work with a quality inpatient stroke rehabilitation unit to help them regain their abilities over time.

"A stroke typically causes brain cells to die, and that's what causes all the issues afterward," Lim said. "Still, the majority of stroke recovery occurs within the first one to three months after a stroke."

Lim explained that while stroke recovery continues after six months, it may proceed at a slower pace. Due to this, rehab is recommended right after a stroke.

"Stroke recovery is also based on neuroplasticity, the brain's ability to form new neural connections," Lim said. "Neuroplasticity is something that occurs throughout a person's whole life, not just after strokes. Still, it's the reason rehab on an inpatient rehab unit is so important. The more intensive and frequent the therapy occurs, the more neuroplasticity occurs, resulting in better recovery."

Another aspect of inpatient rehab is the individual plan of care for stroke survivors.

"For example, a patient who has no cognitive issues, but only physical impairments, would not necessarily need speech therapy, but more time with physical and occupational therapy," Lim said. "Patients who have more speech or cognitive impairments, but less physical impairments, will be focused on speech therapy with less time on physical and occupational therapy."

A customized plan of care allows recovering stroke survivors to focus their treatment on their specific needs and make improvements in critical areas.

Lim explained that due to the individualized care plan, all the team members who work with a specific patient meet weekly to discuss plans, concerns and overall goals.

"The interdisciplinary team meetings are where things like follow up therapies, maybe to home health or outpatient and even family training is set up to ensure that patients continue to improve and recover," Lim said.

What Is A Typically Day In Inpatient Rehabilitation Like?

"A typical day for patients in the inpatient rehab unit begins with breakfast at 7 a.m.," Lim said. "A patient with a stroke may then have their first therapy an hour later. Let's say it's occupational therapy, as an example."

An occupational therapist may work with a stroke survivor to help them relearn how to shower, dress up and use the toilet alongside activities to increase the use of their stroke-affected arm. This session should last one hour.

"The patient will return to their room around 9 a.m. for their morning meds and go to speech therapy for 30 minutes around 10:30 a.m.," Lim said. "Between that time, patients may complete other tasks like speaking with a dietician, ordering their meals for the day or speaking with doctors that might be rounding on the unit."

Lim explained that patients may work on swallowing food during speech therapy by trying different foods or liquid textures, which will help return the patient to a regular diet.

After lunch at noon and afternoon medicines, the patient will work with the physical therapist at 1 p.m. for an hour, including relearn their ability to walk or climb stairs, and do balance activities, she continued.

"Speech therapy may arrive again at 2:30 p.m. to do another half an hour session and they may work on cognition, which can include problem solving with memory cards or medication management or recall tasks," Lim said.

Lim explained that by 4 p.m., patients receive their therapy schedule for the following days, including what time to expect their therapist. Finally, dinner is at 5 p.m. and then patients have the evening to relax and get ready for bed.

Progress And Improvements Following Quality Inpatient Rehab

With the help of a quality inpatient rehab unit, stroke survivors can feel comfort and confidence in their journey toward regaining lost abilities.

"As a physical therapist, since I do a lot of walk training with patients," Lim said. "It's great to see them take like one or two steps that maybe that first day or that first week. And then, by the time they leave me, they're walking 300, sometimes even 500 feet, making laps around the unit."

Lim shared that patients come back months to years later to show off all their progress over time.

"They'll raise their arm up in the air and they want to show all the things that they can do," Lim said. "Patients that had trouble walking in the past will come back and show us how they're not walking with any support. It's such a great feeling to see how much progress they make and it really makes me happy to see them get so much better."