Stroke rehabilitation programs start as soon as possible and continue well after a patient leaves the hospital. And the goal of these programs is to get patients functioning on a level where they can regain some independence. But to ensure that patients get the most out of their time and effort, there’s a lot of thought and work that goes into designing these programs.
Organizations like the American Heart Association (AHA) and the American Stroke Association (ASA) work closely with patients and do a lot of research to come up with science-based recommendations for doctors to use with their patients. The goal of these guidelines is to facilitate organized, coordinated, and interdisciplinary care, avoid readmissions, and maximize functional recovery. And by following these recommendations, your doctor can make sure you’re getting the right kind of attention.
How your doctor makes decisions about your care
Your doctor uses the latest recommendations when it comes to making sure you get the care you need. And here are the most recent guidelines that doctors follow:
- Patients should remain in an inpatient rehabilitation facility for care if possible rather than be transferred to a skilled nursing facility/nursing home. Inpatient rehabilitation should be considered when there is a requirement for skilled nursing services, regular contact by a physician, or the need for multiple therapeutic interventions.
- Patients should be screened for cognitive deficits or problems in mental processes (e.g., confusion, memory problems, decreased mental ability) and depression before discharge home.
- Patients should receive activities of daily living training customized for individual needs and location to which they will be discharged and be assessed for early dysphagia (difficulty swallowing), balance, and communication problems.
- Urinary catheters should be removed within 24 hours after hospital admission for patients with acute stroke. Urinary retention should be assessed using bladder scanning or postvoid urinary catheterization.
- Fall prevention training should be provided during the initial hospitalization and after discharge; after rehabilitation, home or community exercise is recommended
How can you benefit from these new rehab guidelines?
Although this set of guidelines is for physicians involved in stroke rehabilitation, knowing these can help you make wise choices with your doctor. These also help you know what you should expect.
What about insurance coverage?
Medicare can help cover the costs of stroke rehabilitation. These include inpatient, outpatient, and at-home rehabilitation services. Medicare benefits may extend to services offered by your doctors, therapists, and nurses involved in your care. Medicare may also cover some of the necessary therapy services on an outpatient basis.
There are usually cap limits on rehabilitation services that Medicare covers. However, there can be exceptions. To qualify for these exceptions, your therapist must establish your need for certain medical services. Medicare’s website provides a comprehensive overview of stroke rehabilitation coverage. It also has a helpful search tool for comparing inpatient rehab facilities.
Being informed helps you get the most of your rehab
Being able to review the guidelines that your doctor uses gives you a clearer idea of how your therapy should look. And the more you know about what to expect, the more you can benefit from your rehab. Work together with your doctor to create the best program for your needs.
The lead author of the published document is Dr. Michelle Gittler of the Schwab Rehabilitation Hospital, Chicago, Illinois.