By its very nature, therapy is personal, and sometimes
conflict arises between patient and therapist. Harvey says
that when this happens, they rarely assign a new therapist,
preferring instead that the people work out the problem.
“We encourage them to communicate about it and to
be honest about what the issues are and see if they can
come to an understanding,” he said. “That’s what you’re
supposed to do in life, isn’t it? So, it’s part of the therapy
to do that. Now if that conflict cannot be resolved, then a
manager can arrange for a different therapist. But we try
not to do that because that’s just not the way to deal with
things in life. Working with a therapist is not a business
transaction, it’s a relationship.”
WHEN IT IS TIME TO LEAVE
Discharge protocols differ from facility to facility but
often involve a home assessment, caregiver education,
family involvement, home therapy referrals as well as
information on driving and community resources.
“What we usually do is family education and training
and then we order equipment, if that is needed,” Harvey
said. “We arrange for follow-up including with a neurologist
and also for outpatient therapy. That may be home therapy,
but it could be outpatient therapy. Some patients may go
from an inpatient rehab facility to a nursing facility before
they transition home. But when you do transition home, it’s
important to have follow-up outpatient therapy and continue
rehabilitation after discharge.”
Actual inpatient therapy, Harvey points out, is an
important, but small, part of the whole rehabilitation
process. “Inpatient care is intended to help a patient be safe
to return home, but it does not address all the functional
and rehabilitation needs a patient has. Stroke recovery takes
three to 12 months and beyond, and inpatient is usually less
than three weeks.” To maintain gains and work on evolving
needs, patients must continue to work at recovery.
Caregivers play a crucial role in a survivor’s recovery.
“It’s important for caregivers to understand how much the
survivor can do and what they can’t do so they assist them
to the level they need but don’t over-assist them,” Harvey
said. “Survivors need to continue working on independence.
It’s always good to have some things that you’re working on
improving at home. For example, if you can’t put on your
shirt on your own maybe that’s something that the patient
can work on doing and improving at home and the family
can support this. Encourage them to continue working on
getting more independent.
“The other thing is to remember that rehabilitation is
lifelong. I tell all my patients, all of us should have time
when we take care of our bodies, when we exercise, when
we work on strength or conditioning, and people with stroke
are the same. They should always be working on their body,
always taking care of it.
“The last thing you want is for a stroke survivor to
go home and say, ‘I had a stroke so I can’t do anything
anymore.’ Maybe you can’t do everything you used to,
but there are certain things that you can do and there are
certainly ways that you can improve your performance if
you just focus and work on it a little bit every day. We can
all practice being better people in this world, and stroke
survivors are no different.”
For more, download our free PDF, Making Rehabilitation Decisions.
“Working with a
therapist is not a
it’s a relationship.”