Specific Locations Used in the Stroke Recovery Process
Inpatient Rehabilitation Units
Inpatient facilities may be freestanding or part of larger hospital complexes. Patients who have had a stroke may stay in the facility for two to three weeks, and engage in a coordinated, intensive program of stroke rehabilitation. Such programs often involve at least three hours of active therapy a day, five or six days a week. Inpatient facilities offer a comprehensive range of medical services, including full-time physician supervision, and access to the full range of therapists specializing in post-stroke rehabilitation.
Outpatient facilities are often part of a larger hospital complex and provide access to physicians and the full range of therapists specializing in stroke rehabilitation. Patients typically spend several hours, often three days each week, at the facility taking part in coordinated therapy sessions and return home at night. Comprehensive outpatient facilities frequently offer treatment programs as intense as those of inpatient facilities, but they can offer less demanding regimens, depending on the patient's physical capacity.
Rehabilitative services available at nursing facilities are more variable than those at inpatient and outpatient units. Skilled nursing facilities usually place a greater emphasis on rehabilitation, whereas traditional nursing homes emphasize residential care. In addition, fewer hours of therapy are offered compared to outpatient and inpatient rehabilitation units.
Home-Based Rehabilitation Programs
Home-based rehabilitation after a stroke allows for great flexibility so that patients can tailor their program of rehabilitation to their needs and follow individual schedules. Stroke survivors may participate in an intensive level of therapy several hours per week or follow a less demanding regimen. These arrangements are often best suited for people who lack transportation or require treatment by only one type of rehabilitation therapist.
Patients dependent on Medicare coverage for their rehabilitation must meet Medicare's "homebound" requirements to qualify for such services; at this time, lack of transportation does not meet these requirements.
The major disadvantage of home-based rehabilitation programs is the lack of specialized equipment. However, undergoing treatment at home gives people the advantage of practicing skills and developing compensatory strategies in the context of their own living environment.