Rehabilitation Facilities And Services - Rehabilitation: Stroke

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Rehabilitation facilities and services

Stroke rehabilitation takes place in the following settings. Although there is some overlap, they differ in the amount and type of therapy given.

Rehabilitation hospitals. These include free-standing hospitals and special units in acute-care hospitals that offer short-term inpatient rehabilitation. The rehabilitation usually lasts about three or four weeks, but it can be slightly more or less depending on your needs. Rehab hospitals provide about three hours of stroke rehabilitation a day, a fairly demanding schedule. Physicians specializing in rehabilitation are actively involved in overseeing each person's care. A variety of other rehabilitation specialists — such as physical therapists, occupational therapists, and speech therapists — meet regularly as a team to discuss each person's progress. Rehab hospitals also have psychologists on hand to treat depression.

Skilled nursing facilities. These are nursing homes with rehabilitation capabilities. They offer a combination of short-term and long-term care. In contrast to rehab hospitals, skilled nursing facilities provide only about an hour and a half of rehabilitation services a day and have fewer rehabilitation specialists. A physician is usually employed part-time. A skilled nursing facility may be the best option for an elderly person who does not have the strength or stamina for the more demanding and comprehensive regimen of a rehabilitation hospital.

Outpatient rehabilitation facilities. These centers allow you to live at home but come during the day for rehabilitation, generally at a hospital or other facility. Here, you will work with physicians and therapists who specialize in stroke rehabilitation. You usually spend several hours a day, several days a week, at the facility. Services include physical therapy, occupational therapy, speech therapy, and social or psychological counseling. To attend outpatient rehabilitation, you need to be physically able to travel between the facility and your home. Comprehensive outpatient rehabilitation facilities offer more flexibility than inpatient facilities because the programs can be adjusted to your needs. The regimen can be just as demanding as that offered by a rehab hospital, or it can be scaled back if you don't need or can't handle such a rigorous program.

At-home rehabilitation. A rehabilitation specialist may come to your home for a set number of hours and days on a short-term basis. The specialists are provided by a home health agency. Home rehabilitation can address physical impairments and speech and language difficulties. The intensity of the program can be tailored to your needs. At-home rehabilitation is usually best for people who need one type of rehabilitation therapist (say, a physical therapist or a speech therapist) instead of several therapists, and who can't get to and from an outpatient facility. But to some extent your choice is dictated by your insurance coverage. At-home rehabilitation may not be covered unless you are homebound — physically unable to leave your home. If you are not homebound but simply lack transportation to and from your home, check with your health insurance provider to find out whether you are covered.

Last updated:	September 05, 2008