The Upsides of Ongoing Therapeutic Sessions
Once Rick had completed his physical, occupational and speech therapy post stroke, I assumed that this was it. This was as good as it gets! I was wrong. About 18 months later, we realized that he was declining. Immediately after discharge from therapy, he could do more and was motivated but as time passed, the motivation and improvements slowed down to a halt. As the caregiver, I gave up on pushing him to improve - He had to be motivated to improve.
Aha Moment
After several months, I noticed that Rick’s balance was getting worse, and his speech was getting more garbled. He would try to compensate by using his non affected hand and limiting conversation. He had become comfortable with the status quo. My gut told me there was more that could be done and did some research that I want to share with you. Bottom line --- Don’t give up!!!!
A study completed by NPR - www.npr.org › study-stroke-recovery-best-treatment
A study of 72 stroke patients suggests this is a "critical period," when the brain has the greatest capacity to rewire.
Regain more hand and arm function if intensive rehabilitation starts two to three months after the injury to their brain.
The idea that there is a critical period when the brain is most able to recover is "something we've suspected all along, based on the animal models," says Dr. Jin-Moo Lee, chair of neurology at Washington University in St. Louis. "But this is really the first human evidence that there's a period in which rehab therapies are most effective in improving recovery."
Solution that worked for me.
I followed the below guidelines from www.stroke.org › rehab-therapy-after-a-stroke Rehab Therapy After a Stroke | American Stroke Association
The American Stroke Association’s Together to End Stroke initiative, nationally sponsored by Kindred Hospital Rehabilitation Services, offers these recovery tips for stroke survivors and their caregivers:
Ask your doctor to assess the physical and cognitive challenges you face after stroke and provide a specific plan to address each challenge.
We met with our MD and discussed a plan. He provided an order for Physical Therapy and Speech Therapy.
The plan was to improve balance and walking. The initial rehab goal was for him to be able to walk well enough to get home. Now he was ready to be able to learn better walking skills.
The second plan was to improve his speech. He was able to be understood but he avoided conversation.
Start your personalized rehabilitation program as soon as your medical team gives you the OK. Early rehabilitation matters. Recovery can take years, but the most rapid progress usually occurs during the first three months after a stroke.
The early rehab helped but now after being home, we needed to address the deficits that needed finetuning.
Met with a PT and she addressed the concerns. He will always have to think about walking, but she taught him to properly walk, exercises to improve balance and motivation to work to not give up.
Met with a ST and she addressed the concerns. She was excellent in providing support to improve his communication – slow his speech, practice words and phrases that are difficult and to not stop.
After a few weeks of therapy, I noticed an improvement in his abilities but more importantly he had a renewed sense that he could improve certain aspects. We both understand that what he lost with the stroke will never return 100%, any small improvement makes a BIG difference.
Financial Coverage:
Private Insurance –
Most plans have a yearly therapy benefit that requires a physician’s order. It is not unusual to have a copay. Contact your insurance carrier or your policy to determine your benefits.
Medicare (Based on Medicare 2024 Official Handbook – see Section 2 page 48)
Physical therapy services
Medicare covers evaluation and treatment for injuries and diseases that change your ability to function, or to improve or maintain current function or slow decline, when your doctor or other health care provider, including a nurse practitioner, clinical nurse specialist or physician assistant certifies you need it. You pay 20% of the Medicare-approved amount. The Part Bdeductible applies.
Occupational therapy services
Medicare covers medically necessary therapy to help you perform activities of daily living (like dressing or bathing). This therapy helps to improve or maintain current capabilities or slow decline when your doctor or other health care provider certifies you need it. You pay 20% of the Medicare-approved amount. The Part B deductible applies.
Speech-language pathology services
Medicare covers medically necessary evaluation and treatment to regain and strengthen speech and language skills. This includes cognitive and swallowing skills, or to improve or maintain current function or slow decline, when your doctor or other health care provider certifies you need it. You pay 20% of the Medicare-approved amount. The Part B deductible applies.
Stroke Caregiver Connection…Because you care!