Community and Work Re-Entry

 

Frequently Asked Questions

Will I ever be back to normal? How will I know when I have reached my potential?
A stroke affects everyone differently. There are various factors that affect recovery. These include mental readiness for recovery, family support, medical management, rehab efforts, the amount of brain tissue damaged, the ability to learn new information, environmental factors, and previous body type or medical history. Most persons never recover from a stroke feeling “the same” as they did before. This may be due to changes in one’s physical capabilities, but most often it is due to the experience of having had a stroke. Your treatment team will discuss your recovery progression with you. They will determine treatment needs and length of stay based on clinical judgment, as well as discussing when discharge may be appropriate. It is important to know that research is showing changes in function from up to two to five years following stroke. Therefore, even upon discharge from rehab, it is important to continue with a home exercise program that addresses any remaining problem areas.

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How long will I need therapy?
This is dependent on the factors discussed above. Again, your treatment team will take all of these factors into consideration and determine an appropriate length of stay. The need for outpatient therapy may not be necessary for some, or it may go on for months for others. When being discharged from outpatient therapy, it is important to know that recovery does not necessarily end at that time. If positive changes occur during your home exercise program, it may be appropriate to ask for a referral from your doctor to return to therapy for an evaluation.

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What kind of changes need to be made to my home?
This is dependent on your level of functioning upon returning home. It is important to know whether the therapists think you will go home using a wheelchair or a walker. If going home at a wheelchair level, you may need to have a ramp installed for access to the home. If there are major concerns regarding your home environment, discuss them with your therapists. It may be necessary to do an evaluation of the home in order to make specific recommendations for safety. Your occupational and physical therapists will discuss home considerations during treatment. They will recommend any necessary equipment or home modifications.

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Where can I get resources after my insurance is gone?
If insurance is a problem, it is important to discuss this with your case manager. Your case manager will try to help guide you toward any available funding or assistance necessary to assist you in your recovery.

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When can I drive again?
It is necessary to get approval from your doctor prior to driving again. If there are concerns regarding your safety, a driver’s evaluation may be recommended. Driver’s evaluations are completed at one of the Frazier outpatient satellite clinics. Recommendations and training (if necessary) are provided by the occupational therapist who is a certified driving instructor. For more information about the Driver Education and Training Program, click here.

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What type of transportation is available for persons with a disability?
Depending on your physical functioning, you may be able to ride in a typical vehicle. Your physical and/or occupational therapist can practice getting in and out of your vehicle with you and your caregiver. If this is not a possibility or if you have been dependent on public transportation in the past, TARC in Louisville provides a special service for transportation of individuals with a disability. This service is called TARC 3 and it requires an application process for use. Your case manager has more information regarding the application process.

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I was told I would need supervision in my home. What does that mean?
There are several different levels of supervision that may be recommended to you upon returning home. Your treatment team will specify the level of supervision that is required to maintain safety in the home. Supervision is sometimes recommended for physical reasons, but it may also be recommended due to difficulty with thinking skills or vision. You may need someone to care for you 24 hours per day, or you may simply need someone to check in on you one or two times per day. Recommendations are based on your problems since the stroke, and they are made to ensure a safe and successful return home.

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As a family member or caregiver, should I be attending therapy with my loved one?
Most often the answer is “YES”! However, several factors need to be considered. The treatment team may recommend that your attendance at therapy is limited based on the responses of your loved one. Some people do better when left on their own, and others do better surrounded by their family and friends. It is important though, to try to attend fairly consistently. You will be able to help your loved one carry over new things learned in therapy, and you may even be educated with “hands-on” ways of assisting with the recovery process.

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Once I return home, how do I know what medical problems need to be reported to my doctor and what may be just common side effects from my stroke?
If you experience any symptoms of a stroke, call 911 or go to the emergency room immediately! Other symptoms that you should report to your doctor promptly include:

  • New onset of swollen or painful arm or leg
  • Chest pain or shortness of breath that is currently under a doctor’s care. If you are experiencing chest pain for the first time, call 911 or go to the emergency room.
  • Bleeding of gums and skin or blood in the urine
  • Severe indigestion
  • Presence of a seizure or loss of consciousness that is currently under a doctor’s care. If you are experiencing seizures for the first time, call 911 or go to the emergency room.
  • Decreased responsiveness
  • Change in urinary functioning (burning)
  • Long lasting depression that affects eating and/or sleeping
  • Fainting when standing up or dizziness

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I have so many medications to take. How do I keep track of them all?
First, it is important to understand what each medication is for. So be sure to ask your doctor if you do not understand. Next, keep a list of all current medications (including over the counter ones). This is very important in case you need to go to the emergency room or a new doctor. Anyone caring for you medically needs to know what medications you are on. Ask your rehab team about Frazier’s personal health profile card, which provides a place to record your medications. Third, use a pill organizer to dispense your medication daily. They can be found at most any drug store. Fourth, keep a consistent schedule for taking your medications. Last, use visual reminders to make sure you have taken all your medications for the day.

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As a family member or caregiver, I feel so helpless. What are some things I can do to help with the recovery process?
Refer to the page on How Can Family Members or Loved Ones Help?. Also, attend therapy and ask the therapist for specific suggestions or things to do to help with recovery. Keep a positive attitude and watch your word choice when discussing your loved one. It is important to keep a mindset that there is an “affected side” and a “non-affected” side in stroke, rather than a “bad” side. Also, do not victimize your loved one, yet empower him/her to regain self confidence by increasing independence. Finally, be sure to discuss progress in relation to where the person started after the stroke. Try not to compare to function prior to the stroke.

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As a family member or caregiver, I am overwhelmed. What are some ways that I can stay on top of everything I need to but maintain my sanity?
Take notes during your loved one’s hospital stay, and get things in writing from others when needed. You can put all this information in one place such as a box or folder. It may be helpful later when this information is needed. Make the hospital room environment as cheery as possible. You may be spending a lot of time there, and it helps to have pictures or personal touches to make it seem less like a hospital. Request a pass home prior to discharge if your insurance allows. This will help uncover any unforeseen problems and allow time to review them prior to discharge. As a caregiver, don’t try to do it all!!! You may need to attend support groups, ask for help from others, get time away, and attend to your own physical and mental health. It’s important to maintain a balance of being organized yet having a “go with the flow” attitude.

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How do other people deal with having a stroke? I’d like some suggestions from stroke survivors on how to handle this difficult time.
Frazier's new Stroke Peer Visitor Program is based on a program that was originally developed by the American Heart Association and the American Stroke Association. The program is designed to match stroke survivors with newly diagnosed stroke patients to provide an additional avenue of support from someone who has had the same experiences.  “Peer visitors” undergo an eight-week training program, including extensive education on active listening skills, before being available to visit new stroke patients on an as needed basis. The goal of the peer visitor is not only to share information, support and encouragement, but also to provide the newly diagnosed stroke patient with opportunities to think independently through therapeutic listening. The program also provides peer caregivers for family support.

For information on community support groups, visit the Community Resources page. To hear what some of our patients have to say about their stroke recovery process, please read below.

"When I look back at my experiences in rehab, especially in speech therapy, I think the most important suggestion I could offer a person in similar circumstances would be to listen to your therapist and do all they ask no matter how silly or trivial it seems at the time. You are not in the right frame of mind to evaluate the benefit of the work you are being asked to do while you are actually involved with it. I can recall now things that, at the time, seemed so foolish and beside the point, but in looking back were of great value. Most of these things dealt with improving cognitive and reasoning skills. Of course, it is certainly as important to respond in the same way to all those who are trying to improve your quality of life. Keep an open mind. Most patients have never had to experience this kind of ordeal before. Don’t set or allow anyone else to set unrealistic expectations for you. Rehab is a process that will require you to be committed to a long-term goal."

Bill Fleming

"At the beginning of my recovery, I felt as though I was on the outside of my life looking in. I was unable to do all of those things that had once been so easy. However, after a great deal of hard work, I am now able to feel in control of my life again. You must be persistent with your therapy program and never lose hope."

Dr. Rafiq Rahman

"You’ve just gotta do the best you can with it. Try to live the best you can and do the best you can. You can’t ask ‘why me’ or cry over it because then it will just be worse. You’ve got to accept it and move on!"

George Mosley

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© 2013 KentuckyOne Health
200 Abraham Flexner Way•Louisville, KY•40202

Last Updated: 9/6/2013