After stroke, inpatient rehab helps patients get back to their lives
Ralph Fiala, 83, uses his walker to balance himself as he attempts to move from standing up to lying down on a bed. He doesn’t quite get it right the first try.
“You’re in the middle of the bed,” observes Debbie Kassens Holdren, a certified occupational therapy assistant at MultiCare Good Samaritan Hospital. “That won’t work.”
“I’ll have to sleep in the guest room,” teases Ralph’s wife, Ann Fiala.
“That won’t be no fun,” Ralph quips.
He gets up and tries again.
Ralph is a patient in the inpatient rehabilitation unit at Good Samaritan, recovering from the stroke he suffered April 3.
What happens after a stroke?
Ischemic stroke — the most common kind of stroke and what Ralph experienced — happens when blood vessels to the brain become clogged, cutting off blood flow.
When symptoms appear, it’s important to act quickly to lessen damage to the brain. Treatment for stroke involves clot-busting medication and sometimes additional medication to treat brain swelling.
Once the immediate crisis has passed, stroke survivors may have to relearn how to perform everyday tasks such as speaking, walking and bathing.
That’s where Good Samaritan’s rehab unit comes in. Stroke survivors are treated there, along with others recovering from spinal cord injuries, brain injuries and a few other conditions.
A team of nurses, therapists, psychologists, social workers and care coordinators help patients relearn the tasks of everyday living, manage mental health issues, navigate health insurance and, ultimately, get back to their lives.
A typical stay in the unit ranges from 10 days to six weeks.
A team to address all needs
Stroke survivors face many challenges requiring multiple kinds of therapies — physical, speech, occupational and recreation. They’re all under one roof at Good Samaritan.
Janet Blaisdell, a certified therapeutic recreation specialist in the unit, helps patients through — you guessed it — recreation, or things people want to do versus need to do.
For example, she might play card games with a patient as a way to work on both physical skills (shuffling and dealing) as well as cognitive skills (interpreting the cards and making decisions).
Recreation therapy also takes patients outside the hospital on outings to local parks, stores or restaurants — wherever the patient would like to go. It’s about taking the skills learned at the hospital and applying them to the real world.
“Where we go is not as important as what we’re doing,” Blaisdell says.
Skills practiced on outings may include those learned in physical therapy, which helps patients learn to walk and regain their motor skills, as well as speech therapy, which addresses both eating and communication issues.
Occupational therapy focuses on the activities of daily living such as doing laundry, making the bed, getting dressed and taking a shower.
“Occupational therapy is the link between physical and speech,” says Kassens Holdren, the certified occupational therapist. “It’s putting movement into function.”
Nurses help coordinate all therapies, reinforce the skills patients are learning and manage their meals and medications.
“We couldn’t do this without them,” Blaisdell says.
The ‘best you could ask for’
Ralph is looking forward to going home and getting back to gardening, one of his favorite things to do at home.
“I want to get back to being outside,” he says.
Ann credits Ralph’s positive attitude for his good progress in rehab.
“He’s never once said ‘I can’t,’” she says. “He always says ‘I’ll try.’”
Ralph’s sense of humor and support system have been a huge help in getting him through rehab, says Caroline Prewitt, his physical therapist.
“It’s been gratifying to see his progress,” she says.
Ralph praises the whole team for helping him recover.
“Everybody’s been fabulous,” he says. “The therapists are graceful in telling you what you’ve done wrong and help you do it right. They’re the best you could ask for.”
This story was originally published in May 2016.
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Roxanne Cooke tells stories in words, photos and video.More stories by this author