The Long Road Back

The Long Road Back

Much of you is required to rehabilitate after a stroke

by Patrick Kenney

Life is unpredictable. Most of us go about our days concerning ourselves with immediate tasks. What to pick up at the grocery store for dinner. Getting the kids to soccer practice on time. Meeting that deadline at work.

Rarely do we consider the possibility of all those daily demands being swept away, replaced by new demands we thought we’d never face again. Learning to walk. Learning to speak. But life-altering accidents and medical emergencies happen everyday. Maladies like Parkinson’s, cancer and stroke can strike almost anyone at any time. And when they do, a person in the prime of life is not ready to surrender. This is where the field of physical medicine and rehabilitation provides a necessary way forward.

The American Stroke Association reports that, on average, someone in the United States suffers a stroke every 40 seconds. It is the country’s third leading cause of death. Because of its prevalence, stroke touches the lives of many millions of Americans, at least indirectly. Studies show that more than three quarters of a million people suffer a new or recurrent stroke each year. But to think that stroke is usually fatal is a misconception that could leave people unprepared for the challenges ahead when someone they love is affected.

In fact, the majority of stroke victims survive. But according to the National Stroke Association, 40 percent of stroke survivors experience moderate to severe impairments that require special care, making stroke the number one cause of adult disability in the United States.

The Joint Commission, along with the American Stroke Association, has named Rush University Medical Center and Northwestern Memorial Hospital as Stroke Centers of Excellence, and University of Chicago (U of C) Medical Center as a primary stroke center. This certification means that these facilities have shown an exceptional capacity to deliver swift and proper stroke care.

These hospitals have excellent rehabilitation programs as well, but only the Johnston R. Bowman Health Center at Rush is a stroke specialty rehabilitation facility certified by the Commission on Accreditation of Rehabilitation Facilities, (CARF).

“Part of the reason we did the stroke specialty certification is because it’s very much been a part of what is an area of emphasis for us as a campus,” says Dr. Anthony Perry, director of the Bowman Center. “We’re a comprehensive stroke center.” There is a need for the Bowman Center to get the bar as high as possible in order to support Rush as a Stroke Center of Excellence, Perry says. “We’re ready to be the aftercare for these very complex people with very profound changes that happen in their lives.”

The Bowman Center houses all of Rush’s inpatient rehabilitation services. Here, a patient can work with a physiatrist, a physician in the field of physical medicine and rehabilitation, as well as occupational, speech and physical therapists as needed. Inpatient rehabilitation is geared toward providing an interdisciplinary team of doctors and therapists to work to restore function in a complex patient like a stroke victim. If patients recover to the point that they no longer need the constant medical supervision of a hospital but still have complex needs and require interdisciplinary therapy, they can move into a day rehab program.

A stroke patient at Rush or U of C could be discharged from the inpatient program and find a new location, perhaps closer to home, for day rehab therapy. U.S. News and World Report has ranked the Rehabilitation Institute of Chicago (RIC) the number one rehabilitation hospital in America for 20 consecutive years. It has day rehab and inpatient programs at its main hospital in Streeterville near the campus of Northwestern.

One of RIC’s world-class inpatient programs, the Prime of Life Stroke Program is specifically tailored to help younger victims return to their demanding lives. As many as one out of every four stroke victims is under the age of 65. They also have a number of day rehab programs at a variety of other locations in the city and suburbs.

Perry explains why patients may decide to stay with them throughout recovery. “What we’ve uniquely done at our day rehab program is to embed it into our inpatient rehab program.”

This means that patients entering day rehab therapy actually go back to some of the same treatment gyms that they were treated in while they were inpatients and, therefore, get continuity of treatment by some of the same therapists.

“We love that continuity as opposed to a handoff with a new team,” Perry says. The smooth transition between stages of recovery can be a comforting experience.

“Therapists love it because they get to see the patient for a longer period of time as the patient progresses and for them, that’s a really exciting piece of what they do,” Perry continues. “Traditionally, when a patient leaves the rehab facility, a therapist would say goodbye to that patient and not see him or her again. With the day rehab program, they’re coming back for weeks; oftentimes four or six weeks after they’re discharged from the hospital. The patients love it; our therapists love being able to do it as well.”

The Bowman Center strives to provide patients with programs that best suit their specific needs. To that end, the center has created an advisory council of former patients who work to offer advice on improving the rehabilitation programs at Rush.

Perry describes a recent advisory group meeting, “It was the first meeting for a new group of patients, and the stories they were sharing were profoundly emotional. They weren’t all people who suffered from having had strokes, but several of them were in that group, and it’s pretty powerful to hear people talk about the stroke and how the disability that gets created by that impacted them and their path toward trying to rebuild function and strength and so forth.

“I was feeling choked up just sitting there listening to the conversation,” he says. But the council isn’t just about inspiring stories. “We want to hear good and bad about ourselves.”

Former patients often want to tell Perry and his team that they had a wonderful experience and valued the care that they received. “We love that, and we appreciate that they say it, but we want to get [them] looking at everything that happened. Was there stuff that puzzled them or confused them or set them back in their process? It has proven to be a very valuable learning experience for us.”

Perry says one group even created products that “we’re going back and using for our patients. They did things like work on a manual of helpful hints for future patients coming in. It’s been a neat process for us.”

——————————————————————————————————————-

FOR MORE INFORMATION

Visit Rehabilitation Institute of Chicago’s website at ric.org, for more information on its inpatient and multiple-day rehab programs. The RIC website also provides a collection of inspiring patient stories. For helpful information about CARF certified rehabilitation providers, visit its website at carf.org where you can search for a provider certified in the specialization that best suits you or your loved one’s needs. Find information about the Bowman Health Center and the rest of the Rush University Medical Center at rush.edu.

[email_link]

Published in Chicago Health Summer 2011