What to Expect as an Inpatient
Your Stay in the Stroke Unit
While no two patients' stays are exactly the same, this page provides information that will help you prepare for your stay in the Stroke Program at Rehabilitation Hospital of Indiana (RHI). Note that the average length of stay on the stroke unit is 14 days, but your length of stay will be determined by your specific needs. Approximately 70% of our stroke patients are discharged to the community after their inpatient stay.
Upon admission, you will receive a transition binder, which will include information pertinent to your rehabilitation program. This binder is meant to serve as a central location for patients and caregivers to keep important material throughout the continuum of care, as additional information and resource materials specific to your brain injury and recovery will be added to the binder periodically.
Working Toward Your Goals from Day 1
The first two days of your stay are busy setting goals and settling into a routine, so it is important for family and/or caregivers to be present.
Your first day at RHI will be light to allow you to transition and get settled.
- The nurse will greet you when you arrive
- The nurse will do a head-to-toe assessment and ask you questions about your health
- A visit with your rehabilitation doctor is possible depending on what day you arrive
- Family or caregivers should be with you to help answer questions and get you settled in
- The treatment team performs comprehensive evaluations
- Meet your care coordinator
- Meet with Physical Therapy, Occupational Therapy, and Speech-Language Pathology, who will each assess abilities and help set goals
- Meet with a clinical dietician
- Meet with a wound care specialist (if needed)
- Talk with your rehabilitation doctor (if not done on day one)
Within the First Week
- You will meet your ongoing therapists, who have specific training and experience with therapeutic interventions for patients at all levels of injury, the care coordinator, recreation therapy, neuropsychology team, rehabilitation psychology team (as needed), and dietary (as needed)
- The team will meet to discuss your treatment plan and goals and to develop a tentative discharge date
Sample Daily Routine and Expectations
Patients receive a minimum of three hours of individual one-to-one therapy 5 days per week. Time not spent in therapies can be used to rest and visit.
6:00 - 8:30 am*: Wake up, get dressed, and eat breakfast
8:30 am -12:00 pm: Morning therapy sessions
12:00 - 1:00 pm: Lunch (in common area) and rest
1:00 - 5:00 pm: Afternoon therapy sessions
5:00 - 6:00 pm: Dinner (in common area)
6:00 - 9:00 pm: Relax and get ready for bed
*Occupational Therapy or Speech Therapy may work with you before or during breakfast, depending on your specific therapy needs
[My PT] was the best motivator to get me to do things I thought I couldn't.
WilliamStroke Rehabilitation Patient
What Else to Expect on the Stroke Unit
Our goal is for patients in our stroke program to regain as much independence as possible. The following are some other helpful things to note about your stay:
- Caregivers and families are encouraged to be fully involved in the recovery and therapy process. Research indicates that patients make more progress when caregivers are involved.
- While working toward independence, patient safety is the highest priority. Therefore, patients will be asked to wait for staff members to assist them with daily activities, including self-care, transfers, and toileting. Caregivers may assist their loved one once training with therapy has been completed.
- Patient progress and goals will be evaluated on a weekly basis to ensure the provision of appropriate treatments, training, and care at the patient’s current functional level.
- A tentative discharge date will be set at your first team conference
- Expect to receive a summary of this conference (held within the first week of your stay) that includes your current level of function, the estimated length of stay, and team goals
- Your interdisciplinary team will then meet weekly to discuss your progress, barriers and overall discharge plans
- See the Stroke Program FAQ page for additional information
Working with an Interdisciplinary Team
Your interdisciplinary team is composed of Neuropsychology, Physiatry, Physical Therapy, Occupational Therapy, Speech-Language Pathology, Nursing, Nursing Rehabilitation Techs, Care Coordination, Recreation Therapy, Dietary, Wound Care (if needed), and Respiratory Therapy (if needed). The Stroke team has specific training and experience with therapeutic interventions for patients with strokes.
The OT checks current abilities and develops a treatment plan for meeting goals in Activities of Daily Living(ALDs) including:
- Self-Care, such as dressing and bathing
- Leisure, such as hobbies
- Work-related tasks
- Problem solving to accomplish any of the above
- Fine-motor skill development and strengthening, such as hand and arm exercises
The PT checks current physical abilities and develops a treatment program for meeting goals in:
- Mobility needed for ALDs such as exercising muscles and joints, moving in bed, using a wheelchair, transferring (for example, from a wheelchair to the toilet)
- Walking with or without equipment
The SLP works on communication, cognition, and eating skills including:
- Listening, understanding and remembering what is heard in a conversation
- Thinking quickly and putting thoughts into words
- Sounding out words and explaining ideas
- Reading, understanding and remembering what is read
- Writing and putting thoughts into writing
- Cognitive skills needed to complete IADL's (meds, finances, scheduling, etc.) including problem solving, memory, attention, reasoning, mental flexibility
The TR helps patients and families apply skills learned in rehabilitation activities that support personal growth and active community participation:
- Developing self-confidence and comfort in social situations both at home and in the community
- Experiencing individual and group activities to practice skills and develop strategies to nurture friendships and social support networks. Examples: athletics, travel, music art, and hobbies as well as field trips to restaurants, theaters, and sporting events
- Finding new ways to pursue old interests through adaptations
- Identifying new areas of interest
The neuropsychologist tests for thinking abilities and provides help with:
- Understanding the links between brain injury, brain functioning, and behavior
- Attention, memory, problem-solving skills, language skills, and other areas of thinking
- Vocational recommendations
- Adjusting and coping with changes from a brain injury
The rehabilitation psychologist meets with patients, family, and significant others to help with adjustment to hospitalization and disability. The psychology collaborates with the rehabilitation team to support psychological and interpersonal functioning.
The case manager coordinates discharge plans and communicates with insurance or other players about benefits. The case manager shares this information with the rehabilitation team to develop a plan that maximizes the rehabilitation stay. The case manager may have a background in either social work or nursing,
Doctors in the rehabilitation field who receive advanced training and certification in physical medicine and rehabilitation. Physiatrists are experts on how nerves, muscles, bones, and the brain work together. They look at the whole person, not just one symptom or condition.
Rehabilitation nurses are very involved in teaching both patient and family about care needs and routines and have a variety of responsibilities:
- Monitor and oversee daily care
- Teach and help patients and families practice care routines
- Administer medication and teach patients and families about schedule use and possible side effects
- Collaborate with other team members regarding rehabilitation goals and needs for community reentry
- Patients learn to become as independent as possible, with education and training based on the individual’s needs.
- We encourage family to participate in therapy sessions if it is not a distraction to the patient. If appropriate, caregivers can participate in family training.
- We ask that family attend Stroke Education classes with therapy and nursing, held on Fridays from 1-3 pm in the Therapeutic Recreation North Conference Room (TR North).
All of it is so exciting to see. You personalize it all. Your creativity is awesome! From baking to kayaking to putting makeup on to playing yard games to dancing to my favorite songs!Stroke Rehabilitation Patient
What to Bring
- Comfortable clothes, including tennis shoes, to wear to therapy
- Personal grooming items including toothpaste, comb, shampoo
- Dentures, hearing aids, glasses
- See a complete list of what to bring
It's possible that your treatment plan will also include services such as treatment for dysphagia, modified barium swallow testing, community outings, or vision rehabilitation.