When world-famous environmentalist and animal conservationist Joan Embery suffered a stroke, she feared her life would be forever altered. She wondered if she would be able to continue her work or even enjoy some of the things she loves most, such as riding horses and educating others about the issues most important to her.
Thankfully, Embery found herself in the care of Dr. Roxanne Hon, a physiatrist (also known as a physical medicine and rehabilitation specialist) affiliated with Sharp Grossmont Hospital, a Joint Commission-certified Primary Stroke Center. The center provides a wide range of services to help those who have suffered a stroke return to their highest level of independence.
"Our goal is to get our patients home safely and then back to doing the things they could do and enjoy prior to the stroke," says Dr. Hon. "Everyone is different and so we must first learn what their functional status, occupation and interests were beforehand. We can then individualize their care."
The rehabilitation team first assesses a patient's functional abilities in the areas of mobility, activities of daily living, communication and cognition. A treatment plan is then developed to facilitate performance of necessary activities. The goal for every patient is to address stroke-related complications, prevent another stroke and return home as safely and quickly as possible.
"The initial focus of our treatment plan varies widely, based on the severity of the stroke," says Daniel Debeliso, a rehabilitation therapist. "Sometimes patients need to focus on very basic motor skills, such as being able to sit or stand under their own power, before they can address skills related to their previous recreation or employment."
Embery's treatment team knew that her goal was to be able to ride horses again and resume public speaking engagements. The team responded by developing therapeutic activities to help her meet her goals. Her occupational therapist worked with her on tying horse knots, her speech pathologist worked on her verbal expression, and the physical therapists worked to help her be able to mount her horse and even to safely walk in high heels when appearing before an audience.
"Joan came to us moderately impacted by her stroke," says Dr. Hon. "She was in good health, had strength, her cognition was good and she was very determined when she came to us, which is promising."
Unfortunately, not all patients are as lucky as Embery and many have severe impairments after stroke. However, according to Dr. Hon, knowing and recognizing the signs of stroke and receiving early intervention can vastly minimize the effects of a stroke.
Each patient in the inpatient program receives approximately three hours of treatment per day. Treatments may include self-care training; education on the use of adaptive equipment; strength, coordination and mobility training; listening and verbal expression practice; memory exercises; and practicing safe swallowing. Activities of daily living are addressed and patients practice concepts to make dressing, cooking, cleaning, shopping, personal hygiene, toileting and even doing laundry easier.
"We all have strengths that we bring to the table," says Diane Ward, RN. "Together, we can come up with really great, individualized goals for each patient."
Sally Hunsche, an occupational therapist, helped a woman in her 80s who loved to bowl regain the mechanics necessary to return to her beloved pastime by practicing on a video game console. A drummer used a music glove to practice keeping the beat and fine motor skills. And a mechanic was given basic tools, nuts and bolts to refine his skills. Recreational therapist Stephanie Ousley works with patients to prepare to once again be able to play golf, swim, garden and even go holiday shopping for their grandchildren.
"We know we are making a difference in a patient’s outcome," says Ward. "Our patients come back to visit us months and years after their treatment to thank us and show us their progress. I’ve been here 32 years and still wake up and want to go to work."
For the news media: To talk with Dr. Hon about rehabilitation after a stroke for an upcoming story, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.