Stroke Rehabilitation Program

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Stroke Rehabilitation Program Description

Burke’s Stroke Rehabilitation Program is dedicated to providing you the most effective, patient-centered, state of the art rehabilitative care after you have sustained a stroke. The inpatient program provides you with comprehensive services that prevent secondary complications, minimize impairment, reduce activity limitations and maximize participation in and quality of life. Interdisciplinary rehabilitation, provided by a trained and experienced team, maximizes recovery from the physical, visual, cognitive and psychological impairments caused by stroke. The multidisciplinary team works collaboratively with you and your family and/or caregiver, using evidence-based practices, to help you achieve your full potential.

Burke’s intensive and comprehensive program focuses on maximizing each person’s ability to function, through personalized care and individually-designed therapy programs. Preventing complications, improving self confidence, and optimizing adaptation and education helps patients achieve the highest level of independence possible.

Within a safe, secure and structured environment, Burke offers intensive therapy seven days a week. Your schedule will be determined by your individual needs and goals. As a patient in any of Burke's inpatient programs, you will receive a minimum of 3 hours of therapy a day, 5 days per week, generally Monday through Friday, and additional therapy on Saturday and/or Sunday for at least 1.5-2 hours. Skilled therapy will be provided in a combination of physical therapy and occupational therapy and/or speech therapy as needed. Rehabilitation nursing and access to a physician are available 24 hours a day, seven days a week.

Scope of Services
The Stroke Rehabilitation Program provides comprehensive services and medical management, anchored by interdisciplinary professionals who involve you and your family and/or caregiver in all phases of rehabilitative care. These stroke specialists assess your abilities individually and help you develop realistic short- and long-term goals, applying the latest research and technology methods. The program provides ongoing access to information about available services and resources that can improve your quality of life.

Burke’s Stroke Rehabilitation Program:

Maximizes recovery from the physical, cognitive and psychological impairments caused by stroke
Focuses on the individual’s capabilities and use of compensatory strategies and devices to lessen activity limitations
Removes or lessens restrictions to participation in life roles and situations to the extent possible, and counsels and educates individuals and families on alternative possibilities for life participation when necessary
Prepares the individual and family/caregiver to make the transition to the next stage of the rehabilitative process
Provides interdisciplinary rehabilitation that emphasizes communication, collaboration and cooperation

Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training.

In 2017, the Stroke Program:

Served 490 patients, ranging in age from 23 to 97 years, with an average age of 73 years old, who had a recent stroke or who live with impairments from a prior stroke
Discharged patients to the following environments:

51% (251) of the patients returned home with home care, outpatient, or no further services because services were no longer needed.
30% (146) of the patients went to a sub-acute facility to continue their inpatient rehabilitation.
19% (92) of the patients were transferred to an acute hospital.
0% of the patients entered a long-term care facility.

In order to ascertain the long-term outcome for the individual, Burke contracts with a company to conduct follow-up interviews via phone at 3-months post-discharge.

Three months post-discharge from Burke in 2017, the patients experienced the following outcomes:

Percent of patients living in the community: 93%
Overall satisfaction with community participation, quality of life and goal attainment 3 months after discharge: 3.8 (out of 4)

Within the scope of the Stroke Program, patient evaluation and care planning are designed around traditional medical disablement models. These models assess three levels of dysfunction which stem from the patient’s admitting diagnosis (pathology).

Impairments: Weakening, damage or deterioration of function within a specific component of the cardiopulmonary and/or musculoskeletal system resulting from injury or disease.

Examples: Decrease in exercise tolerance, decrease in balance, limitations in pulmonary hygiene, decreased cardiac output, decreased ventilator capacity, decrease in strength, decrease in active and/or passive range of motion.

Activity Limitations: The inability to perform a specific task as a consequence of the impairments mentioned above.

Examples: Difficulty with ambulation, stair negotiation, dressing, grooming, or self-care.

Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles.

Examples: Inability to perform duties as a parent, caregiver, employee, or participant in social and leisure activities.

Team Description
The rehabilitation team consists of you and your family and/or caregivers, as well as medical, nursing and other rehabilitation personnel who, by virtue of their education and experience, are trained to work with individuals who have sustained a stroke. The medical and rehabilitation professionals on the team are responsible for assessing your medical, behavioral and rehabilitation needs, establishing individualized goals in consultation with you and/or your family/caregiver, designing and implementing a treatment program, assessing its outcome, communicating with the team and preparing the individual and family for the next phase in the rehabilitation process.

The Stroke Rehabilitation Program focuses on building a caring and compassionate relationship with each patient and his or her family members and/or caregivers. Rehabilitative care is provided through the integration of services from an interdisciplinary team.

The rehabilitation program’s interdisciplinary team consists of:

Individual who has sustained a stroke, or other brain injury
Individual’s family and/or caregiver(s)
Physician
Rehabilitation nursing
Neuropsychology
Occupational therapy
Physical therapy
Speech and language therapy
Recreation/complementary therapy
Social worker/case management
Nutrition
Respiratory therapy

Additional services are available on site to meet the needs of each individual. These include:

Medical consultations
Pastoral care
Orthotic services
Pharmacy
Radiology
Laboratory services

Additional medical needs are met, either on site, through consultative services with various specialists, or at a local hospital for any specialized services.

From admission through the discharge planning process, all team members work collaboratively to ensure that the specific needs of each individual are addressed. Based on assessment results, goals are determined with the individual and/or family, and a treatment plan is implemented. The individual’s progress is discussed formally once per week at team conference/medical rounds. Team consultation and collaboration occur throughout the treatment program. In addition to speaking directly with members of the team regarding the patient’s medical condition, progress, functional status, participation in therapy, achievement of established goals, and prognosis, family members and/or caregivers are strongly encouraged to attend and participate in treatment sessions and patient care. Family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.

Patient and Family/Caregiver Education

Ongoing education of the individual who has had a stroke and the family and/or caregiver is essential in order to maximize recovery from the physical, cognitive and psychological impairments and effectively prepare for the transition to the next stage in the rehabilitation process. Education to patients and families/caregivers is provided throughout the rehabilitation process, during all treatment sessions, patient care interactions, discussion with physicians and other staff, in both formal and informal manners. Patients’ families and caregivers are encouraged to make arrangements to observe therapies and nursing care in order to be aware of their loved one’s progress.

In addition to speaking directly with members of the team regarding the patient’s medical condition, progress, functional status, participation in therapy, achievement of established goals, and prognosis, family members and/or caregivers are strongly encouraged to attend and participate in treatment sessions and patient care. Often, the team will initiate not only observation of treatment, but active participation in training, so that families/caregivers are educated regarding safe and effective techniques to assist their loved ones. Providing education and training for the family and/or caregivers is an essential component of the patient’s rehabilitation stay and provides an opportunity to successfully transition the patient to the next phase of rehabilitation. Family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.

Much education focuses on the fact that, for many patients, their conditions are life-changing and lifelong. Coping, resources, and the need for lifelong follow up to deal with changing needs are provided. In addition, a monthly stroke support group meets on the Burke campus for former patients and caregivers.

Admission Criteria
Every potential patient who may benefit from our care is discussed with the screening staff, physician, and/or program director. The rehabilitation potential for every patient is evaluated prior to admission.

Screening Process

Referrals to Burke are usually made by physicians, social workers, discharge planners or case managers. Nurse Screeners may accept patients from referring acute care facilities. The patient screens may be done in person or from faxed material and staff phone interviews. A rehabilitation nurse may also perform a detailed evaluation at the referring institution. A reasonable medical and functional profile must be provided and appropriate sections of the medical record from the acute care hospital are included. Recommendations are then made to the appropriate member of the medical staff who renders a final decision with regard to admission.

Discharge Planning
The discharge planning process begins when the patient is first admitted to the program. The social worker/case manager leads the planning process, coordinating information from all members of the interdisciplinary team and acting as the primary liaison between the team and the patient and family. Based on the individual’s functional status for self-care, mobility and other daily life skills, family/caregiver support, medical needs, pre-morbid living situation and level of function, and available health insurance, the team, in collaboration with the patient and family, makes recommendations for the most appropriate and suitable discharge plan for the patient. At the team or family’s request, a meeting with the team and patient/family is scheduled to discuss available discharge options. The patient’s and family’s preferences are of primary concern and the team will make recommendations for a safe discharge when options for continued care and rehabilitation are considered.

Recommendations may include, but are not limited to:

Home with home care services
Home with outpatient services
Sub-acute rehabilitation services
Long term care services
Hospice services

Financial Information
For information regarding fees and insurance, please click here.

Location
Located in White Plains, New York, Burke Rehabilitation Hospital's Stroke Rehabilitation Program attracts patients from Westchester County, New York City, Long Island, Northern New Jersey, and Connecticut. Burke also welcomes stroke-recovery patients from across the country and around the world.