Years after stroke survivors have been discharged from therapy, recovery can continue.
Of course, the speed of recovery diminishes over time. There is no time that is quite as fertile as the period of natural recovery in the first few months after stroke.
But recovery can continue. Stroke survivors should be encouraged to see discharge from therapy not as the beginning of the end, but as the end of the beginning. The baton of the conductor of the grand symphony of recovery is passed from therapists to survivor.
Most of the time therapists will leave stroke survivors with little guidance for further recovery. Some therapists think “HEP” stands for “Hand ‘em photocopies.” Too often the HEP reflects nothing more than a watered down version of the exercises that were done in the clinic.
Irony: The survivor is left with the same exercises that caused the very plateau that caused the discharge!
A good home exercise program will help the survivor to continue making progress if it is started the day the therapist meets the survivor. Therapy itself can be part of the HEP. If the survivor and caregivers can see what goes into the basic concepts that therapists use all the time, they will be able to direct their own recovery long after they’ve forgotten your name.
The HEP should explain:
--progression of exercise,
--measuring and documenting progress,
--tips on equipment needed for a home gym.
Therapists: Your job is done. You would have liked more time with them, but this is all manged care has allowed. At least, you’ve helped them to be functional, safe and return home.
Survivors: Your job has just doubled. Not only do survivors have to continue the quest towards recovery through their own efforts, but they have to do it without therapist's guidance. Leaving stroke survivors with the tools they need to continue the quest is critical helping them to be in the best position to reach the highest level of potential recovery.