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 as not 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!
Therapists have a very good reason for prescribing the same exercises as were done in the clinic: They don't want you to go home, do an exercise that you don't fully know how to do, and get hurt.
Therapists have a very good reason for prescribing the same exercises as were done in the clinic: They don't want you to go home, do an exercise that you don't fully know how to do, and get hurt.
A good home exercise program
will help the survivor to continue making progress once they are home. The HEP can and should be 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:
àprogression of
exercise,
àmeasuring and documenting progress,
àtips 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.
