Guest Robin Adams Posted April 9, 2008 Share Posted April 9, 2008 My stepfather had a stroke 3 weeks ago.. it was a brain bleed which affected his speech and balance. He did not have any paralysis. He has been moved to a rehab hospital and has PT, OT and speech therapy and is making progress but has not started walking on his own yet. He has been walking with assistance on the parallel bars and is starting to balance himself sitting on the side of the bed a little more each day. I was just wondering what to expect with regards to walking... what are some things to look for that will indicate if/when he will regain the ability to walk. Any thoughts? Robin Link to comment Share on other sites More sharing options...
Guest lwisman Posted April 9, 2008 Share Posted April 9, 2008 Robin, Three weeks is a very short time in stroke rehabilitation. Many on this site took months to be able to walk. Talk with his therapists and see what they have to say about it. But, remember many medical personnel are negative. Keep encouraging him. It will come. BTW, three weeks after my stroke I was no where near walking with the help of parallel bars. I walk now. It takes time and persistence. Link to comment Share on other sites More sharing options...
cdewald Posted April 9, 2008 Share Posted April 9, 2008 Three weeks? If he is up and they have him walking between the parallel bars..Fantastic..He is up !!!! I thought I could walk after mine and ended up examining the tiles on the hospital floor...Did not know the stroke took away my side. Every therepist must have a "plan" of action that the insurance companies require. This is a log that charts your every success and every stumble. Go over the plan with his/her therepist...Make sure you have the right to view them under HEPA regulations. Develop a "show me" attitude with a smile.... Never "upset" the nurse with the needle....Another life's lesson I learned..Good Luck Link to comment Share on other sites More sharing options...
dstraugh Posted April 9, 2008 Share Posted April 9, 2008 Robin, Definitely three weeks is not a long time. Your Dad suffered a brain trauma and it takes time for the healing to begin. Healing and recovery will continue to occur even though medical professionals may say that it will not. It takes time and patience as Lin said. Recovery doesn't occur quickly as many of us here can attest to. Keep encouraging him - you don't want things to be rushed and he get injured in the process. Part of successfully walking is being able to maintain balance while doing so. Hang in there and please keep us posted on his progress. Try to look at it as his learning to walk again can be compared to a child learning to walk - it can be a slow process and once he starts, he will forge ahead. Link to comment Share on other sites More sharing options...
kanderson Posted April 9, 2008 Share Posted April 9, 2008 robin, when he is ready, therapy will know. that is usually the 1st thing they will attempt with the survivor if he is ready. the parallel bars is very important. i had to use those very well before they tried to get me to walk. the pathways were injured by the stroke, so careful planning on the therapist's part is very important. your step dads care plan should be discussed with you. it does take time and is slow in coming sometimes. keep encouraging him and praise any improvement no matter how small. remember he is still healing. i wish you and your stepdad a very good recovery. NEVER GIVE UP HOPE. i didn't start therapy until 3 weeks after my stroke. but i do walk today with a cane and afo. Link to comment Share on other sites More sharing options...
myhome Posted April 9, 2008 Share Posted April 9, 2008 I guess I was ready because four days after my stroke they had me in the hospital's out patient rehab walking ( if you called it that) in the bars as well. They sent me to the rehab hospital three days later. I guess I showed that I wanted to get better, your step father seems to have that attitude as well. Keep encouraging him, and keep us informed of his progress. Link to comment Share on other sites More sharing options...
cindyg1947 Posted April 9, 2008 Share Posted April 9, 2008 My husband had a brain bleed on 12/24/05 and the Dr's said he would probably never walk because he has a bad case of Ataxia so his balance is so bad. He is now walking with a walker a little bit. He can make it to the bathroom and back to his chair on a good day. His present therepist said it will take a long time before he can do it with a cane but at least he's starting to do better. Good luck because there really is no time limit............recovery just keeps progressing but for some very slow........ Link to comment Share on other sites More sharing options...
lliu Posted April 10, 2008 Share Posted April 10, 2008 hi robin, this is the time to get as much therapy as your stepdad can get. make sure therapists work with him often. after my stroke, my therapists made me do a lot shifting at the trunk area and that really helped with balance issues. i can walk throughout the house without a cane, but i look like a giant penguin. my physical therapist assured me that lots of walking is very helpful in regaining strength. encouragement from family members is very helpful. although recovery is slow, it's still progress. Link to comment Share on other sites More sharing options...
Guest Robin Adams Posted April 10, 2008 Share Posted April 10, 2008 Thanks for the encouragement. I love this site because it balances me out.... and helps me to be patient. Robin Link to comment Share on other sites More sharing options...
Guest Robin Adams Posted April 17, 2008 Share Posted April 17, 2008 Hello All - you all were correct.. my stepdad is in his third week of rehab and everyday we see improvements. He is inpatient and the dr. said he is doing well so they have approved him for another week of inpatient. They plan to re-evaluate him again next week to see how he's doing. I'm trying to figure out the answer to a few questions: 1) How do they determine whether or not you can stay as inpatient or not? Obviously we want to stay as long as we can inpatient so he can get the most help. He has Medicare Part A and also private insurance (he's retired). I just can't seem to figure out what is the criteria for inpatient versus outpatient. Is it insurance? or his level of improvement? 2) How to negotiate for more inpatient? Any ideas anyone? Link to comment Share on other sites More sharing options...
kanderson Posted April 17, 2008 Share Posted April 17, 2008 robin, great news to hear about your dad. they determine it by progress your dad is making and the therapists documentation to medicare or other insurance companies. his participation and progress in therapy is very important. the longer the therapy the better. he will reach a point that therapists call the plateaued stage. where he has reached the stage that he is not improving anymore. but can continue to do exercises at home versus being an inpatient, or can continue therapy as an outpatient under medicare part b. the more therapy the better. is he getting OT or ST also. pushing for more therapy is important. sometimes insurance companies will only allow for so many days in a rehab facility. i hope that changes in the future. some survivors need extensive therapy depending on their stroke from all 3 disciplines, for longer periods of time. ins co's have established guidelines for therapy after a stroke which is ridiculous, just so they don't have to pay. we are hoping congress stops this in a bill called s-999. i hope i have explained it for you to better understand the system. Link to comment Share on other sites More sharing options...
myhome Posted April 17, 2008 Share Posted April 17, 2008 robin, great news to hear about your dad. they determine it by progress your dad is making and the therapists documentation to medicare or other insurance companies. his participation and progress in therapy is very important. the longer the therapy the better. he will reach a point that therapists call the plateaued stage. where he has reached the stage that he is not improving anymore. but can continue to do exercises at home versus being an inpatient, or can continue therapy as an outpatient under medicare part b. the more therapy the better. is he getting OT or ST also. pushing for more therapy is important. sometimes insurance companies will only allow for so many days in a rehab facility. i hope that changes in the future. some survivors need extensive therapy depending on their stroke from all 3 disciplines, for longer periods of time. ins co's have established guidelines for therapy after a stroke which is ridiculous, just so they don't have to pay. we are hoping congress stops this in a bill called s-999. i hope i have explained it for you to better understand the system. Yes when you hit that plateaued stage they start getting ready to turf you, but don't let that discourage you. Try to get him on the out patient list, I spent 8 months in outpatient rehab. I now walk with and without my cane (depends if I want to be adventurous or not), drive, and have decent quality of life. Link to comment Share on other sites More sharing options...
Guest lwisman Posted April 17, 2008 Share Posted April 17, 2008 Robin, I would recommend you talk to his therapists about his situation. Sometimes when medical staff sees extra interest on the part of family they will do what they can do get insurance to approve more. Link to comment Share on other sites More sharing options...
arogers Posted April 18, 2008 Share Posted April 18, 2008 After having surfed the system for over three years and numerous set-backs and various therapy situations I have determined it is almost 100% based upon the goals set for the patient by the therapist and whether or not the patient has met the goals in the specified time. My husband had difficulty and "plateaued" several times. It's pretty interesting. When your dad is discharged from inpatient rehab he may be moved to a Skilled Nursing Facility designed for rehab, then be discharged home where he can have in-home therapy and after a time discharged from in-home to outpatient. That is the way it has worked for my husband. At any time you feel it would help him after he has been discharged from therapy you (he) may go to his doctor and request additional therapy sessions. Generally I've found the recommendation to be for three or four weeks, then an evaluation and the therapy has been extended. Bill is almost ready to head back for a session to help him with his walking again. I'm sure he would be approved and some strengthening will make him less of a fall risk at home. It's a journey - not a race! Link to comment Share on other sites More sharing options...
Guest Robin Adams Posted April 18, 2008 Share Posted April 18, 2008 Yes he is getting OT, PT, ST...... we have talked to the dr's and they are happy with his progress...I think that's why he's getting extended. Thanks for the tidbits of info... we are at the rehab center with him every day.. My mom (who is also disabled walks w/walker) stays up there from 1:00 p.m. to 9:00 p.m. every day. Even tho he's in therapy, she's there when he goes and comes back...talks to nurses, doctors, therapist. The rest of us come up daily as well. He has a host of friends/family that come every day so I do think that's making a difference in his progress and his attitude. I was just trying to figure out what the definining factors are for more therapy... but this informations helps a lot!! Link to comment Share on other sites More sharing options...
arogers Posted April 18, 2008 Share Posted April 18, 2008 Hi Robin, Your mom sounds like me. What have the folks at rehab said about her being there all day? The reason I'm asking that question is that when my husband was in rehab I was encouraged to back off on my time spent with him so they could really work on independence issues most stroke survivors have in the beginning. Also, your mom needs rest if she is planning to bring your dad home. Believe me, it is a huge job to manage. The emotions we feel when our husband returns home and suddenly we care for him 24 hours a day are huge. Sleep is sporadic and exhaustion can quickly set in. If your mom uses a walker, no doubt she will have in-home assistance when that time comes. She needs to take care of herself, especially right now when there are so many people there to take care of your dad. Believe me, please the employees at the rehab center are all well aware of your commitment to help your dad. Your story brings back so many memories of Bill's strokes. Warmly, Link to comment Share on other sites More sharing options...
glaidice Posted April 22, 2008 Share Posted April 22, 2008 Robin, All I've got to say for your dad is HOORAY for all his FAST progress! :laughbounce: Link to comment Share on other sites More sharing options...
Guest Robin Adams Posted April 22, 2008 Share Posted April 22, 2008 Good suggestions... speaking of coming home.. they are talking about releasing him to come home this weekend. I'm so nervous. These are the things they've told us.. he will come home with an attendant to assist as well as therapy for a while and then I guess we'll re-evaulate him for out-patient. I live in Syracuse, NY . My step dad and mom are in South Carolina. I was there for two weeks. I've been waiting for him to come home from the rehab center before I returned to SC to help out. I figured they would need me more. I probably can take another couple of weeks right now and maybe more later. He also has two daughters and I was trying to figure out how we could each stay with them for a week or so... that would hopefully give him more time to become a little more independent.... Coordinating every body is also stressful because I'm trying not to tell everyone what to do... I really wanted him to have more inpatient but I guess this is all we're getting for now.... My nerves are shot!!!! I worry constantly about my mom and now I can't even begin to imagine how this is going to work. The good part is tht his progress continuess. It will be 5 weeks on Saturday. He is able to walk about 150-200 feet with walker; can transfer from chair to bed, etc... Can go to the bathroom but needs assistance to get there... Cognitive is good and speech is really improving.... Link to comment Share on other sites More sharing options...
dstraugh Posted April 23, 2008 Share Posted April 23, 2008 Robin, Thank you for the update. All will fall into place. Someone needs to take charge in coordinating family members involvement. I can understand you not wanting to be "pushy" but just explain to his daughters your plans and the importance of team work. Hope they work with you so you're not doing everything yourself. Link to comment Share on other sites More sharing options...
kanderson Posted April 23, 2008 Share Posted April 23, 2008 robin, great news about your stepdad coming home, as donna said it will all fall into place. after you get him home and see how he does,then maybe , get everyone together and say this is what he needs, how are we going to coordinate it between all of us, then take it from there. you might be surprised how well he does back in his comfort zone. its slow going at first, but he sounds like he is doing well. having adaptive equipment at home will help too. grab bars, shower chair, etc. therapy should advise you of all he needs. i know it is nerveracking at 1st, hang in there. i was so happy when i could go home. therapy came to my home to evaluate me getting around it in and what i needed to do to make it safe and accessable for me. Link to comment Share on other sites More sharing options...
lliu Posted April 23, 2008 Share Posted April 23, 2008 hi robin, thanks for the update regarding your stepdad. i can imagine your feelings of axiety and concerns, but don't worry too much. as long as everyone pitches in and the lines of communication remain open and clear, things will sort themselves out. i'm sure you've taken all precautions to see that the home is properly equipped with the right safety devices so that your stepdad will be able to manuever around okay. take one day at a time and remember to take time for yourself. Link to comment Share on other sites More sharing options...
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