Stroke Rehab

1. First, we need to see if the MK is medically stable before we can even consider any rehabilitation by performing an assessment of complications. Here, we can also get additional information of his prior and current impairments, as well as his functional status (ability to sit upright for an hour, etc). We need to see if he is able to actively participate in rehabilitation, and whether or not he has any functional deficits (LE weakness and inability to move right UE) and how it affects his activity and participation; as well as any other limitations in other domains. Additionally, we have to look at what his social support system is, prognosis of functional recovery, and his level of independence. 2. First, he would have to possess a certain level of motor and cognitive function, and be medically cleared to go home. I would then assess with the family the ability for MKs ability to negotiate his home, with or without assistance from his spouse or daughter; where I make sure he is able to ambulate around his house safely by evaluating with them any potential hazards he may face while doing so. I would additionally go over his goals with his family, and educate them on their roles in helping him develop them in order to get him as independent as possible. Moreover, I would educate his family about the risk factors for stroke, especially modifiable ones where they can help him out with avoiding these to avoid a reoccurrence of stroke; and educate both MK and his family on the stroke warning signs, and how to react in the event that he were to suffer another attack. 3. MK is going home! The rehab team has determined that MK would benefit from continued physical and occupational therapy. Using the Community Based Rehabilitation Algorithm C from the VA Clinical Practice Guidelines for Stroke Rehabilitation, what factors will the team consider in determining if these services will be delivered in an outpatient setting or in the home? (Answer should not be longer than 2-4 sentences; 3 points) They would determine the optimal environment for community based rehabilitation, where home would be functional because it is their environment and an outpatient setting would require more independence with an adaptive environment. The team would also have to see where MK is most motivated at for therapy, as well as whether or not he has transportation to an outpatient facility.