Strokecast

Guest Post: My spouse had a stroke, now what? (Part 3)

Editor’s note: Today’s post comes from stroke spouse Melia Wilkinson. You can read Part 1 of her story here, and you can read Part 2 here.

— Thanks, Bill

Off to a sub-acute facility

If your loved one is not ready to move to acute rehab for any reason, they will likely be moved to a sub-acute rehab facility or a nursing facility. Not all of these facilities are created equally, unfortunately. At a sub-acute facility, there is access to therapy to, in some cases, “ramp up” to a level that might qualify for acute rehab. Kerry received care and lots of therapy at his sub-acute therapy stay. It is more likely to receive weeks, if not months (we were there for over three months), of care in a sub-acute setting. Acute rehab is usually only 2-3 weeks, and the focus is on discharge to home.

Remember what I said earlier, the more rehab the better. It would be a lovely thing if your loved one needed only a few weeks of therapy. You should celebrate that. If they decide they need to go to a sub-acute rehab facility first, though, you should EMBRACE it. You will get help, and you will get them on track.

If they decide they need to go to a sub-acute rehab facility first, though, you should EMBRACE it. You will get help, and you will get them on track. -- @MeliaWilkinson #stroke Click To Tweet

The feeding tube was a godsend…

Another condition they will be monitoring is your loved one’s ability to swallow. MANY stroke patients lose some of their swallowing reflex. When my husband was tested, we could not get him to eat. It wasn’t absolutely clear if he just wasn’t interested, or if he couldn’t, but he hadn’t had real food in over a week. They pulled me aside and had a gentle talk with me about a feeding tube.

I’m going to be blunt, the feeding tube was a godsend. It got him the nutrients he needed, I didn’t have to force him to eat, and we could focus on other things. I understand that they thought I would be upset, but I wasn’t (and you shouldn’t be either). This is just one step. There is a HIGH likelihood they will get off the tube (my husband has zero issues today), and it really is the best thing for recovery and everyone’s sanity. The only caveat I’ll put here is that many of the rehab facilities are not comfortable with a feeding tube, so that may limit your choices, slightly.

I’m going to be blunt, the feeding tube was a godsend. It got him the nutrients he needed, I didn’t have to force him to eat, and we could focus on other things. -- @MeliaWilkinson #stroke Click To Tweet

Making sure that your next facility can truly accommodate your needs

By now, you probably have a team of folks who are working with you. One is a counselor of sorts who will help you juggle “what’s next”. Unfortunately, they are not able to (or at least ours wasn’t) recommend or advise, just inform. My husband had to go to a skilled nursing facility (rather than straight to acute rehab). Our counselor gave me a list and pretty much said, “Pick one”. Luckily, I had friends with some nursing background, and between us we visited the ones that made the most sense. They had to accommodate his feeding tube, as well as the helmet he had to wear when out of bed after the craniotomy. In the end, we picked a swing bed facility. These are hospitals that are in a bit more of a remote location, so they are used as both an emergency facility and as a skilled nursing facility (thus, the beds can swing from one use to the other). The thing about a swing bed facility is that the nurse to patient ratio was 5:1, whereas all the other facilities had 7:1 or 9:1 ratios. I didn’t have much to go on, but that seemed enough of a difference to make the choice for me. And with that, we were off to the next chapter of our stroke recovery story…

Click here to read Part 4

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