Rehabilitation

Question 1

What are the primary goals of stroke rehab?

Answer 1

Prevent complications
Minimize impairments
Maximize function

Question 2

When should rehab start

Answer 2

24-48 hrs post stroke stability

Question 3

When participating in rehab patients should be should be taught

Answer 3

To reduce dependency on others

Emphasize positive and abilities

Question 4

The major concept of rehabilitation is

Answer 4

Recovery and restoration

Question 5

The major concept of restorative care is

Answer 5

Maintenance of optimal level of functioning - often in LTC settings

Question 6

What are the levels of rehabilitative/restorative care

Answer 6

Acute care settings
Acute care for elders (ACE ) unit
Postacute care settings (PACs)

Question 7

Name the types of post acute care (PAC) settings

Answer 7

Inpt rehabilitation Facility (IRF)
Subacute rehabilitation care facility 
SNF
LTACH
Assisted living
Board and care
Adult day care
Independent living center
Outpt rehab
HHC
Private care

Question 8

IRF characteristics

Answer 8

Often selective regarding age and dx
Stroke is usually top dx
Rehab team members must be well versed in age specific care

Question 9

What type of rehab is provided at an IRF

Answer 9

Bowel and bladder management
Medication management 
Nutritional management
Skin care management
Pulmonary and cardiovascular management
Safety management 
Reinforcement with pt and family

Question 10

Why type of care is provided at a subacute rehabilitation care facility

Answer 10

• Lower cost than IRF
• Pts that don’t require acute care but more care than a SNF
• Patients are medically fragile and may need resp interventions, IV therapy, complex wound management
• Therapy is shorter in duration and less intense than IRF

Question 11

Describe the care provided at a SNF

Answer 11

• Pts medically stable but still require nursing care with MD oversight
• Services cannot be provided at home such as wound care, IV meds, enteral feedings, bowel/blader management, pulmonary care, vent care in some settings
• PT/OT/SLP
• Lower intensity, daily usually M-F
• Can also provide outpt care after pt dc’s
• Optimal pt wellness is goal

Question 12

Describe the care provided at LTACH

Answer 12

• Acute care hospital for pts that will need care >25 days
• intensive medical and rehab care
• pt is too sick to be at SNF but not sick enough for acute care

Question 13

Describe assisted living centers

Answer 13

• Resident and not a pt
• Private room or apt
• Tiered payment system according to needs
• Covered by private funds
• Some Medicaid
• Residents are independent but have access to personal and support services
• Nurse is usually on duty

Question 14

Describe board and care

Answer 14

• Most common form of residential setting
• Non- medical
• Meals, medication supervision, activities, transportation, help with ADLS

Question 15

What are the 3 type of licensures for board and care

Answer 15

• Develomental disabilities
• Mental illness
• Physically frail or cognitively impaired

Question 16

Describe adult day care

Answer 16

• Safe environment
• M-F usually during wrk hrs
• Most are federally or state funded
• Helps to foster stoke pts functional improvement and sense of control

Question 17

Describe outpt rehab

Answer 17

• Rx from MD which states type, specific functional deficit to be addressed, and number of times for therapy
• Assistance with self care, mobility, swallowing, communication

Question 18

What does the Barthel Index measure

Answer 18

• Self care and mobility measurement scale
• 100 is independent 0 is dependent
• Measures 10 self care domains
• Can be trended over time
• can not quantify disability in high functioning stroke pts

Question 19

What are the 10 areas of self care evaluated in the Barthel Index

Answer 19

Feeding
Bathing 
Grooming
Dressing
Bowel
Bladder
Toileting
Transfer to bed to chair
Mobility
Stairs

Question 20

What is FIM TOOL used for

Answer 20

Measures burden of care
Can be used to develop care plan
Done on admission, Q shift, weekly