In stroke rehabilitation circles the sick joke is, Speaking, Writing or Walking; pick one. What that means is that our health care system for rehabilitating patients post stroke is so poor (being both broken and insufficient) that if you have a stroke you can only get enough rehab paid for to re-learn one life skill; talking, writing or walking.

Please try to imagine for one minute that you are a care giver (spouse or other family member) and your loved one’s life has been devastated by a stroke. You may be somewhat relieved that he or she survived this lethal event. Your love for that person allows you to be blind to their current inability to talk to you, but you understand them nonetheless. Although, no one else understands them and you become a translator. Still, you are encouraged because every day they seem a little better.

After about 10 days in the hospital they are transferred to a rehabilitation institute. This raises your hopes because you are sure that the rehab will bring them back to normal. At the rehab hospital, every day you see improvements in balance and communication. The occupational and physical therapists are firm with the regimen but fair and compassionate in the care they provide. After about three weeks there are still many difficulties with simple skills like walking and communication, but it is announced that the rehab is over and you’re given some literature on how to care for a disabled stroke patient at home.

Now at home without the skill and training the therapists had you are unable to motivate your loved one as well and the status quos that results is they depend upon you for everyday tasks; getting dressed, preparing food etc. You are now the main caregiver of a physically dependent adult, which is a full time job. You may need to quit your job or hire home health care workers to give you time to make some money. Insurance often falls well short of this. They are depressed because their lifestyle is shattered. Sadly, many stroke patients only receive about 30% of the physical rehabilitation they need or would benefit from. This leaves patients disabled and family devastated by trying to figure out what to do after being given a bunch of literature with lots of information but few answers.

These post stroke victims are largely unable to care for themselves and less able to fight to get the help they need. That is because they are ‘disabled’ and society tends to not want to see them. But please take a close look at this deserving segment of society estimated to be growing by 300,000 people per year in the USA. A productive member of society has a stroke and not only is their income lost to the family, but often a second income is lost caring for that person. Families are hit with a financially catastrophic double-whammy. Every family in the USA is one stroke short of bankruptcy.

That is just sad.

The current health care plan being bantered around in Washington DC will not fix this. What is needed to fix this is an understanding that rehabilitation is not finished when the insurance runs out. More and better rehab will return insurance premium paying people to the insurance companies and work force. So the simple policy that is needed is that if a patient’s improvement is continuing post stroke and the feasible goal is return to work / normal, keep up with the rehab. I believe that three extra weeks of physical therapy will be paid for by the years of extra life we can get from those people after successful rehabilitation.

Oh yeah, and one more thing. Lets support more rehabilitation research to get even more people back to work post stroke.