Wednesday April 25, 2012

Health News

On Their Own Turf 

Stroke patients see faster recovery at home than in hospitals

Submitted by Fraser Health


fter nine weeks in the hospital, Patrick Bell was itching to go home.

At that point, the Chilliwack resident was in Eagle Ridge's High Intensity Rehabilitation Unit recovering from a stroke in August 2011. He still needed a cane to walk, still had problems with his speech and his right arm, and still needed help with everyday tasks. But he desperately wanted to be home.


"About the last two weeks, I was going a little crazy. I wanted to go home," admitted the 52-year-old boilermaker foreman.

A year earlier, Bell would have stayed in hospital for several more weeks to complete his high-intensity physical, occupational and speech therapy treatments.

But a new Fraser Health program allowed him to return home to his wife Colleen and continue receiving the same level of rehab he had received in hospital. Launched last summer, the Rehab Early Discharge (REDi) Program targets patients like Bell, who still need rehab but no longer require 24/7 care, can get to appointments, and can manage at home with support from either family or Home Health services.

Recent North American research suggests rehab patients are happier and improve faster when they are discharged earlier and continue therapy as outpatients. This has been the case for REDi, which allows patients to go home an average of nine to 11 days sooner - freeing up hospital beds - while reducing a patient's recovery time.

"It's the best of both worlds," said Val Spurrell, Fraser Health's Executive Director of Clinical Programs & Operations for Rehab, Older Adult and Allied Health. "We've created a program that provides great service with great outcomes, and the feedback from patients has been so positive. It's also increasing our capacity. By reducing inpatient stays, we can see more patients."

The program has been so successful that after its launch at Surrey Memorial and Eagle Ridge hospitals in 2011, it was expanded to Peace Arch Hospital and Queen's Park Care Centre and is now being considered for other sites in Fraser Health.

Through REDi, patients come in up to four times a week and will see multiple therapists during each appointment, which reduces a patient's travel and speeds recovery.

Stroke recovery is also improved when patients are more active, and Bell felt being at home gave him more opportunities to keep mobile - particularly since he and his wife were still unpacking from their move to a new home in Chilliwack just prior to his stroke. He participated in Eagle Ridge's REDi program for two months before starting another rehab pilot program for stroke patients at Abbotsford Regional Hospital.

"At home you have to do things for yourself. I think it helped me," said Bell, who has two adult children and a granddaughter. "The people in the REDi program, they're very good. They're a big part of it."

Bell is still working on improving his speech as well as dexterity and strength in his right arm. But he can now walk four kilometers and reacquired his driver's licence on Mar. 23. He hopes to return to work in about a year's time.

"At the beginning you couldn't understand a thing I said, I was stuck in a chair, my right side was completely dead. That's where I came from," he said.

Spurrell noted that increasingly, outpatient programs such as REDi are helping Fraser Health address the rising demand for health care. Redesigning rehabilitation services to meet patient needs in a way that is equally effective but more efficient enables Fraser Health to reduce hospital congestion and serve more people.

This is particularly important for conditions such as stroke, which are closely linked to age and on the rise. In B.C. stroke is the leading cause of disability in adults, the second leading cause of dementia, and the third leading cause of death.

"Our philosophy is that home is best," Spurrell said. "In the past many services were only provided in a hospital. This program is changing that. It's allowing people to be at home with their families and receive the same level of care they could receive in the hospital."


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