Rehabilitation – The Post Stroke “What’s Next”

Rehabilitation is a critical component of our continuum of care, because the time stroke patients spend in acute hospital care is typically short, says Joe Piselli, OTRL, ACSM-EP, therapy manager, Mary Free Bed at Covenant HealthCare. “Getting stroke patients ready to go home independently or under the care of family requires a ‘next step.’ For many, what comes next is inpatient rehabilitation.”

Covenant’s affiliation with Mary Free Bed provides post stroke patients with a level of quality AND results unmatched anywhere in the area.

Because strokes are such complex medical events impacting the brain and body in a wide variety of ways, patients recover with varying degrees of deficits – from physical or functional…to cognitive or speech. Mary Free Bed at Covenant addresses each patient individually, with program highlights including:

CARF Accreditation
The Commission on Accreditation of Rehabilitation Facilities (CARF) has awarded Mary Free Bed at Covenant with the highest level of accreditation for its stroke rehabilitation program based on extraordinary quality and results.

Specialized Evaluation
Our well-trained and diverse team of physical, occupational, and speech & language therapists develops a personalized treatment plan based on a comprehensive evaluation of each patient’s lower body muscle strength and mobility, upper body coordination and strength, vision, ability to perform self-care tasks, swallowing, speech and expression, as well as in-depth cognitive functions like managing finances and safely driving a car.

Goal-Based Treatment Plans
After the specialized evaluation, each patient’s team determines measurable goals to guide the recovery journey – whether recuperating from or adapting to deficits from the stroke. The first three weeks are critical, so patients can expect high intensity therapy at least three hours a day, five days a week. In an ordinary skilled nursing or assisted living facility, therapy time is typically just 30-90 minutes.

Utilizing research conducted at Mary Free Bed, therapists follow guidelines established by a medical rehabilitation physician specialist – called a physiatrist – to get patients walking immediately and increasing their heart rates using an array of assistive equipment and technologies. Similar strategies and technologies are used to encourage upper body movement and even accelerate progress on swallowing.

Advanced facilities
The inpatient stroke rehabilitation program for Mary Free Bed at Covenant is currently housed at the Michigan Campus but will be moving into a newly constructed building attached to the main hospital in Fall 2021. The new Mary Free Bed at Covenant will provide 60 beds for patients. For stroke patients, much of the assistive equipment is built-in to the ceilings of patient rooms and hallways, providing even safer and more effective therapy.

Discharge planning
Mary Free Bed at Covenant therapists visit stroke patients’ homes to assess what, if anything, patients will need when they are discharged to return home – from higher toilet seats or hand grips to wider doors for walkers or wheelchairs.

“We reintegrate stroke rehabilitation patients back into their familiar community surroundings to help them successfully navigate trips to the grocery store or dining out at restaurants.” Piselli explains. “Therapists focus on not only what patients NEED to do, but also on what they LIKE to do – and we have even taken patients fishing on Ojibway Island or working out at the YMCA.”

Before patients return home, stroke rehabilitation discharge planners arrange for home health care or continued outpatient therapy at Mary Free Bed at Covenant if needed.

For more information about stroke rehabilitation, visit

Posted Date: 5/21/2021

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