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What Are the Facilitators and Barriers to Independence for Stroke Survivors?

Katherine George, PT, DPT, Alaena McCool, MS, OTR/L, CPAM

December 15, 2023

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Question

What are the facilitators and barriers to independence for stroke survivors?

Answer

Achieving independence following a stroke is a complex and multifaceted journey influenced by various facilitators and hindered by distinct barriers. Facilitators encompass elements that contribute to the enhancement of functional well-being and successful reintegration into community life. Continued therapy post-stroke emerges as a crucial facilitator, promoting ongoing recovery, improving motor and cognitive functions, and enhancing overall quality of life. Additionally, access to financial assistance provides a supportive foundation, addressing economic challenges and facilitating engagement in necessary rehabilitation services. Mental health services play a pivotal role in the facilitation of independence, offering crucial support for emotional well-being and addressing psychological aspects associated with the stroke experience. Support groups provide a communal environment, fostering peer connections, shared experiences, and mutual encouragement, further empowering stroke survivors on their journey toward independence.

Conversely, barriers to independence post-stroke constitute challenges that impede the achievement of autonomy and functional recovery. A significant barrier is the lack of services, encompassing limitations in access to comprehensive rehabilitation, specialized healthcare, and support programs. This dearth of resources hampers the ability of stroke survivors to address their diverse needs adequately. A pervasive sense of abandonment further compounds the challenges, as individuals grapple with the impact of stroke on their relationships, social connections, and broader community engagement. Grief associated with the stroke diagnosis represents a formidable barrier, as individuals navigate the profound changes in lifestyle, roles, and independence. Finally, denial of rehabilitation programs emerges as a tangible barrier, hindering engagement in essential therapeutic interventions and impeding progress toward independence. Recognizing and addressing these barriers, while leveraging facilitators, is integral to fostering a holistic and supportive environment that empowers stroke survivors in their pursuit of independence.

 

This Ask the Expert is an edited excerpt from the courses Interdisciplinary Approach To Stroke Rehabilitation: Acute Care And Inpatient Rehabilitation Phase and Interdisciplinary Approach To Stroke Rehabilitation: Outpatient, Home Health, And Community Rehabilitation Phase by Alaena McCool, MS, OTR/L, CPAM, Katherine George, PT, DPT.


katherine george

Katherine George, PT, DPT

Katherine (Katie) George graduated from the University of Albany in 2010 with a Bachelor of Science Degree in Human Biology and a Bachelor of Arts Degree in Psychology. She completed her graduate work at Columbia University, graduating in 2013 with a Doctorate of Physical Therapy degree. Katie has experience working with pediatric, adult, and geriatric patients in acute care and acute rehabilitation settings. Katie specializes in the neurological population, specifically with stroke and traumatic brain injury patients.


alaena mccool

Alaena McCool, MS, OTR/L, CPAM

Alaena McCool is an occupational therapist at Kennedy Krieger Institute working within the International Center for Spinal Cord Injury. Alaena graduated from the University of Pittsburgh in 2011 with a Bachelor of Arts Degree in Communication Science. She went on to pursue a Master's Degree in Occupational Therapy from New York University, graduating in 2015. Alaena specializes in the neurological population and has a special interest in spinal cord injury with adults and pediatrics.


Related Courses

Interdisciplinary Approach To Stroke Rehabilitation: Outpatient, Home Health, And Community Rehabilitation Phase
Presented by Alaena McCool, MS, OTR/L, CPAM, Katherine George, PT, DPT
Recorded Webinar

Presenters

Alaena McCool, MS, OTR/L, CPAMKatherine George, PT, DPT
Course: #4609Level: Intermediate2 Hours
  'The case studies are very informative'   Read Reviews
The unique relationship between the occupational and physical therapist when treating an acute, subacute, or chronic stroke diagnosis will be distinguished in this two-part series. Part two will focus on the subacute and chronic stroke, differentiating the home, outpatient, and community phases of rehabilitation, as well as examining the evaluation, evidence, and interventions in each setting to optimize independence for the patient.

Interdisciplinary Approach To Stroke Rehabilitation: Acute Care And Inpatient Rehabilitation Phase
Presented by Alaena McCool, MS, OTR/L, CPAM, Katherine George, PT, DPT
Recorded Webinar

Presenters

Alaena McCool, MS, OTR/L, CPAMKatherine George, PT, DPT
Course: #4607Level: Intermediate2 Hours
  'Carryover from acute care setting to inpatient rehab'   Read Reviews
The unique collaboration and relationship between physical and occupational therapists throughout the evaluation and treatment of acute, subacute, and chronic stroke diagnoses will be analyzed in this two-part series. Part one will distinguish important stroke definitions used within the medical field and compare and contrast the differences between the acute and inpatient rehabilitation phases.

Caregiving For The Spinal Cord Injury Patient
Presented by Alaena McCool, MS, OTR/L, CPAM
Recorded Webinar

Presenter

Alaena McCool, MS, OTR/L, CPAM
Course: #4921Level: Introductory1 Hour
  'Good general overview for care of SCI patients and impact on caregivers'   Read Reviews
This course will explore how to identify caregiver challenges, as well as resources and creative problem-solving solutions available for caregivers and patients with spinal cord injuries. Case studies will be discussed at the end of the course to engage providers to think critically and ask questions to advance our treatment plans.

Neuro Examination: Back to Basics
Presented by Jill Seale, PT, PhD, NCS
Recorded Webinar

Presenter

Jill Seale, PT, PhD, NCS
Course: #3862Level: Introductory2 Hours
  'Great instructor! Great material and the way to teach them!'   Read Reviews
This course will provide participants with a practical guide through the comprehensive neurological physical therapy examination. The course will progress from the neurological screen through all the specific areas of examination common in persons with neurological diagnoses. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 2 hours of Direct Access CE credit.

Diabetes in Adults: Current Guidelines and Evidence
Presented by Sally Stillings, MA, PT, MPT, CHT
Recorded Webinar

Presenter

Sally Stillings, MA, PT, MPT, CHT
Course: #3958Level: Intermediate2 Hours
  'Current evidence, guidelines and research'   Read Reviews
This course gives us an overview of diabetes in adults, discusses current perspectives and guidelines, and addresses its significance in PT practice. It also looks at some of the current literature that addresses the evidence for risk factors and interventions and to see how they may apply to our practices. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

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