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Speeding up stroke recovery

New Fraser Health program allows stroke patient to continue receiving intensive rehab as an outpatient.
Janis Hoskins receives therapy from Roni Braslins (below)

Not too long ago, Janis Hoskins was lying in a hospital bed, unable to speak or move her right side. But inside, she was mustering her strength.

“I’m a fighter,” said Hoskins, a south Surrey resident who had a stroke last August. “The physiotherapist at Royal Columbian Hospital saw that spark in me. He pushed me so that he could build me up to send me to Eagle Ridge for intensive rehab.”

Hoskins, 63, put everything she had into her physical, occupational and speech therapy at Eagle Ridge’s High Intensity Rehabilitation Unit so that she could go home to her husband Michael as soon as possible. About five weeks later she achieved that goal, thanks to a new Fraser Health program that allowed her to continue receiving intensive rehab as an outpatient.

The Rehab Early Discharge (REDi) program targets patients like Hoskins, 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.

“I was really eager to go home,” she said. “When you know you have someone at home to help you, all you can think about is getting out of the hospital. It’s not home.”

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 and 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.

Being home also encourages patients to be more active, which is important for stroke recovery.

“You have to do things for yourself at home so you have no choice but to get better,” Hoskins said. “We had a dog at the time. He was old so didn’t pull me when we walked. I was able to get him out after a month or so by myself and do little walks. That was wonderful. I felt independent.”

The outpatient therapy was just as intensive as what she received in hospital, she found. “I was very damaged and I needed a lot of therapy, but they really bridged the gap. They were definitely there when I needed them.”

Hoskins was discharged from Surrey Memorial’s REDi program in February and continues occupational therapy to improve her writing, build strength and dexterity in her right fingers, and eliminate a slight limp. From her speech, a stranger would never know she had a stroke.

“I’m getting better all the time,” she said. “I owe a lot to the program. I can’t say enough about the people who worked with me.”

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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