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Life After a Stroke
Kessler Institute for Rehabilitation provides a comprehensive rehabilitation program that puts stroke survivors on the road to recovery.

by Catherine McBride

For those who have experienced a traumatic medical event, such as a stroke, recovery can seem like a great unknown. Individuals will face different physical, emotional and cognitive challenges, and overcoming them can be greatly impacted by the medical rehabilitation facility they choose. However, stroke survivors throughout our region have the benefit of an accredited provider in stroke rehab in Marlton at Kessler Institute for Rehabilitation.

With 70 years of experience and leadership, Kessler Institute—which has three other hospital locations in New Jersey and more than 95 outpatient therapy centers—provides comprehensive rehabilitation programs for individuals with brain injuries, neurological diseases, spinal injuries, orthopedic trauma, amputation, stroke and other conditions.

Stroke survivors typically achieve better outcomes as a result of the strong inpatient through outpatient continuum of care at Kessler Institute. In fact, guidelines from the American Heart Association/American Stroke Association indicate that “stroke survivors should be treated at an inpatient rehabilitation hospital [like Kessler] rather than a skilled nursing facility.” Kessler Institute is accredited by CARF (Commission on Accreditation of Rehabilitation Facilities), meaning it meets or exceeds the highest standards of care as set by this independent organization.

The sooner, the better
“If someone develops any symptoms of a stroke—new on-set weakness, slurred speech, visual impairment—the most important thing is to understand [that] time is of the essence,” says Medical Director Kenneth Wu, M.D. “A stroke is a ‘brain attack’ and the sooner you go to a hospital for treatment, the better your chances of recovery. Unfortunately, people often don’t recognize or will ignore these symptoms, thinking they will go away.”

Strokes affect people in different ways depending on where it occurs in the brain. “They may have weakness or paralysis in their arm or leg; dysarthria, which is problems articulating words; or aphasia, difficulty processing communication or trouble getting words out. They may also have trouble swallowing,” explains Dr. Wu.

Because of this range of deficits, a highly coordinated effort by a large team of specialists can maximize the effectiveness of rehabilitation. Studies show that the sooner a stroke survivor can begin a comprehensive, multi-disciplinary stroke rehabilitation program tailored to their needs, the better the outcome. “While we typically see the most recovery in the first one to three months of rehab, gains can continue to be made over time,” says Dr. Wu.

As a physiatrist—a board-certified physician specializing in physical medicine and rehabilitation—Dr. Wu and the other doctors lead the team, which includes physical therapists, rehabilitation nurses, occupational therapists, speech-language pathologists, dietitians, case managers and other clinical and support staff. “The main difference in acute rehabilitation is our team approach. We are all involved in the patient’s recovery, collaborating and communicating to ensure the best possible outcomes for the patients and their families,” says Dr. Wu.

The acute rehabilitation difference
Following a stroke, patients may not be aware of the critical decisions they must make. “In the hospital, a physician or case manager may make a recommendation for acute rehabilitation, which is what we provide, or sub-acute care delivered in a nursing facility,” says Ken Turley, DPT, director of rehabilitation. “Most families aren’t aware of the difference in these levels of care and treatment. What sets us apart is that we are held to specific requirements in the amount and intensity of the rehabilitation services we provide.”

Patients at Kessler Institute must receive a minimum of three hours of therapy, five days a week, which is geared to an individual’s needs, goals and ability to tolerate activities.

With this team approach, Kessler Institute is able to treat the whole patient. “We’ll establish a plan of care, and have weekly team conferences to formally discuss each patient’s progress and adjust treatment accordingly,” Turley says.

For example, in occupational therapy, patients focus on their “skills of daily living:” getting dressed, bathing, using the bathroom, etc. “Patients often need to retrain their brain and relearn how to do certain tasks to regain their confidence and independence,” he says. “And we provide the supportive environment in which they can do that. Similarly, physical therapy focuses on restoring mobility and ensuring that our patients are able to get around safely—whether it’s walking on their own or using a cane, walker or wheelchair. We also take patients out in the community to help them learn to navigate curbs and steps, and interact with other obstacles and people in a store or market.”

Speech therapy helps build communication skills, which are reinforced in other aspects of care, including recreation therapy. These leisure time activities provide a great opportunity to socialize, learn from other patients and participate in support groups and stroke education sessions,” he says.

Specialized rehabilitation nurses play an important role in the round-the-clock care of patients, reinforcing the strategies learned in therapy, educating patients on fall risk and prevention and instructing them on medication management. Denise DeForest, chief nursing officer, explains that “Some medications or other health issues may require that a patient follow a specific diet, such as low-sodium or carb-controlled, to help reduce the risk of a second stroke. And we work with our dietitian to provide an appropriate nutritional plan for each patient.”

A hand to hold
Turley says one of the biggest hurdles for patients is being able to accept that they had a stroke. Neuropsychologists are available, in addition to the stroke education and support groups, to help survivors and their families understand this new chapter in their lives.

Encouragement is provided by all members of the team. “Lifting spirits and handholding are a big part of nursing,” says DeForest. “A stroke impacts the entire family and frustration, anger and depression are not uncommon. We make sure to listen to our patients and families and let them know we are always here for them.”

“Rehabilitation doesn’t end upon discharge,” says Dr. Wu. “Patients return home with the equipment they need and generally continue their recovery through our outpatient programs. It’s this unique continuity of care and support that helps our patients rebuild their lives. And that holds true whether they have had a stroke, brain injury, orthopedic trauma, amputation or other life-changing event. At Kessler Institute in Marlton, we really do make a difference.”

Understanding the risks and signs of stroke
While some factors like age and family history can’t be changed, taking charge of your health can help reduce the risk of a stroke:
• Control blood pressure, cholesterol, heart disease and diabetes
• Maintain a healthy weight
• Eat a healthy, low-fat, low-sodium diet and limit alcohol use
• Stay physically active
• If you smoke, quit!

And listen to your body. If you experience any signs of a stroke, think F-A-S-T:
• FACE – Is your mouth drooping or do you have a sudden, severe headache, dizziness or trouble seeing in one or both eyes?
• ARMS – Can you raise your arms equally or have sudden weakness or numbness in your arms or legs, loss of balance or coordination, or difficulty walking?
• SPEECH – Are you suddenly unable to speak clearly, feel confused or have difficulty understanding others?
• TIME – Call 9-1-1 immediately!

Kessler Institute for Rehabilitation
92 Brick Road | Marlton
(856) 988-8778 |

Published (and copyrighted) in South Jersey Magazine, Volume 15, Issue 5 (August 2018).

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