Where does stroke rehabilitation take place?
Inpatient Rehabilitation Hospitals
At Brooks Inpatient Rehabilitation Hospital (BRH), our Stroke unit is dedicated to treating patients after they have experienced a stroke. Our interdisciplinary team works closely together with each patient to determine their goals and help them work towards achieving them. This team consists not only of Physicians, nurses, physical therapists, occupational therapists, speech therapists, and case managers, but it also often includes music therapists, recreational therapists, peer mentors, neuropsychologists, and other consulted specialists that can provide service that go above and beyond to help our patients work toward their goals and their prior level of function.
In our inpatient rehabilitation hospital, we treat our patients using a two pronged approach that emphasizes both stroke recovery and increased independence. We believe that this simultaneous approach is essential because not only do we want our patients to return home with their loved ones safely, but we want to maximize their recovery during their time with us since research has shown that time matters! Not only does time matter but so does intensity, repetition, salience, and specificity supported by our programs that are designed to address each of these principles of neuroplasticity. Additionally, our program provides access to state of the art equipment that has been shown to promote neurological recovery after a stroke.
At BRH, but we work closely with our patients and their caregivers. During a patient’s stay caregivers will be provided with one on one training from the clinical team as needed to ensure that caregivers can safely assist the patient with their at discharge. During these trainings, patients and caregivers will be taught anything from medication management, to how to get in and out of a car, to how to communicate effectively. Our goal is to provide the best possible care while ensuring that all of our patients and caregivers have their needs met.
Skilled Nursing Facilities
At Brooks Rehabilitation we have two skilled nursing facilities that promote stroke rehabilitation and recovery: Bartram Crossing and University Crossing. Stroke rehabilitation in our skilled nursing facilities includes physical therapy, occupational therapy, and speech therapy services. Our team of neurologic therapists will evaluate you to create an individualized treatment plan specific to your needs. Your rehabilitation will also include interdisciplinary collaboration with physicians, nurses, and case managers to promote a safe discharge.
In our skilled nursing facilities, we provide access to technology aimed at the promotion of neurorecovery including but not limited to electrical stimulation technologies for pain management and neuromuscular re-education, harness systems for walking recovery, and biofeedback devices for dysphagia treatment and balance training.
Our goal for stroke rehabilitation in our skilled nursing facilities is to promote functional independence with mobility, activities of daily living, cognition, communication, and swallowing in order to assist you with reaching your highest level of recovery. We welcome you to be a part of our Brooks family!
At Brooks Rehabilitation we have more than 15 multidisciplinary clinics throughout the greater Jacksonville, St. Augustine, Daytona, Orlando, and Hudson areas. We offer Physical Therapy, Occupational Therapy, and Speech Therapy services aimed to maximize your recovery. Our teams work collaboratively with you and your loved ones to develop an individualized plan to meet your needs, wherever you are in the recovery process.
Our main goal for stroke rehabilitation in our Outpatient Division is to empower you to achieve your highest level of recovery and participation in life through excellence in rehabilitation. We perform formal and thorough assessments on each individual and work with you to set and achieve your goals for therapy. We provide access to a variety of equipment best supported by the literature to facilitate your recovery including but not limited to electrical stimulation for neuromuscular re-education, harness systems, balance training, and biofeedback devices for dysphagia treatment.
In addition to our rehabilitation teams, our Outpatient Division has a variety of resources aimed to facilitate your therapy including the Aphasia Center, Research Department, and Motion Analysis Lab. We also offer Independent Wellness programs at our Neuro Recovery Centers and local YMCA’s to further optimize your level of functional independence, community re-integration, and management of your overall health.
Brooks Rehabilitation Home Health serves patients in 23 counties across the state of Florida. Stroke rehabilitation in the home setting is based upon the specific care needs of the patient and includes the indicated combination of skilled nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aides. The evaluating clinician from each ordered service will evaluate you from their discipline-specific area of expertise, and all of the clinicians collaborate too coordinate your specific plan of care. Each home health plan of care is tailored to the care needs of the individual and the care team is in constantly communicating and updating the plan of care as indicated.
It is the goal of our team to facilitate the greatest and safest return to function possible, and we accomplish that goal through excellence in rehabilitation and medical care services. We will work with you to ensure your home is set up in the safest way possible while we strive to improve your level of independence with functional mobility and activities of daily living, and we look forward to helping you achieve your goals in your recovery.
Stroke Rehabilitation Program
At Brooks Rehabilitation our Stroke Rehabilitation Program takes place in a variety of settings depending on the severity of stroke and the recovery phase of the patient. After a stroke we recognize that timing is crucial and our goal is to get your rehabilitation started as soon as possible and continue to support you throughout your entire journey. We offer several innovative programs and technologies to empower you to achieve your highest level of recovery and improve your quality of life.
As a regional leader in rehabilitation for over 35 years, Brooks Rehabilitation is focused on using state-of-the-art technologies and innovative, research based practices to provide our patients with the best possible care. After a stroke, our expert trained clinicians will evaluate your needs and determine which technologies can be used to provide you with task specific exercise and activities that are both repetitive and intense enough to cause neuroplastic changes in your brain.
Hybrid Plus Program: At Brooks Rehabilitation we recognize that neuro-recovery takes a lot of time and hard work and so our goal is to provide therapy in the inpatient rehabilitation setting that can be continued as our patients progress all the way to outpatient rehabilitation. To support this, our Hybrid Plus Program is designed to bridge the gap from inpatient rehabilitation to outpatient by offering structured cognitive and exercise based programs. Our Hybrid Plus program utilizes a variety of technologies including Functional electrical stimulation, virtual reality, and computer/tablet applications and games to maximize your recovery. We utilize an ergonomic exoskeleton with integrated springs and computer based games to simulate functional activities in a 3D workspace.
FES Bike: Functional electrical stimulation of the peripheral nerves along with the patterned movement of the bike allows the muscles to work even if the patient has limited or no muscle control due to the stroke.
Body weight support: Utilizes a body harness that is worn by the patient and suspended from the ceiling and/or body weight support device. Body weight support allows for a percentage of ones weight to constantly be off loaded by the device in order to create a permissive environment for challenging activities such as walking, jumping, and squatting.
Cognitive Lab: A computer and tablet based lab with interactive software and applications to challenge and improve cognition and communication.
Circuit Training: A combination of strength, balance, and endurance activities that are individually prescribed to promote neurorecovery after a stroke.
Exoskeletons: Robots worn by patients that assist them to walk by providing mechanical assistance. This assistance allows patients to take larger more consistent steps in order to accelerate motor learning after a stroke.
Research Study Opportunities
The Brooks Clinical Research Center features a robust Neuromuscular Research Program focused on developing effective treatments for individuals with neurological disorders. The Neuromuscular Research Program is led by nationally recognized experts who are part of the collaboration between Brooks and the University of Florida (Brooks/UF-PHHP Research Collaboration). Opportunities are available for patients and community members to participate in studies aimed at improving health and mobility, walking recovery and respiratory function after stroke.
Learn about opportunities to participate.
Expert Stroke Team
Depending on where you are at in your recovery process and what your needs are, the members of your individualized stroke team may vary. Regardless of who is involved, our team members will work closely together throughout your rehabilitation to ensure your needs are met. Our team is constantly communicating through meetings, huddles, and emails to ensure you receive the best care possible.
Physical needs specialists
At Brooks Rehabilitation, our Physical Medicine and Rehabilitation Physicians are the leaders of the stroke team. Our physicians provide evidence based treatments with special consideration of the individual needs of each and every patient. As team leaders, our physicians will consistently communicate closely with you and the rehabilitation team in order to make informed decisions regarding your care as well as to maximize your potential. Our physician’s number one goal is your continued success and recovery after stroke and they will work diligently to ensure that you achieve the greatest outcome possible.
Our Rehabilitation Nurses work closely with all of our patients, their families, and their caregivers soon after the onset of a Stroke in order to restore patient’s freedom and Independence. Our nurses collaborate closely with an interdisciplinary team to help the patient and family develop and work toward goals that maximize their recovery. Our nurses are highly trained to safely handle all patients regardless of their impairments, working closely as a part of the interdisciplinary team to train family and caregivers.
Additionally, our nurses use a holistic approach where strong consideration is made of the physical, emotional, and social wellbeing of our patients in the treatment of stroke and in the prevention of further complications. As an example, our nurses are trained to prevent and recognize pressure injuries and in cases where patients have pre-existing wounds, our certified wound care nurses are consulted to determine the proper course of treatment. Coping with a stroke can be very difficult for both the patient and caregivers. Our nurses guide patients and families through the grieving process since emotional wellbeing is such an important part health. Our nurses are focused on our patients’ wellbeing, teaching independence to both the patient and family so that they can return home safely.
Our Physical Therapists work closely with all of our patients, their families, and their caregivers in all rehabilitation settings to establish goals as well as a therapy plan to work towards achieving those goals. Regardless of the setting, our Physical Therapists always begin with a thorough neurological evaluation that assesses the patient’s neurological impairments, their function, and their current level of participation in everyday life. Based on the evaluation, our therapists then create an individualized treatment plan for every patient in order to help them achieve their goals and get back to their life.
Gait training: Many of our patients are unable to walk or have difficulties with walking when our physical therapists begin working with them after a stroke. As a result our Physical Therapists are highly trained in hands on facilitation for gait training so that they can assist patients to walk even before they can do it themselves. At Brooks, our therapists have access to state of the art equipment that allows them to practice safe walking with any patient regardless of their level of function.
Balance Training: Difficulties with balance are very common after stroke and improving balance is crucial to avoid having falls which can lead to further injury and disability. At Brooks all of our stroke therapists are trained to evaluate and treat balance impairments in order to decrease the risk of falls and help patients achieve their prior level of function. Additionally, in cases where balance impairments may be more complicated, Brooks has an outpatient Balance Center where patients can be referred to as needed.
Bed mobility and Transfer Training: Getting in and out of a bed or chair can be very difficult after a stroke. At Brooks, our therapists can teach you the skills and appropriate equipment to use in order to improve your independence and safety with getting out of bed and getting into your wheelchair, car, shower, etc. Additionally, in cases where patients remain unable to do these things on their own, our therapists can train family and caregivers how to safely assist the patient in doing these things so that they can safely and confidently assist the patient.
Hobbies: After a stroke, it is very important that we get our patients back to doing the things that they love. Our physical therapists use a two pronged approach to help patients return to their hobbies and activities. This approach involves promoting neurorecovery with the goal of return to prior level of function while simultaneously providing the patient with the knowledge of safe adaptations that can be made to allow them to get back to doing the things they love as soon as possible.
Our team of occupational therapists provide comprehensive and holistic treatment to individuals following a stroke. Our occupational therapists perform extensive evaluations to gather information related to an individual’s routine, roles, and daily occupations, or the typical activities that an individual engages in every day.
Additionally, our therapists utilize a variety of resources and standardized outcome measures to identify and quantify specific deficits that limit an individual’s engagement in daily occupations as a result of a stroke. They collaborate closely with patients, families, and caregivers to establish goals for increased independence in the individual’s home and community environments. Based on these client-centered goals, our occupational therapists utilize functional, individualized, and research-based interventions to increase independence and engagement with activities of daily living, household tasks, leisure and social activities, community participation, work or school related requirements, and other activities included in an individual’s daily routine. Additionally, our occupational therapists may provide specialized education on stroke recovery, introduce adaptive equipment and technology, or discuss alternative methods for completing tasks to further increase a patient’s independence and quality of life following a stroke.
All of our occupational therapists are highly skilled and stay up to date with technology and advanced interventions in stroke rehabilitation, and they collaborate closely with the entire interdisciplinary rehabilitation team to provide quality and individualized care to every patient. Additionally, our therapists provide skilled training and education to family members and caregivers early in the rehabilitation process to ensure comfort and confidence in caring for their loved one in the home and community environments. To maximize safety and independence in the home, occupational therapists at Brooks Rehabilitation also provide recommendations regarding appropriate medical equipment and modifications to the home environment. Together with the entire rehabilitation team, our team of occupational therapists strive to increase independence and improve quality of life for individuals following a stroke.
Cognitive needs specialists
Speech and language pathologists
Speech language pathologists address patient goals of communicating how they feel, what they think, and interacting again with their loved ones. Our therapists are highly trained to help patients regain functional communication through specialized and individualized therapies to address aphasia, speech, and voice difficulties which frequently occur following a stroke. Aphasia is a medical term for impairment in understanding language or the ability to express language. The therapists engage the patient’s loved ones in supported communication® techniques to improve interpersonal communication as quickly as possible to empower patients and their loved ones with the tools for communication success at home and throughout the Brooks continuum of care.
When appropriate, we collaborate and make referrals to our Brooks Aphasia Center, where patients can continue their journey in aphasia rehabilitation. High tech alternative and augmentative communication systems with eye gaze capability can assist loved ones in communicating messages when speech is non-functional. Our technology can also facilitate access to emails, social media, and the Internet to help patients feel connected again. Our iPad and desktop computer assisted therapies can be accessed beyond our individual sessions in our Hybrid-Plus Communication and Cognition lab.
Speech language pathologists also actively work to help individuals improve their swallow function in order to safely enjoy foods and liquids of their preference again. We offer specialized technologies in variations locations throughout our continuum of care that facilitate swallow recovery, such as non-invasive electrical stimulation and biofeedback devices for strengthening swallowing muscles, lips, and tongue. Advanced instrumental assessments of swallowing function through video fluoroscopy and fiberoptic endoscopic evaluation of swallowing (FEES) provide detailed information of a patient’s swallowing ability to enhance outcomes by guiding treatment. We provide hands-on training of swallowing techniques, exercises, and dietary modification recommendations because we strongly believe that including loved ones and caregivers in the recovery process is important for the patients’ success in achieving their goals.
Cognition (Thinking Skills)
Speech language pathologists can help bridge that important gap in regaining functional independence; cognition. Research indicates that patients improve their overall independence when cognition is addressed in their rehabilitation. Strokes commonly impact attention, memory, decision making, and safety awareness. When any of these areas are affected by stroke, integrating back into home and community life can present daily challenges.
A speech language pathologist is specially trained in providing rehabilitative cognitive-communication based exercises and personalized strategies. When we think about a patient’s recovery, we think of the big picture and what a person wants to get back to doing independently, not what “we think” that they want to do. In this way, we avoid a cookie-cutter approach to rehabilitation. When beginning treatment, patients are encouraged to describe their preferences and daily routines, which our speech therapists communicate with the rest of the team.
The rehabilitation process is person centered, and we want to know everything we can to make patients feel like themselves again. Based on their goals, a speech language pathologist will address areas of thinking skills like attention, memory, and problem solving that may include managing medications, finances, and everyday household tasks such as grocery shopping and meal planning.
Social workers and Case Managers
At Brooks Rehabilitation Hospital we have Case Managers with educational backgrounds in Social Work, Nursing and Rehab Counseling to assist our patients and caregivers to transition to the next level of care. The Case Manager role in the Inpatient Setting consists of meeting with patients and their caregivers to assess needs to create a safe discharge plan. The Case Manager is a significant part of the interdisciplinary team and works very closely with the Physician to help determine which level of care is best for the next phase of stroke recovery.
Many of our patients will be discharging home and multiple community referrals such as Home Health nursing and therapies, Private In-Home Care for custodial services, medical supplies including respiratory equipment, tube feeding, ramps, financial assistance, outpatient therapy and IV antibiotics are common services coordinated.
Depending on the level of care needed some Stroke patients will require daily therapy and nursing. In this case, we refer to a Skilled Nursing Facilities like Brooks University Crossing or Brooks Bartram Crossing. Bartram and University Crossing have Social Workers who will then take on the role of continuing to assess the patient’s needs. In the skilled nursing setting, Social Workers also make similar community referrals in order to transition home safely. In some cases, stroke patients may have to transition to long-term care or Assisted Living. Social Workers will support the patient and family on new placement. Other stroke patients will be able to transition to home with Home Health Care.
Once at home with Home Health Care services, a Social Worker can provide assistance with reintegration into the community, promote Support Groups and refer to a number of Brooks outpatient services such as Adaptive Sports and Recreation. When patients are no longer homebound Social Workers will coordinate the next phase of stroke recovery which include Neuro Recovery Center, Clubhouse, Aphasia Center, Brooks Independent Gym Program and becoming a Stroke Mentor or Volunteer.
Psychological services are available to help patients and family cope and adjust to illness or injury. As an integrated team member, the psychologist provides intervention to support the overall goal of increasing function and quality of life for persons following an injury or illness.
Neuropsychological services are available to help the patient, family or care provider, and rehabilitation team better understand the thinking skills, emotional functioning, and behaviors following an injury or an illness. Clinical neuropsychologists also provide therapeutic consultation to patients and families in need of education and emotional support concerning their neurological injuries or illness.
Therapeutic recreation specialists
A Certified Therapeutic Recreation Specialist (CTRS) delivers direct patient care using recreation and leisure activities as the primary modality, with a goal of health restoration, remediation, and rehabilitation for persons with limited functional abilities due to a stroke. Recreation therapy is the purposeful use of recreation and activity interventions to improve a patient’s functioning, after the onset of a stroke, in the following domains: physical, emotional, social, cognitive, spiritual, and leisure.
Our Therapeutic Recreation Specialists promote the overall health and well-being through recreation and leisure activities. The recreation therapy staff work very closely alongside the stroke rehabilitation team to meet each patient’s individual goals throughout their stay with us.
Services offered by Therapeutic Recreation Specialists:
- Arts and crafts
- Aquatic therapy
- Adaptive sports
- Cards and board games
- Computers (Including eye-gaze system, touch screen computer, iPad)
- Cooking and baking
- Exercise and sports
- Gardening and yardwork
- Outdoor Activities (including putt-putt and yard games)
- Community reintegration outings
- Pet therapy
- Reading and writing
- Trikes and hand cycles
- Scavenger hunts
- Video games (Wii, Xbox)
Vocational Counselors at the Brooks Clubhouse can help you understand your capabilities and develop appropriate career goals. We can assist with a variety of services designed to help you keep or find a new job and helping to ensure you are employment ready. Some services include but are not limited to resume building, interview skills, job development (finding a job), placement services, and on site job coaching. We work in collaboration with the local State Vocational Rehabilitation offices. To get started contact Brooks Clubhouse Vocational Office at (904) 394-1697.
Why choose Brooks
Brooks Rehabilitation is a community leader in providing excellence in care throughout our healthcare system and has received national recognition for its commitment to providing cutting-edge technology, forward-thinking research and continuing education and training. Annually, we help more than 500* stroke survivors and their families achieve their goals and rebuild their lives through our Brooks system of care. This places us as the number one Stroke rehabilitation provider in Florida and the Southeastern US and in the top ten in the nation.
We recognize that each and every stroke survivor is unique with specific needs and goals, which is why Brooks Rehabilitation will provide you with a customized rehab team to meet all your specific needs. Together, with our team, you and your family will develop a personalized care plan and goals so we may best support you. All our patients, family and caregivers will have access to hands on training with expert clinicians, educational classes with clinical specialists, interactive patient room TV education, system caregiver support groups and psychologist supported counseling, and educational hand-outs.
Our Stroke program provides patients the ability to achieve their greatest possible outcomes by utilizing technology paired with intensive evidence based therapy provided by expert clinicians. At our state-of-the-art facilities, we use the most innovative technology available in the country, including motion assisted technology, functional electrical stimulation, virtual reality systems, body weight support and over ground gait training systems, biofeedback systems and Hybrid Assisted Limb technology (HAL). Through our Brooks Institute of higher learning we offer world-class educational opportunities to the local and regional healthcare community and boast of a nationally recognized clinical residency program. Our program has array of clinical specialists including, but not limited to neurological residents, specialists in lymphedema, wound care, gait training, technology, vision, orthopedic consults, wheelchairs and adaptive technology.
At Brooks Rehabilitation our mission is to serve our community, provide high quality care and facilitate continual growth and advancement in the field of therapy. We strive to provide the best rehabilitation experience for our patients so they may achieve their greatest goals. When you begin your recovery journey with us, we want you to know that you are a part of our community. Brooks is dedicated to you ever step of the way!