Therapy and rehabilitation
- Kate Mulgannon, Occupational Therapist | Áine Keher, Occupational Therapist | Libby Cunningham, Occupational Therapist | Aine Mahon, Physiotherapist | Claire Connolly, Physiotherapist
- 9 minute read
- Last updated: March 2024
If you are in hospital after a stroke, you will be cared for by a stroke multidisciplinary team (MDT). Team members include occupational therapists, physiotherapists, speech and language therapists, medical social workers and psychologists. Depending on your needs, you may need the help of one or more team members.
Therapy Team
There are many members of the stroke multidisciplinary team (MDT). Each play a different role in supporting you through your inpatient journey. Please find a short description of each team member below. You may require input from one or more team members, depending on the stroke you had and the challenges you face.
Occupational therapist
The occupational therapist helps you get back to doing the everyday things that are important to you. They identify and work on the different ways that your stroke has affected your physical and mental abilities. They can then work alongside you in addressing these affected areas. Areas that can be affected include:
- Cognition - thinking skills such as concentration, memory and problem-solving
- Vision - what you can see or have difficulty seeing
- Perception - how your brain makes sense of what you see, hear and feel
- Physical function - changes to your power, coordination, balance and energy levels
- Psychological function – changes to your mood and motivation
Occupational therapists work alongside stroke survivors and their families to identify the daily activities that they want to get back to doing by collaboratively setting goals and developing a therapy programme to achieve these goals.
Physiotherapist
Physiotherapy helps with your physical recovery after stroke. A physiotherapist will work with you on regaining as much movement and independence as possible. Physiotherapy will focus on things such as your strength, balance, co-ordination and movement (eg. Walking).
Your physiotherapist will work with you to set goals, to make sure your rehabilitation is tailored to things that are important to you and to help you to be as independent as possible.
Speech and Language Therapist
Speech and language therapy will help you with swallowing and communication difficulties after your stroke. It focuses on talking, understanding, listening and swallowing.
Your speech and language therapist may assess your swallowing with a videofluoroscopy (an x-ray of your swallowing) or FEES (a fibreoptic endoscopic evaluation of swallowing that uses a small camera). This helps them to decide what kind of rehabilitation and diet you might need.
Speech and language therapists are also involved in supporting assessments of mental capacity for decision making. This may be necessary if it is difficult for you to voice your own consent after a stroke.
Medical Social Worker
The medical social worker gives patients and their families psychological, social, practical and emotional support. They help you adjust to your new situation and potential disability.
Where possible, they help you return to your community, making sure that you can function independently and participate socially. Your medical social worker also supports you in dealing with practical issues such as financial difficulties.
Dietitian
A stroke dietitian works with patients whilst in hospital to ensure they are meeting their nutritional requirements. Patients can be fed orally or may need tube feeding for short or long term. We help patients that require modified diets, tube feeding or patients that have unintentional weight loss due to poor appetite or other factors. Having adequate nutrition can help improve post stroke recovery and rehab.
If you need ongoing dietetic support after discharge, we can refer to community dietitians for follow up. If you didn’t need to be seen by a dietitian in hospital but you are struggling with your weight post discharge GPs can also refer to community dietitians.
Psychologist
Psychologists can help if you experience changes in mood or cognition after stroke. They can work with you or your family if you experience things such as:
- low mood or depression because of your stroke
- stress or anxiety because of your stroke
- thinking or memory problems because of your stroke
- trouble coming to terms with your stroke or adjusting to life with stroke
- fears about the future
The therapy and rehabilitation pathway
After your stroke, you will meet members of the multidisciplinary team (MDT). They will support you in your rehabilitation and in accessing the supports you need.
Rehabilitation begins early in your post-stroke journey. As soon as the medical team feels it is safe to begin rehabilitation, you will be assessed by the members of the team described above. The MDT members will then begin discussing and setting goals with you.
Everyone who has challenges following a stroke will be seen by the MDT and get rehabilitation while in hospital. Following a stroke, you may require further rehabilitation outside of the hospital setting. There are several different services and pathways available. It is important to talk to your MDT and ask for their professional recommendations. Some of the options that are available to stroke survivors are listed below.
(It is important to note that you may have to meet certain criteria to avail of these options. You will need to discuss these with your MDT. The information below is based on the services available in the Mater Hospital catchment area. Different services may be available elsewhere).
Off-site Rehabilitation
Off-site rehab is an inpatient facility that is situated outside of the acute hospital site. It aims to continue building on the progress you made with your MDT, focusing on further improving how you function and adapt to daily life outside of the hospital. The aim is to provide ongoing support and help you get back your independence.
Achill stroke rehabilitation unit is a specialist stroke rehabilitation unit located in St Mary’s Hospital in the Phoenix Park. Stroke patients who are in the Mater hospital and require further inpatient rehab often transfer there.
Early supported disacharge
Early Supported Discharge (ESD) is a service which helps patients who have had a stroke, go directly home from hospital, while still continuing their rehabilitation. Like the in hospital MDT team, the ESD team consists of a physiotherapist, an occupational therapist, a speech and language therapist and a medical social worker. You might meet one or more of these therapists during your ESD journey.
With ESD, your rehabilitation will continue in your own home and community. The therapists will set goals with you, to help you keep doing the things that are important to you and to become more independent.
Additional national services
Headway
This is an organisation in Ireland that provides support and services specifically for people who have experienced an acquired brain injury, including stroke. From rehabilitation services to counseling and support groups, they offer a wide range of programmes and resources to help with your recovery.
They understand the unique challenges you face after a stroke and are dedicated to helping you get back your independence and improve your quality of life. You can self-refer to Headway services here.
Acquired Brain Injury Ireland
This is an organisation that provides essential support and services for individuals who have experienced a brain injury, including stroke, aged 18 – 65 years. They offer a range of programs and resources tailored to meet the unique needs of each person. Acquired Brain Injury Ireland works closely with individuals and their families to provide the necessary support and guidance throughout the entire process. Your MDT can refer you to this service if appropriate.
National Rehabilitation Hospital
Based in Dun Laoghaire, the National Rehabilitation Hospital (NRH) provides comprehensive inpatient and outpatient services to patients who have disabilities as a result of stroke or other acquired brain injury. If you are deemed to require and be suitable for this service, your team will make the appropriate referral. You can learn more about the services provided by Brain Injury and Stroke Programme in the NRH here. HYPERLINK
Primary Care
Primary care is provided by therapists in your local HSE-run health centre. If this is an appropriate option, you will be referred by your therapists during your inpatient stay. The primary care therapists, also known as community therapists, would continue your rehabilitation in your own community.
Frequently asked questions
You will be seen by the multidisciplinary team during your hospital stay, and they will assess your rehabilitation needs with you. The multidisclipinary team will assess your ability to engage and participate in the rehabilitation process and make appropriate recommendations.
You will meet as many of the MDT as needed to help you get back as much independence as possible and return to the things that are important to you. This might be one member of the team or it might be all of them. It is specific to your challenges and rehabilitation needs after your stroke.
Your therapists on the MDT will work with you and your family to help you get back as much independence as possible.
Your rehabilitation journey will be specific to you and the challenges you face after the stroke. Timeframes for rehabilitation journeys can be very different for different patients. Your therapists will be able to help guide you with this.
