While a stroke can happen to anyone, it's seniors who are more at risk, and it's seniors who have a tougher time in rehabilitation. Thus, Skyline Medical Center's inpatient Rehabilitation Center, on the second and third floors of the main hospital on Dickerson Pike, designs its stroke-rehab services with older patients in mind.

 

"The risk of stroke increases as we age. Every decade, the risk increases. While there are some younger strokes, the vast majority occur after age 60 or 65," said Robert Serro, MD, Skyline's medical director of rehab services.

 

Skyline offers what Johnny Harrison, the hospital's rehab administrative director, described as a "whole continuum of care" that begins when a patient presents in the emergency department. Then care progresses from intensive care to treatment on a regular floor by neurology or neurosurgery. When appropriate, the patient moves to the Rehabilitation Center, a 41-bed, acute, inpatient unit within the walls of the hospitals. That means "easy access" to many consultants for patients who might have additional health challenges such as hypertension, diabetes, heart issues or the need for dialysis, Serro added.

 

Because of this comprehensive approach, Skyline was the first hospital in Tennessee designated by the Joint Commission as a Certified Primary Stroke Center. That was in 2004, and today, the three hospitals of Saint Thomas Health Services also hold that distinction. However, Skyline's is the only inpatient rehabilitation program in Nashville with specialized stroke certification awarded by the Commission on Accreditation of Rehabilitation Facilities. There are only two others in the state.

 

"The physical demands of rehabilitation are fairly intense. Our patients work at least three hours of therapy a day," Serro said. To meet that challenge, the rehab staff tries to avoid back-to-back therapy sessions, ensuring the patient has downtime throughout the day. Inpatient stroke rehab, on average, takes three weeks.

 

Working within the patient's limitations is important, too. "There's a different expectation with different age ranges. That doesn't mean that we lower our expectations as our patients get older, but we set realistic goals and realistic expectations based on the patient's age, the previous level of experience and the previous level of activity," Serro said. "It can be a challenge, because for some of our patients, we're taking them to a more active level than they may have been in quite a while."