The first most confusing thing I had to deal with inpatient vs subacute rehab. All I understood was that inpatient rehab was going to be 1-2 weeks and subacute would be nearly a month, naturally I thought longer = better. But inpatient was more high intense therapy and in an actual hospital type setting. I didn't feel like 1-2 weeks was enough... So at first I chose subacute. After touring these facilities and realizing they had no way of dealing with my dad who was a major fall risk, had no idea he couldn't walk so he tried to get up constantly, I ended up switching to inpatient.
I was told be secret sources to remain unnamed to do inpatient for as long as possible, then when they start talking about discharge, freak out about having to take him home and they can suggest he continue on to subacute rehab. They said 9 times out of 10 it works....
I didn't end up having the play that card because after a week and a half in inpatient (plus a week of the flu while there) it was decided my dad needed much more therapy then they would be able to accomplish in the 1-2 weeks insurance would give them, and they suggested I take him to subacute.
THERE ARE MANY DIFFERENT INPATIENT OPTIONS
I went with the inpatient rehab with-in the hospital system that my dad was in. This was most likely my biggest mistake through this whole ordeal. I just thought that's how it worked. Months and Months later I found out about a state of the art top of the line neurological inpatient rehab that probably would've made my dads recovery go much quicker. I kick myself in the ass on a daily basis for this. Make sure you look for a stroke/neurological/brain injury specific rehab. All rehabs are NOT the same!
Michigan Residents, please look into Rehabilitation Institute of Michigan.
SUB-ACUTE REHAB
Sub acute rehab is basically a nursing home that has rehab in it. There are nurses and CNAs on staff, about 1 to every 10 patients. The problem with my dad and these kind of places is while in inpatient they have measures in place similar to a hospital to "restrain" a patient - Nursing Homes do not. My dad, not knowing he had a stroke and was disabled, therefore was turned down from all of my top 3 choices because they "didn't have the staff to handle him" - In other words he was a liability. I even told them I would have someone with him 24/7, still a no. So I had to settle for a sub-par facility. While we were there I thought it was well enough, I don't know what rehab is supposed to be like, once we got out and got into home therapy / outpatient therapy I learned the entire month we spent in sub-actute was a complete waste of time. I'm sure this isn't true of all facilities, but this place was set up more for people who've had hip surgery or something of the like - They were not at all equip for neurological problems. BUT - We didn't have any other options and sometimes I guess that's how the chips fall.
Michigan Residents: Heartland is where we went and I would not wish them on my worst enemy.
HOME THERAPY
Upon being discharged from rehab, assuming additional rehabilitation is needed, the doctors will then put you into the care of a home care company. Like before, you can shop around, you don't have to go with who they suggest as they are most likely getting paid to refer you to their "preferred" company. Fortunately, this is where my years caring for my aunt finally were useful, and we already had a home care company in place for her, so I went with them. We did 5 weeks of 2x a week in-home speech, physical, and occupational therapy. I learned a lot from this, and this is when my dad finally started progressing.
Michigan Residents, Michigan Community VNA is the company we used and I highly recommend them. They also have outstanding hospice services should you need them.
OUTPATIENT THERAPY
When home therapy is over, you still most likely have insurance benefits for outpatient therapy. Again, Shop around. Find a neurological specific outpatient center. The top of the line inpatient rehab I had mentioned earlier also had outpatient programs, which is where we enrolled as soon as possible (there could be a waiting list, call ahead and get on it when you know about when you will be discharged from the previous therapy).
Michigan Residents, Rehabilitation Institute of Michigan has several outpatient locations and I highly recommend them. They're therapists have training above and beyond the normal scope. They are highly resourceful and have helped me with A LOT through-out this process
Know that if you get into a facility or program that you don't like, you CAN change to a different place.
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