Post-Stroke Rehabilitation Care

Post-stroke rehabilitation is the structured recovery that follows once a stroke is stabilised and the acute hospital work is done. In Nepal, families face a common gap in that moment: the ward has managed the medical crisis, but continued daily therapy — physiotherapy for the affected side, speech therapy for aphasia or swallowing difficulty, nursing that watches for the small signs of a second event — is not something most homes are set up to provide, and not something a hospital ward keeps a resident for. Our home in Maharajgunj was built for exactly this in-between: minutes from Gangalal and Neuro Hospital by ambulance if a scan is needed urgently, and a full-time care team so the recovery does not stop when a family member goes to work.

The daily rhythm is deliberate. Physiotherapy runs in short sessions morning and afternoon — gait training and balance work for those regaining walking, spasticity management and passive range for the affected side, transfers for those still building sitting strength. Our speech-language therapist works on aphasia and articulation, and — where the swallow is unsafe — the graded diet plan that returns residents from tube feeding to safe soft foods. Nursing tracks blood pressure tightly (uncontrolled BP is the single biggest risk for a second stroke), keeps to the medication timing the discharge summary calls for, and prevents pressure sores on the affected side with turning schedules that do not slip. Doctor rounds happen on-site; when a specialist review is needed, our staff arrange and escort.

Recovery follows a shape families do best when they understand. The first three months carry the most productive gains — this is the window where daily therapy has the biggest return, and where we ask families to plan for a longer stay if they can. Months four through twelve bring slower gains that still add up: a hand that starts to grip a cup, a sentence that finds its ending, steps between parallel bars that turn into steps along a wall. After that, meaningful recovery continues for years, but the pace changes, and residents often move home with a scheduled monthly physiotherapist visit. Every stroke is different — a left-hemisphere and a right-hemisphere stroke recover differently, ischaemic and haemorrhagic strokes follow different arcs — and our job is honest weekly updates, not promises.

Most of our stroke residents come directly from a Kathmandu hospital discharge — Gangalal, Neuro, Grande, Norvic — and admission is usually same day when the family calls with the discharge plan in the morning. We handle the transfer paperwork, medications, and where needed the ambulance. Both branches (Pipalbot near Gangalal, Bansbari near Budhanilkantha) run the same rehabilitation programme; families usually choose based on which is nearer for their daily visits. Toward the end of a stay, our physiotherapist rewrites the exercise plan for the home floor and bathroom the resident is returning to, and if the family wants we can arrange a home nurse or physiotherapist for the first weeks back home so nothing regresses in the handover.