I don't know where the best treatment for stroke is, but I do believe God has guided me to this article which may be helpful:
you could try the US News & World report on best Rehab places and try contacting those around you and ask for a recommendation.
That's a good question. I just rescued a patient of as friend from a facility billed as "the best". I thought they were pretty crummy. The caregivers view themselves as hourly workers and don't physically touch the patients. If you want to evaluate a facility note when a nurse or doctor visits and whether or not they physically touch the patient. If they don't then write them off. I don't know what the answer is. The people who work at the homes get burned out quickly. When I hire aides I like to get fresh intelligent people who have never worked in a nursing home who have affect. That is to say they emphasize with people. You don't need a fancy resume to demonstrate that quality. I currently have two excellent aides assisting my 102 year old pal. They fawn over her, laugh with her, and play with her. I think the best rehab takes place at home with caring people who love the patient. Forty five is very young and there should be significant room for improvement, providing the cause of the stroke is identified and the condition stabilized. Lots of love and stimulation and hugging is a good prescription for recovery.
My husband was recently discharged from an inpatient rehab facility in Plano (Health South) after having a stroke at age 41. The building and equipment weren't the newest, but the therapists and nurses were terrific and they really helped him a lot - he was able to come home and move to outpatient therapy. I don't have anything to compare them to, but it does sound very different from what caregiver222 is describing.
Not all rehab facilities or hospitals are hell-holes. The Veterans Administration has a bad rap, however I have oberved patients at several rehab faciloities and the care and comfort could not be equaled anywhere. In Florida I have been at nursing homes where stroke patients are tied to their beds in their own urine and feces and you can't enter the hallway without gagging. I have also been present where hospitals for the rich and famous refused to treat critically ill patients because they were black and poor. That is no myth. Medical care is a business and if you got the money honey, they've got the time. But this is a business relationship and you have to make sure you get what you pay for. The squeaky wheel gets the grease and the best role a relative can play is to not hesitate to be the "bad guy" and demand service.
If your loved one can gain admission to a rehab facility the best thying to do is to secfure permission for a family member to observe the rehab process. Then, when the patient returns home, the exercises may be continued, or the family member can instruct aides in what to do. There are two major problems with the rehab centers. The first problem is that their strict admission criterion often eliminates many clients. The second problem is that stroke patients often benefit from a "teensey weensey" bit of rehab every other hour or so, and the payment schedules and rehab schedules in the centers are geared for longer periodsm which is too tiresome for many who are very debilitated. It is important for a family member to visit daily, even for a few minutes, and interact with the rehab people. A patient who has family members who care gets better attention. There are good people and bad people and I certainly do not want to condemn everyone associated with rehab centers.
There were some news stories recently about some in-home telerehabilitation in Canada and Australia- http://vimeo.com/5275044
Well, I would interview whatever one you go to and ask these questions? Negative responses mean they are not up-to-date.
How many patients has he/she seen fully recovered and what did they do to recover? This is not the ADL recovery.
What has been done and still needs to be done to prevent another stroke?
What area of the brain was disabled by the stroke? What functions did they cover?
What type, clot or bleed?
How big was the penumbra? What areas did it affect?
What clinical trials are going on right now that the patient would be a good candidate for?
What treatment options have been discovered in the last 5-10 years for stroke rehabilitation? Of these options which ones are available in your clinic? This is to determine if he/she is up-to-date or if you will have to do all this research yourself.
Who are the best therapists working in your clinic for stroke rehabilitation and why do you consider them to be the best?
Who do I work with if depression takes hold?
What books on stroke recovery do you recommend?
What stroke related magazines do you recommend?
What internet sites do you recommend about stroke? There are at least 15 stroke forums out there.