WRHA Home Care Community Stroke Care Service (CSCS) embraces opportunity for change

The need for post-stroke rehabilitation does not stop during COVID-19 and the WRHA Home Care Community Stroke Care Service (CSCS) team has continued to provide specialized in-home stroke rehabilitation following Canadian Stroke Best Practices during the COVID-19 Pandemic.

The CSCS team provides case coordination, home care support, and in-home rehabilitation (occupational therapy, physiotherapy, rehabilitation assistant support, social work and speech language pathology) for persons with acute stroke discharged from hospital to home. The service is designed to help people with stroke maximize recovery and respond to evolving client and caregiver needs as they deal with life after stroke. By promoting recovery and using an early supported discharge model, the CSCS team helps clients return home earlier, remain at home, and achieve greater independence in daily activities.

During COVID-19, required health care responses made the CSCS program even more valuable. Persons with stroke leave hospital faster and allied health professionals typically involved in outpatient or community rehabilitation programs have been redeployed or reassigned to support acute care teams.

As part of the Home Care program, the CSCS team is fortunate to have access to protocols and personal protective equipment to continue providing in-home rehabilitation. Given this unique position, the CSCS recognized an opportunity to contribute to the COVID-19 response and responded in many ways to support clients, caregivers and the health care system:

• Made virtual rehabilitation visits a reality – procured laptops and cell phones for Allied Health staff, advocated for remote access, participated in creating virtual visit guidelines for WRHA Home Care, and began using virtual visits for rehabilitation.
• Ensured CSCS clients received critical rehabilitation services – developed and utilized priority codes to prioritize service delivery and ensure needs were addressed in a timely way.
• Supported rehabilitation services not operating at full capacity – collaborated with other community and out-patient rehabilitation services to re-direct referrals to CSCS.
• Advocated for persons with communication and hearing impairments – advocated for a clear mask option for clients requiring facial visualization.
• Developed stroke self-management tools – partnered with Heart and Stroke Canada to create a checklist to support those transitioning home after a hospital stay offering guidance to people recovering from stroke and their families and caregivers.

Crisis brings an opportunity for change. The CSCS responded to COVID-19 in a way that demonstrates collaboration, creativity and a commitment to the clients and caregivers they serve.