Your Stroke Rehabilitation at RSU

The multidisciplinary team at RSU works with each other to promote your independence after stroke.

Rehabilitation is most effective when it is started very early after the onset of stroke so that we can maximise your recovery.

The RSU multidisciplinary team will show and educate you and your family /carers the basic principles of rehabilitation.

We also aim to ensure a continuum of care for you following discharge from RSU.

Your dignity and privacy is of paramount importance to us and will be upheld at all times.

Stroke Liaison Nurse

Acute stroke patients are initially admitted to acute wards (mainly medical but sometimes to neurology or neurosurgical) at the University Hospital of Wales (UHW), Heath Park, Cardiff. Here, a stroke liaison nurse will assess your suitability for transfer to the RSU for stroke rehabilitation to ensure 100% occupancy of the RSU beds.

When you are medically stable and a bed is available, you will then be transfered to the RSU.

Your Admission to the RSU

Following your admission to the RSU, a comprehensive assessment is carried out by the multidisciplinary team (doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, clinical psychologist, dietician, social worker and family support coordinator).

We will have your care-plan developed with you and your family/carer. This is coordinated through an allocated named nurse as well as a key worker, who will provide guidance through a series of goal planning meetings. Individual goals are reviewed with you at pre-determined intervals to ensure appropriate and safe discharge planning.

Your Key Worker

Soon after your admission to the RSU, a member of the team will be allocated to you as your key worker - this may be your named nurse, physiotherapist, occupational therapist, psychologist, social worker, speech and language therapist, dietician or family support coordinator.

They will make themselves known to you soon after your admission. It is their job first of all to help you settle in and then to make sure you have the information you need about your rehabilitation. They may not be able to answer all your questions straight away but they should be able to find out for you.

One of the key worker's responsibilities is to keep track of your rehabilitation progress and to liaise with other members of the team. The key worker may also ask to meet your family/carers to discuss issues of your care, if you feel this is appropriate.

Your key worker will also talk to you about your goal planning meetings and help you prepare for each one. It is sometimes helpful to write down questions that you may want to bring up at the meeting and your key worker will help you do this. They will also chair the meeting and make notes of what is discussed.

Goal Planning Meetings

In order to assess the progress of your rehabilitation, regular meetings will be held on the ward between you and your rehabilitation team. These are called goal planning meetings. They offer an opportunity for you to meet with the team to discuss your strengths, limitations and needs.

Using such information, you will be able to set yourself goals or targets to aim for in the coming weeks. You can also talk about anything that is connected with your rehabilitation and it is an opportunity for you to ask any questions that you or your family/carers may have.

These meetings are an important part of your therapy as they help put you in control of your rehabilitation. Generally, they are attended by yourself and the team. A member of your family/carers can also attend with you.

◄ About Your Care At RSU Multidisciplinary Team ►