physical therapy has the purpose of recovering as much independent physical function as possible. Its objectives are as follows: diagnosing the functional disorder, and achieving and improving motor skills, balance and coordination, independence in and outside the bed, independent transitions and mobility, reduced pain and improved tolerance. Therapeutic methods vary and are tailored to every patient’s physical condition. They include ensuring a proper position in bed, correct posture in sitting and standing, encouraging motion, increasing motion ranges, sensory stimulation, maintaining motion ranges and muscle strength, and selecting mobility aids for the patient as needed. In addition to personally treating the patient, the physical therapist’s role is to instruct the family, particularly the patient’s main source of support, and provide them with the tools to assist the patient in the hospital and at home so as to promote rehab. What does the health basket contain as far as physical therapy? So long as the patient is in an acute condition after the stroke, they are entitled to unlimited physical therapy based on medical need. After the rehab process has ended and when the patient is stable, they are entitled to 12 treatments every year.
Please note – waiting periods for physical therapy Based on Health Ministry instructions:
- An appointment specified as urgent – up to 3 work days
- An appointment not specified as urgent – up to 15 work days
- If an appointment is set to a later date, you should bring this obligation to the HMO’s attention, and if any problem is encountered, contact the Neeman Association and the Society for Patients Rights.
a physical therapy program done inside a special pool with the purpose of improving skeletal, nervous and muscle functions. Hydrotherapy can make motions easier, reduce spasms, induce relaxation, reduce edemas, re-teach various functions, provide
resistance to motion without the use of devices, increase cardiovascular fitness and improve self esteem. It usually does not replace physical therapy.
What does the health basket contain as far as hydrotherapy? Done as part of physical therapy with no additions to the health basket.
The purpose of occupational therapy is to diagnose the functional disorder, achieve maximum independence in daily life, improve fine motor skills and coordination, encourage correct motions and suppress incorrect patterns, increase awareness to the injured side and encourage its use, and increase awareness to lack of sensation and “neglect” (neglecting the injured side). Occupational therapy instructs the patient and caregivers as to correct body positions in lying down, getting up and sitting, provides instruction on correct handling, activates the patient in order to increase motion ranges and strength, utilizes flexible or stiff splints,provides sensory stimulation, exercises thinking, memory and concentration in areas that have been damaged (cognitive therapy), assists the patient in experiencing various functions depending on the stage of the disease, fits various physical aids to the patient to improve daily function, recommends changes in the person’s living environment and provides their
family with guidance.
What does the health basket contain as far as occupational therapy? So long as the patient is still in an acute condition after the stroke, they are entitled to unlimited occupational therapy based on medical need.
Its purpose is to diagnose the disorder, rehab the motor skills of the speech organs (dysarthria), and improve swallowing difficulties and difficulties in using one’s voice. It can also involve language / communication rehab for patients with damaged language (aphasia) and teaching them to effectively use existing language / communication abilities to improve communication with the environment. Family instruction focuses on learning the conditions and means that can be used to communicate to the patient and understand him or her.
What does the health basket contain as far as speech therapy? The law supposedly established a limit of 20 treatments in an acute condition, but in actuality all HMO’s provide unlimited speech therapy during the acute stage after the stroke, based on medical need.
A stroke is a sudden event that disrupts the normal course of life of the patient, their family and their close environment. The shock and confusion in the initial period following the stroke is considerable. The more intense the stroke, the greater the
fear, tension and helplessness experienced by the patient’s family. This can lead to crisis reactions such as shock and anxiety about the future that can be expressed as anger, aggression and sometimes even depression. Such reactions are normal. Each person has different resources to begin coping with the crisis, and therefore everyone should be permitted to take the time they require, and provided with a place where they can feel comfortable to express their feelings. However, if anyone in the patient’s close environment feels the reactions of a particular family member exceed what could be expected in this family or for that person, take longer than expected or are particularly intense, that person can be referred to a professional (social worker, psychologist, psychiatrist) to assist them in finding additional ways to cope with the new situation.
Psychotherapy: treatment by a doctor, psychiatrist, psychologist or social worker on behalf of the HMO for empowerment and to prevent depression or severe moods that disrupt and inhibit further rehab.
What does the health basket contain as far as psychotherapy? Currently the health basket contains 30 treatments annually for 2 years (60 treatments in total). From July 2015 entitlement will be revised to include unlimited treatments based on medical need.
Bedsores are a complication of prolonged lying or prolonged sitting in a wheelchair. Usually sores are located in the joints and posterior. In order to prevent them,change of positions should be ensured. It is important to use cushions to support the limbs
on the injured side as well as special mattresses.
Relations, intimacy and sexuality:
Sexuality is an important part of everyone’s life that affects a person’s self esteem and quality of life. The functional effects of a stroke can make the patient feel uncomfortable and awkward about their body, which is natural. It is also natural to be afraid of rejection or feel insecure about one’s ability to bring about satisfaction. Sexuality is not only intercourse. It is also expressed in shared enjoyment, intimacy, touching and warmth, a hug, a caress and a kiss. Sexuality varies couple to couple, but for most couples the disease will lead to habit changes.
Nowadays there are ways to assist in this sensitive area, and it is recommended to contact a clinic specializing in sexual dysfunction.
Improving upper limb motion after a stroke – treatment with botulinum toxin:
This treatment is for those suffering from spasticity (permanent intense muscle contraction) after a stroke, who have impaired motion and function in an upper limb.
What does the health basket contain? The preparation is included in the health basket for
the following indication:
Focal spasticity in an upper limb as a result of a stroke, under all of the following conditions:
1. For patients after a serious stroke with severe arm spasticity that does not improve with oral treatment or physical therapy.
2. Further treatment will only be administered to patients with proven improvement under the first two treatments with the preparation.
Treatment should be combined with rehab therapy such as physical therapy and occupational therapy, and sometimes with the use of a splint to maintain muscle length. In order to obtain the HMO’s approval for the treatment, you will need to contact the GP
and obtain a neurologist’s instruction. The clinic list can be seen on the Neeman Association’s website www.neeman.org.il
What is the existing ser vice basket pro vided by the HMO’s for these treatments ?
It is recommended to read the website of the Neeman Association for information concerning
the patients’ rights at the HMO’s.
Please note – some of the HMO’s complementary insurance policies cover rehab treatments that apply in a chronic condition such as therapeutic swimming, a higher limit for physical therapy treatments, etc. It is recommended to check entitlement for each HMO.