Post stroke occupational therapy in North Palm Beach is the part of recovery that deals with your actual day. The morning you try to button a shirt with one hand that will not cooperate. The afternoon you stand at a stove and lose track of what you were doing. A stroke or a brain injury damages the wiring that carries messages around, and the arm, the hand and the attention span all pay for it downstream.
By The First Rehabilitation Team · Reviewed by Dr. Dave Kashuba, Ph.D.
This article came out of an unexpected conversation. On Episode 15 of our podcast, Susan Mann of Bright Minds Processing talked about children with auditory and visual processing disorders, which we do not treat, and mentioned in passing that after her husband’s traumatic brain injury she found the same kind of processing work being used with brain injury and stroke patients. The full story of her kids is in our recap of that episode. This page is about the adult side, and about what happens when someone you love comes home from the hospital and the hard part turns out to be Tuesday morning.
The eyes and the ears are only messengers
The audiologist who treated Susan Mann’s children, Dr. Leah Light, taught her that even though we call those vision and hearing problems, the organ involved is the brain. “They’re only the messengers,” Susan Mann said of the eyes and ears.
It’s a useful way to think about the arm after a stroke. A stroke is an injury to the brain, so the hand that won’t open or the arm that drifts is taking its orders from a part of the system that has been hurt. That’s why our stroke work is task specific. Instead of exercising an arm in the abstract, the therapist rebuilds the routines that arm is needed for, and measures progress in tasks you can do again.
Dr. Dave Kashuba, Ph.D., OTR, our founder, is an occupational therapist himself and has been treating patients since 1991. His starting point for any plan is the same. “What we do is we try to take each person individually and figure out a game plan for them,” he said on Episode 10. Two people with the same diagnosis on paper can need very different first weeks.
Occupational therapy after a stroke: what to expect
Most families come to us with the same few questions. How long is the first visit, will anything actually happen at it, and who are we going to see?
The first visit
Plan on about an hour, one on one with your therapist. They’ll listen to the story, which matters more after a stroke than almost anywhere else, watch how you move and how you handle a task, measure what can be measured, and set goals with you that are specific enough to show progress. Treatment usually begins that same day, and you leave with a plan, the start of a home program and your next appointments already on the calendar.
We email an intake form once the visit is booked, so the hour starts with therapy. Bring three things:
- A photo ID
- Your insurance card, plus any Medigap or secondary card you carry
- Your prescription or referral, if your physician gave you one
Wear something loose that lets the therapist get to the arm and shoulder easily. There’s a free lot right at the building at 733 US Highway 1, Suite 2A, which matters when someone is still unsteady getting in and out of the car.
Who you’ll work with
Our occupational therapy is led by Dave alongside Joan “Joni” Janik, OTD, whose focus includes activities of daily living and stroke recovery. Laura Drumm, MS, OTR/L, CHT, CLT, our certified hand therapist, joins in when the hand is the sticking point, and our physical therapists, Kayla Dorsey, PT, DPT and Logan Van Sant, PT, DPT, handle walking and balance when those need work too.
| Discipline | What it usually takes on after a stroke |
|---|---|
| Physical therapy | Walking and balance |
| Occupational therapy | Dressing, cooking and the rest of the daily routine |
| Certified hand therapy | A weak, closed hand |
All three happen in the same building, under one plan, with the same notes. Dave made the point on air that it’s worth choosing a place with “a good physical therapy team, good occupational therapy team,” and the reason is practical. Nobody has to carry information between separate clinics. We walk down the hall and talk.
What post stroke occupational therapy actually covers
Our occupational therapy program breaks into six areas, and a stroke usually pulls in several at once. The examples in the right hand column are the kind of task we actually work on.
| Area | What it covers | An example of the work |
|---|---|---|
| Activities of daily living | Dressing, bathing, grooming, cooking and home management | Buttoning a shirt with one hand that isn’t cooperating |
| Post stroke recovery | Task specific work on upper extremity function, coordination and daily routines | Rebuilding the sequence that gets you out of the house in the morning |
| Cognitive rehabilitation | Memory, attention and problem solving strategies | Managing a medication schedule or following a recipe again |
| Hand and upper extremity function | Fine motor and functional use training, coordinated with certified hand therapy | A custom splint made in the clinic when the hand needs a position held |
| Ergonomics and adaptive equipment | Workstation assessment and equipment recommendations | Dressing aids and built up grips, with training in how to use them |
| Return to work programs | Graded conditioning and task simulation | Rehearsing the job’s own tasks at its weights, heights and pace |
An evaluation sorts out which of those matter for you, and in what order. Somebody who cooks every night and somebody who needs to get back behind a desk get different plans out of the same diagnosis. Or, as Dave put it about a very different problem, “you can’t cookie cut what programs you’re going to do.”
Cognitive rehabilitation after injury, and what it covers
This is the piece families are least prepared for. The arm is visible. Attention isn’t, so a person can look recovered and still struggle to follow a three step instruction, keep track of a conversation, or hold on to a task through an interruption. They’re often embarrassed about it, too, and good at covering.
Cognitive rehabilitation works on memory, attention and problem solving. The target is the medication schedule, the grocery list, the recipe, the household routine. The therapist works on the real task you’re struggling with, in the order you actually do it at home, and adapts the method until you can manage it without help.
If you’re the family member doing the driving, the most useful question you can bring is simple. Which steps can my relative now do alone, and which ones should I still be helping with? Ask it every couple of weeks. The answer changes.
Getting the hand and arm back to work
Upper extremity recovery is where our occupational therapy and our certified hand therapy program overlap. Laura Drumm, CHT, leads the hand side, and the two run together when a stroke has left the hand weak, clumsy or partly closed: fine motor work, functional use training, and splinting when the hand needs a position held. Splints are fabricated here in the clinic and molded to the person, which saves a trip and a wait.
That coordination also matters when the stroke isn’t the only thing in the chart. Plenty of people arrive with an old shoulder problem or a recent wrist injury alongside the neurological one, and the plan has to account for both. Our hand and wrist, shoulder pain and post surgical pages cover how that side of the work runs.
Adaptive equipment, taught rather than handed over
Sometimes the fastest route back to a task is changing the tool. Dressing aids, built up grips and simple changes to how the kitchen is set up can make a task safe again while strength and coordination are still coming back. We only recommend what helps, and the therapist trains you on it in the session. Then you practice it. A gadget nobody has shown you how to use ends up in a drawer.
A return to work program after injury, for people driving in from Palm Beach Gardens
A return to work program is graded. It uses task simulation and conditioning that build toward the real demands of the job, rather than a blanket clearance handed out at a fixed number of weeks. For desk work that usually means a workstation assessment and adaptive equipment: screen height, chair, keyboard and mouse. For anything physical it means loading the actual movements at the weights and heights the job uses, and reporting progress in those same terms, which is what an employer or a case manager needs to see. If the injury happened on the job, our work injury rehab page explains how authorization works in Florida.
We see people from across the county for this. The clinic sits on US-1 in North Palm Beach, a short drive from Palm Beach Gardens, Juno Beach and Jupiter, and an easy run up from West Palm Beach. Hours are Monday through Friday 8:00 AM to 5:30 PM, with Saturday mornings 8:00 AM to 12:30 PM, which is the slot working family members tend to want when they’re the ones doing the driving.
The homework is the treatment
Mike McGann, who co-hosts Pain 2 Power with Dave, made the point on air that every therapy has the same catch. You have to do the exercises. “You’re not gonna get a result if you don’t,” he said, and Susan Mann agreed without hesitation: “It is exactly true.”
Post stroke occupational therapy works the same way. The hour in the clinic sets the task and corrects it. The practice between visits is where the hour pays off. Every patient leaves with a written home exercise program, and that program is built around the real tasks in your house, which makes it easier for a spouse or an adult child to help without guessing.
When formal therapy ends, some people want to keep going with structure. Our on-site wellness gym lets former patients train with a team that already knows their history. It’s a separate program from insurance-covered therapy and doesn’t take insurance, so the front desk will explain how it works before anyone signs up.
Starting, and what it costs
We take Medicare and Medicare Advantage along with BCBS, Aetna, Humana, Tricare, the VA Community Care Network, workers’ compensation and self pay. Whether you need a referral for occupational therapy depends on your plan, so the front desk checks that, and your benefits, before you come in. Medicare requires a physician to certify your plan of care, and we handle that paperwork with your doctor.
One Medicare detail worries people needlessly. Occupational therapy has its own yearly checkpoint, $2,480 in 2026 according to CMS, after which the clinic adds a code confirming the care is medically necessary. It is not a cap. Medicare also doesn’t require you to keep improving; skilled therapy that maintains function, which matters a great deal after a stroke, can qualify. Our 2026 Medicare guide walks through all of it with sources, and the occupational therapy FAQ answers the rest.
You can read more about the program on our occupational therapy page, compare the two disciplines in physical therapy vs. occupational therapy, and hear the conversation that prompted this article on the Pain 2 Power podcast page. If someone in your family has had a stroke or a brain injury and the hard part has become the daily routine rather than the diagnosis, call us at 561-624-4263 or request an evaluation.
This article is general information, not medical advice. Every situation is different, so please consult a qualified professional about yours.