Hospitals cost big bucks. So managed care (insurance companies) want survivors out of the hospital ASAP. Because of this rush, doctors and therapists are forced to push the survivor into the next step of rehab.
The problem is that there is no way to tell what the survivor actually needs. To put this a research-y way “There are varying degrees of spontaneous improvement in arm paresis over the first 6 months after stroke.”
Making the “where should they go” decision during the 2-5 days survivors are typically in the hospital a problem. The survivor’s brain has not even begun to reveal what its capable of. In the hospital the survivor’s brain has not revealed what it is going to be in one week, let alone one month or one year. Still, therapists and doctors are forced to push the survivor out of the hospital to the next step. And the “next step” choices matter. The “next step” impacts now and for the rest of the survivor’s life.