Longer term care is needed for Stroke Survivors

This article written by Lisa O’Neill Hill in the recent edition of Stroke Smart highlights an issue that has been bubbling under the surface in the long-term palliative & rehabilitative care of stroke patients.This is an international issue that requires greater consideration and a closer focus to establish more effective, cost effective solutions.

More people are surviving strokes and heart attacks, but survivors’ ability to take care of themselves quickly decreases over time.

Many stroke and heart attack survivors have trouble taking care of themselves in the decade after their medical emergency, the new study found. This includes needing help with dressing, bathing, grocery shopping, and handling their finances.  These challenges get bigger each year and many survivors need long-term help with daily activities.

The study, led by the University of Michigan, also found that stroke survivors are at a higher risk of depression and memory loss. The findings recently were published in Circulation: Cardiovascular Quality and Outcomes.

Over 10 years, stroke survivors gained between 3.5 and 4.5 problems with performing daily tasks, the study found.

Stroke Rehabilitation Affects Long-term Outcomes

The findings shed light on the need for effective and consistent rehabilitation after a stroke or a heart attack and show that long-term care needs for survivors may be greater than experts thought.  A recent study published in the Journal of Rehabilitation Medicine found that numerous factors affect the delivery of stroke rehabilitation, including an appropriate therapeutic environment, where patients aren’t bored and isolated, and a team approach to care.

The University of Michigan study included 370 stroke survivors and 391 heart attack survivors; researchers studied Medicare records from 1998 to 2010 and from a national survey of older Americans funded by the National Institute on Aging.

“Our findings suggest that heart attack and stroke survivors should be screened and monitored for functional disability long after discharge from the hospital because patients may need additional help with activities of daily living over the years after heart attack and stroke,” senior author Theodore Iwashyna, M.D., Ph.D. associate professor of internal medicine at the U-M Medical School and researcher in the Institute of Social Research and the VA Centre for Clinical Management Research, said in a press release.

More Research Needed?

Researchers said their findings show that healthcare professionals need to understand why this is happening and look at, among other things, whether patients received incomplete rehabilitation while hospitalized.

Each year in New Zealand, 2500 people survive strokes but that number is expected to increase by 25 percent over the next two decades. That’s because of advancements in treatment and an aging population. But as these numbers increase, the number of caregivers for older adults is expected to decrease dramatically in the same period of time.

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