> Initial Stroke - what to expect
A team approach is the most successful approach to Stroke Rehabilitation.
It ensures there is communication between medical and health clinicians
and allows for team members to work cooperatively for the person
affected by Stroke, and also their families and carers.
DOCTORS
A Specialist, such as a Neurologist or General Physician, assumes overall responsibility
for management of the patient’s recovery in the acute phase of hospitalisation.
Registrars and resident doctors are available to provide day-to-day
patient care. Once rehabilitation has commenced a Specialist in
Rehabilitation may be involved in ongoing medical care. It is their
role to assist patients and families to make choices and adjustments,
on the patient’s rehabilitation and implement measures designed
to prevent further Stroke. Your General Practitioner (G.P) should
be fully informed on all aspects of care and rehabilitation once
the person is discharged from Hospital.
NURSES
The Nurse’s role is very important. They develop an understanding of the person’s
condition while in hospital and assist the person to eat, bath and
dress. The Nurse’s regular observations of the patient’s conditions
provide valuable information to medical staff. Arrangements can
be made for a Community Nurse to call on the person affected by
Stroke once they return home and assist with bathing, to administer
medication and to check their progress.
SOCIAL WORKER
The Social Worker meets patients and families as soon as possible after the
Stroke occurs, to advise on likely family, social or financial impacts,
and to advise on how to obtain assistance if necessary. Family members
may be experiencing emotional problems as a result of their relative’s
Stroke — the Social Worker is skilled in counselling and can assist
in this area. When patients return home, the Social Worker may arrange
any of the following services: Community Nurse, Home Help, Meals-on
Wheels, Respite Care and Day Centre attendance. Not all people affected
by Stroke recover sufficiently to return home. The Social Worker
can assist the family make decisions on care, find suitable Nursing
Home or other accommodation and discuss costs.
PHYSIOTHERAPIST
A Physiotherapist assesses the effect of the Stroke on movements.
They plan a rehabilitation programme, taking into consideration
the patient’s general health, previous level of activity and interests.
Not all people affected by severe Stroke achieve full recovery,
so the Physiotherapist sets appropriate goals, which are adjusted
after continued reassessment. Early emphasis may be on movement
such as turning over in bed, rising to the sitting position, maintaining
balance in the upright position, transferring to and from a chair,
standing and walking, and developing to more complex activities
as progress is achieved. The Physiotherapist coaches people in coughing
and deep breathing exercises that can prevent chest infections.
SPEECH THERAPIST
The Speech Therapist assists people with problems of speech, understanding,
reading and writing. They will determine the nature and extent of
the problem, and design specific treatment. Therapy may involve
practice in enunciating words clearly, but more often will involve
some degree of relearning names of objects and meanings of words.
The Speech Therapist also assists patients with chewing and swallowing
and if necessary and in association with the Dieticians advises
on diet.
NEUROPSYCHOLOGIST
The Neuropsychologist assesses the effect on memory, thinking, personality
and other aspects of brain function. A neuropsychological assessment
provides information about a patient’s intellectual and behavioural
strengths and weaknesses. These assessments are used to aid in the
diagnosis of the Stroke and may also guide therapy. Repeated assessments
may by used to measure improvements or other changes that occur
with time. The Neuropsychologist is also concerned with the treatment
of behaviour and memory difficulties, with counselling and advising
patients and family about problems, which might occur in day-to-day
living as a result of the Stroke. They also advise on issues related
to returning to the workforce.
OCCUPATIONAL THERAPIST
The Occupational Therapist (OT) assesses the effects of the Stroke on independence and daily living activities. They teach the methods of adapting to changed circumstances by designing specific activities concentrating on the skills needed to return home. The OT will visit the person’s home, to assess their ease of movement through doors, stairs etc, and will assist the patient to generally manage at home. They will often recommend some simple modifications to the home and advise on home aids, such as a shower chair and handrails.
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