national-clinical-guidelines-for-stroke-fourth-edition

experience appropriate to meet their needs’, and ‘Commissioners and employers
undertake a review of the current workforce and develop a plan supporting
development and training to create a stroke-skilled workforce’
7.5.3 Implications
The extent of unmet need in the care home population is unknown, but resource
implications are likely. First, the need may be considerable and not easily met within
existing resources. Second, it will usually be more appropriate for staff from the stroke
service to visit the care home which has implications for travel and use of time. Third, in
practice it would be difficult within a single home, both morally and practically, to
restrict input to patients who have had a stroke when it is probable that many other
people would also need and benefit from specialist rehabilitation assessment, advice and
interventions.
7.6 Carers (informal, unpaid)
The word ‘carers’ can refer both to formal, paid carers (people with professional training)
and to informal and unpaid carers – people such as family and friends who undertake
care for a variety of reasons. This section is relevant to informal, unpaid carers. Their
role and their involvement with the person with a stroke is vital from the outset and is
likely to be the only constant and continuing relationship with the patient, long after
other services have stopped.
7.6.1 Recommendations
A At all times the views of the patient on the involvement of their carers should be
sought, to establish if possible the extent to which the patient wants family members
and others involved.
B The carer(s) of every person with a stroke should be involved with the management
process from the outset, specifically:
● as an additional source of important information about the patient both clinically
and socially
● being given accurate information about the stroke, its nature and prognosis, and
what to do in the event of a further stroke or other problems, for example poststroke
epilepsy
● being given emotional and practical support.
C With the patient’s agreement carers should be involved in all important decisions, as
the patient’s advocate, if necessary and appropriate.
D During the rehabilitation phase, carers should be encouraged to participate in an
educational programme that:
● explains the nature of stroke and its consequences
● teaches them how to provide care and support
● gives them opportunities to practise care with the patient
● emphasises and reiterates all advice on secondary prevention, especially lifestyle
changes.
7 Long-term management
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