Improving services for younger stroke survivors and their families

Admission to hospital10The majority of young stroke survivorswere admitted to hospital through A&E. Innine of the hospitals involved in this studyacute care was provided through designatedstroke units. Nevertheless participantsreported that the link between stroke andgeriatric medicine was apparent. Wherestroke units were not present or whenbeds were not available, admissions weremade through general medical wards. Intwo thirds of cases, the first day or two ofcare was spent on general wards prior tobeing moved to designated stroke care.More than half the YSS expressed specificunease at the hospital accommodation. Formany, being admitted to a ward with olderpeople caused considerable anxieties:“It was frightening in the hospital because theysaid,‘We’re going to take you up to the geriatricward…’ I tried to make a joke out of it, sayingthat I’m not a geriatric, but that was whereeverything was done.”Several YSS remarked on the differencesbetween the time spent on the generalmedical wards and the specialised strokeunits, praising the stroke units.Almost all carers had some idea that thestroke survivor was being admitted forsuspected stroke and that tests wouldrequire to be carried out. However, delaysin carrying out tests and inconclusive resultswere found to be unsettling.One carer reported that he had haddifficulty communicating with the hospitaldoctor. He felt that the doctor had nottaken advantage of his familiarity with theway in which his wife normally talked, andthe ways in which her current speechdiffered from this:“The doctor didn’t quite pick it up… she waslosing the power of her speech… he wasn’tquite understanding what we were saying…”Relatives or carers reported varying levelsof satisfaction with information received atthe time of admission. Leaflets that couldbe taken home were particularly popular:“They sat me down and they told me a goodbit… it made me feel a lot better… kind ofsettled me down. We brought some [leaflets]home and I’ve still got them…”However, it was apparent that some carersfound it difficult to cope with uncertainty:“I think [doctor in hospital] was just telling mewhat had happened and what I was looking forat the time was,‘What will happen from nowon?’ …obviously he couldn’t give me anyanswers because they just don’t know…”The level of satisfaction with informationreceived did not appear to be directlyrelated to the amount of information givenby health professionals. While somerespondents stated that they found toomuch information difficult to deal with,others reported having higher informationneeds. One carer felt that hospital staff didnot realise what a shock a young personhaving a stroke was to families, and howinformation could easily confuse or upsetthem:Improving services for younger stroke survivors and their families