Improving services for younger stroke survivors and their families

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wasn’t a ward for taking the kids into… it wasall old people – so I was dropping them off ather friends or her sisters…”In some cases the inpatient stay involvedmore than one hospital,YSS being moved inorder to access specialist services or forrehabilitation. Moving between wardswithin a hospital was also common.However, it could be quite upsetting forrelatives arriving to find an empty bed:“He was in the high dependency ward and hewas sitting all monitored… and when we wentin at night he wasn’t there…”In fact this patient had been taken to thestroke ward. However, his carer was facedwith a similar situation two days later whenshe had intentionally visited early to catchhim before he went for a scan – he hadalready been taken when she arrived.Patients received support from a mixture ofallied health professionals (AHPs) includingphysiotherapists, occupational therapists,speech and language therapists, in additionto stroke nurses during their hospital stay.Stroke nurses were found in a variety ofguises across the hospital sites and carerswho had contact with them reported thatthey were a valuable source of informationand support.The type and level of therapy receivedgenerally appeared to reflect clinicaldecisions; however, several participantsreported that speech therapy was lessreadily available than physiotherapy oroccupational therapy.“There was supposed to be a speech therapistcome… I think the speech therapist came theday she was getting out. I asked the staffnurse and she says… ‘Well we’ve other peopleto see…’”In addition to variations in the type andlevel of therapy received, the way in whichsupport was delivered and informationprovided by staff varied. In some casestherapists explained the purpose behindcertain tasks or exercises and drewattention to the implications for patients’own lives. One YSS whose wife wasexpecting a baby explained:“One day the physio said to me,‘I need to getyou walking… the baby is coming and I needto get you home.’”Another patient reported that he had beentaken out of the hospital into town to seehow he would cope in differentsurroundings:“For me a big thing was getting out of pyjamasand getting into normal clothes… I felt betterin myself because I was going into town.”Other examples included an OT who triedto replicate a survivor’s home kitchen intherapy sessions and another who usedtasks aimed at regaining skills needed in theworkplace.However, a number of YSS reported thatthey had no idea why they were asked tocarry out certain tasks or do particularexercises, which resulted in either apathy orresentment amongst patients and carers.13Improving services for younger stroke survivors and their families
14One YSS reported that he felt rushed andunsupported by his occupational therapist:“She showed me how to put a T-shirt on and Isaid… ‘How do I fasten my trousers…?’ andshe said ‘Oh, you’ll get help’, and that was it.”Some survivors felt that rehabilitation hadnot started early enough following thestroke, Others thought the duration oftherapy sessions was too short, sometimesonly 5-10 minutes in a day. Attention wasdrawn to the lack of input at weekends.Carers reported that they did not feelinvolved in the care of the survivor whilethey were in hospital. While some admittedthat they were not in a position to judgewhether the provision was adequate or not,others reported that they did not knowwhat services were on offer, or that theywere unsure of the difference betweenprofessionals:“There was a speech therapist, or somebody tohelp him swallow… I think she was a speechtherapist…”A small number of carers who wereavailable during the day were encouraged togo to the hospital and help with exercisesor tasks which gave them a feeling ofinvolvement.Carers raised a number of issues regardingfood in the hospital, particularly in generalwards:“The nurses were telling me that he refused toeat anything because [I] was cooking stuff andbringing it in, but on the other hand… theywere bringing things like chicken curry, andsteak, and he couldn’t eat them…”The majority of patients who were in astroke ward fared better. However, onecarer felt that her husband’s food and drinkhad not being monitored adequately causinghis diabetes to become unstable.Relatives or carers reported that it was notalways easy to access information; it wassuggested that staff did not volunteerinformation and that they had to seek it outfor themselves. Others drew attention tothe problems associated with only visiting inthe evenings when therapy staff were noton duty.A number of carers drew attention to thebenefits of having someone else with themwhen receiving information or of coming tothe hospital with a written list of questions.Information leaflets were popular withsurvivors and carers, both for their contentand because they could be taken home andre-read when verbal information might beforgotten.Improving services for younger stroke survivors and their families
Page 1 and 2: Improving services foryounger strok
Page 4 and 5: In addition, however, this report a
Page 6 and 7: People who have a stroke experience
Page 8 and 9: Recognising stroke and seeking assi
Page 10 and 11: Recommendations - recognising strok
Page 12 and 13: “I think people that’s working
Page 16 and 17: Recommendations - Inpatient stay•
Page 18 and 19: e.g. physiotherapy and/or occupatio
Page 20 and 21: Recommendations - Discharge from ho
Page 22 and 23: travelling on hospital transport fa
Page 24 and 25: “I don’t know how quick he’s
Page 26 and 27: Moving onThe rate of physical progr
Page 28 and 29: Despite being prescribed anti-depre
Page 30 and 31: Impact on relationshipsOne of the m
Page 32 and 33: •Younger people who have experien
Page 34: Chest, Heart & Stroke Scotland65 No

Improving services for younger stroke survivors and their families

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