Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, May 10, 2018

Many Older Patients Report No Improvement in Functioning After Rehabilitation Services

For the stroke patients there really should be little expectation for benefit. There are no protocols with efficacy ratings so guidelines are being used which are pretty much worthless. Since 'Only 10% of patients get fully recovered', why would you expect recovery in older patients?
http://dgnews.docguide.com/many-older-patients-report-no-improvement-functioning-after-rehabilitation-services?

May 9, 2018
By Ed Susman
ORLANDO, Fla -- May 9, 2018 -- About 1 in 4 patients sent to receive rehabilitation services such as physical, occupational or speech therapy report that they didn’t receive any benefit from the services, according to a study presented here at the 2018 Annual Meeting of the American Geriatrics Society (AGS).
Among 519 patients aged 65 years and older from the National Health and Aging Trends Study, 25% of patients who received rehabilitation services in nursing home or inpatient settings reported no improvement in functioning.
Of the 372 patients in the study, 85 had experienced a stroke, 39 had Alzheimer’s disease or dementia, 78 patients had depression, and about 40% of the patients reported impairments in the ability to perform activities of daily living.
“We need to develop objective measures of improvement in function because it appears that one of the factors in these self-reported outcomes is that lack of improvement is associated with lower levels of education,” said Adam Simning, MD, Strong Memorial Hospital, and University of Rochester, Rochester, New York. “It seems like there may be some kind of cognitive thing going on in the perception of improvement. It seems that if people believe that are getting better, they feel better too.”
In analysing the socioeconomic demographics and adjusting for multiple factors, the researchers found that patients who did show improvement tended to have achieved higher levels of education, have lower levels of impairment in the ability to perform activities of daily living, have longer periods of rehabilitation services, and received in-home rehabilitation services.
The database used to gather the information was unable to determine if the patient was in a rehabilitation service offered by a nursing home, in the in-hospital setting or in a dedicated rehabilitation facility.
Dr. Simning suggested that health literacy might play a role in perceived advantages of rehabilitation.
He noted that the study is continuing, with 2-year results to be reported soon.
[Presentation title: Self-Reported Improvement in Functioning Following Rehabilitation in a Hospital, Nursing Home, or Rehabilitation Facility. Abstract C123]

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