Showing posts with label home care. Show all posts
Showing posts with label home care. Show all posts
Sunday, November 10, 2019
Friday, February 23, 2018
Stroke survivors and carers feel marginalized due to lack of support from primary care
This is so easy to explain, stroke professionals provide NO concrete ways to recover, NO protocols, NOTHING but guidelines.
Stroke survivors and carers feel marginalized due to lack of support from primary care
A systematic review of studies focused on stroke survivors' and
carers' experiences of primary care and community healthcare services
has found that they feel abandoned because they have become marginalized
by services and do not have the knowledge or skills to re-engage.
The study, by researchers at the University of Cambridge, suggests that primary care and community healthcare interventions which focus on improving active follow-up and information provision to patients and caregivers, especially in the first year after stroke, could help improve patient self-management and increase stroke-specific health literacy.
Globally, stroke is the second leading cause of death. Stroke-related disability burden is on the rise with a 12% increase worldwide since 1990, and contributes to the large economic burden of stroke due to healthcare use, informal care and the loss of productivity. The annual cost of stroke, including health care cost, medicines and missed days of work, is estimated at $33 billion in the USA and £8.9 billion in the UK.
Primary care could play an important role in the care of stroke survivors and their caregivers, supporting access to community services and facilitating transfer back to specialist services when new problems emerge. It could also help provide training, and identify and address health needs of caregivers. However, the feeling of abandonment that people with stroke experience following hospital discharge suggests this role is not being fulfilled.
To better understand the possible reasons behind this feeling of abandonment, a team at Cambridge's Department of Public Health and Primary Care carried out a systematic review of qualitative evidence in the field. In total, they analyzed 51 studies (encompassing 566 stroke survivors and 593 caregivers). Their results are published today in the journal PLOS ONE.
The analysis found an unaddressed need for continued support in a quarter of studies. Survivors and caregivers felt frustrated and dissatisfied with a lack of proactive follow-up either from primary care, the hospital, or allied healthcare professionals. This led to feelings of dissatisfaction, uncertainty, that a stroke survivor was "forgotten and written off" and that their general practice did not care about them.
Lack of support for caregivers was reported in more than one in five studies (22%), even though they felt healthcare professionals assumed that they would provide the majority of care needed. They felt ill prepared and pressured to "become experts" in caring for stroke survivors. In addition, both survivors and caregivers felt emotional support was lacking, even though they are at risk of anxiety and depression.
Long waiting times for assessment and rehabilitation and little or no help from social services left survivors feeling "left in the lurch". Caregivers felt that access to rehabilitation was not provided early enough, causing survivors to "go backwards".
More than two out of five (41%) of studies highlighted gaps in information provision. Opportunities for support could be missed due to the lack of knowledge of what services were available. The lack of information about local services and how to find them was confusing and prevented access. Many caregivers and survivors had to find out information by themselves from the internet, friends and other caregivers. When information was provided, it was often inconsistent and covered only some services.
A quarter (23%) of the studies highlighted inadequate information on stroke, its consequences, and recovery. Information presented too early after stroke disempowered stroke survivors and caregivers, leading to feelings of confusion, fear and powerlessness. Survivors and caregivers wanted specific information on the significance of post-stroke symptoms and how to manage them. Lack of information led to unrealistic expectations of "getting back to normal", leading to disappointment and tensions between the survivor and caregiver.
Ineffective communication between survivors, caregivers and healthcare services as well as within healthcare services resulted in feelings of frustration and having "to battle the system". Gaps in the transfer of knowledge within the healthcare system and the use of medical jargon sometimes caused confusion and were construed as indifference to survivors' needs.
"Patients and caregivers would benefit from active follow up and information provision about stroke that is tailored to their specific needs, which change over time," says Professor Jonathan Mant, who led the study. "People take active efforts to find information for themselves, but navigating and appraising it can be challenging. What is needed is trustworthy information written in an accessible language and format, which could support better self-management."
The study found that that many stroke survivors and caregivers felt marginalized due to the misalignment between how healthcare access in primary care is organized and survivors' and caregivers' competencies. For example, individuals felt that in order to access services they needed an awareness of what services are available, plus the ability to communicate effectively with healthcare professionals. This situation can be compounded by cognitive, speech and language problems that can further affect a patient's ability to negotiate healthcare access.
"Stroke survivors and their caregivers can feel abandoned because they struggle to access the appropriate health services, leading to marginalization," says Dr Lisa Lim, one of the study authors. "This arises because of a number of factors, including lack of continuity of care, limited and delayed access to community services, and inadequate information about stroke, recovery and healthcare services.
"We need mechanisms to encourage better communication and collaboration between generalist services, which tend to provide the longer term care after stroke, and specialist services, which provide the care in the immediate phase post-stroke."
The researchers argue that providing support from healthcare professionals within the first year after stroke would increase patients' ability to self-manage their chronic condition. This can be achieved by providing timely and targeted information about stroke, available resources, and by regular follow-ups to foster supporting long-term relationships with healthcare professionals.(This is a useless suggestion, it assumes managing your stroke disabilities rather than curing them)
"Giving the right information at the right time will help stroke survivors and their caregivers become more self-reliant over time and better able to self-manage living with stroke," adds Dr Lim.
The team identified two key areas of improvement to address patients' and caregivers' marginalization: increasing stroke-specific health literacy by targeted and timely information provision, and improving continuity of care and providing better access to community healthcare services.
The study, by researchers at the University of Cambridge, suggests that primary care and community healthcare interventions which focus on improving active follow-up and information provision to patients and caregivers, especially in the first year after stroke, could help improve patient self-management and increase stroke-specific health literacy.
Globally, stroke is the second leading cause of death. Stroke-related disability burden is on the rise with a 12% increase worldwide since 1990, and contributes to the large economic burden of stroke due to healthcare use, informal care and the loss of productivity. The annual cost of stroke, including health care cost, medicines and missed days of work, is estimated at $33 billion in the USA and £8.9 billion in the UK.
Primary care could play an important role in the care of stroke survivors and their caregivers, supporting access to community services and facilitating transfer back to specialist services when new problems emerge. It could also help provide training, and identify and address health needs of caregivers. However, the feeling of abandonment that people with stroke experience following hospital discharge suggests this role is not being fulfilled.
To better understand the possible reasons behind this feeling of abandonment, a team at Cambridge's Department of Public Health and Primary Care carried out a systematic review of qualitative evidence in the field. In total, they analyzed 51 studies (encompassing 566 stroke survivors and 593 caregivers). Their results are published today in the journal PLOS ONE.
The analysis found an unaddressed need for continued support in a quarter of studies. Survivors and caregivers felt frustrated and dissatisfied with a lack of proactive follow-up either from primary care, the hospital, or allied healthcare professionals. This led to feelings of dissatisfaction, uncertainty, that a stroke survivor was "forgotten and written off" and that their general practice did not care about them.
Lack of support for caregivers was reported in more than one in five studies (22%), even though they felt healthcare professionals assumed that they would provide the majority of care needed. They felt ill prepared and pressured to "become experts" in caring for stroke survivors. In addition, both survivors and caregivers felt emotional support was lacking, even though they are at risk of anxiety and depression.
Long waiting times for assessment and rehabilitation and little or no help from social services left survivors feeling "left in the lurch". Caregivers felt that access to rehabilitation was not provided early enough, causing survivors to "go backwards".
More than two out of five (41%) of studies highlighted gaps in information provision. Opportunities for support could be missed due to the lack of knowledge of what services were available. The lack of information about local services and how to find them was confusing and prevented access. Many caregivers and survivors had to find out information by themselves from the internet, friends and other caregivers. When information was provided, it was often inconsistent and covered only some services.
A quarter (23%) of the studies highlighted inadequate information on stroke, its consequences, and recovery. Information presented too early after stroke disempowered stroke survivors and caregivers, leading to feelings of confusion, fear and powerlessness. Survivors and caregivers wanted specific information on the significance of post-stroke symptoms and how to manage them. Lack of information led to unrealistic expectations of "getting back to normal", leading to disappointment and tensions between the survivor and caregiver.
Ineffective communication between survivors, caregivers and healthcare services as well as within healthcare services resulted in feelings of frustration and having "to battle the system". Gaps in the transfer of knowledge within the healthcare system and the use of medical jargon sometimes caused confusion and were construed as indifference to survivors' needs.
"Patients and caregivers would benefit from active follow up and information provision about stroke that is tailored to their specific needs, which change over time," says Professor Jonathan Mant, who led the study. "People take active efforts to find information for themselves, but navigating and appraising it can be challenging. What is needed is trustworthy information written in an accessible language and format, which could support better self-management."
The study found that that many stroke survivors and caregivers felt marginalized due to the misalignment between how healthcare access in primary care is organized and survivors' and caregivers' competencies. For example, individuals felt that in order to access services they needed an awareness of what services are available, plus the ability to communicate effectively with healthcare professionals. This situation can be compounded by cognitive, speech and language problems that can further affect a patient's ability to negotiate healthcare access.
"Stroke survivors and their caregivers can feel abandoned because they struggle to access the appropriate health services, leading to marginalization," says Dr Lisa Lim, one of the study authors. "This arises because of a number of factors, including lack of continuity of care, limited and delayed access to community services, and inadequate information about stroke, recovery and healthcare services.
"We need mechanisms to encourage better communication and collaboration between generalist services, which tend to provide the longer term care after stroke, and specialist services, which provide the care in the immediate phase post-stroke."
The researchers argue that providing support from healthcare professionals within the first year after stroke would increase patients' ability to self-manage their chronic condition. This can be achieved by providing timely and targeted information about stroke, available resources, and by regular follow-ups to foster supporting long-term relationships with healthcare professionals.(This is a useless suggestion, it assumes managing your stroke disabilities rather than curing them)
"Giving the right information at the right time will help stroke survivors and their caregivers become more self-reliant over time and better able to self-manage living with stroke," adds Dr Lim.
The team identified two key areas of improvement to address patients' and caregivers' marginalization: increasing stroke-specific health literacy by targeted and timely information provision, and improving continuity of care and providing better access to community healthcare services.
Sunday, September 17, 2017
HMC educates families about caring for stroke patients - Qatar
The need to do this means your hospital is a complete fucking failure at getting you anywhere close to 100% recovery. How many of the staff are being fired for such incompetency? All the way up to the president AND board of directors of the hospital? I'm deadly serious here. Leaving most, if not all, of their stroke patients disabled is medical incompetence of the highest order. I bet they don't even have a project in place to address those failures.
http://www.gulf-times.com/story/564151/HMC-educates-families-about-caring-for-stroke-pati
During sessions held in English and Arabic, family members were taught the benefits of stroke management at home. They listened to lectures from healthcare professionals and were encouraged to ask questions.
The workshop covered a range of topics that are important for the ongoing care and treatment of stroke patients, including speech therapy, physiotherapy, and occupational therapy – all of which were designed to aid the patient in regaining faculties that may have been impaired as a result of a stroke. The educational event was organised by the HCCS’s Education Department and led by its education director, Fatima al-Haddad and her team.
“The main purpose of organising this workshop for family members who look after their loved ones that have suffered a stroke is to equip them with the right skills and expertise that will help the patients toward their rehabilitation. We also want to highlight that patients have options – they can live at home and receive rehabilitation services from visiting professionals or if they are well enough, from outpatient clinics. An important advantage of home programmes is that patients learn skills in the same, familiar place where they will use them,” stated al- Haddad.
Also included in the workshop was an introduction to improving the quality of care of people who had a stroke; learning more about the risk factors and how to manage them; explanations of the current guidelines to achieve best practice in lifestyle and pharmacological interventions, and discussing the importance of integration with private nursing agencies.
Presentations were given by Gehan Mohamed, a nursing educator and Daniel Kelly, director of nursing education. Similar activities are planned for the future.
http://www.gulf-times.com/story/564151/HMC-educates-families-about-caring-for-stroke-pati
Doha
A multidisciplinary group of educators from Hamad Medical Corporation’s
Home Healthcare Service (HCCS) recently hosted a workshop for family
members who care for patients who have experienced a stroke.
A stroke occurs when the blood supply to the brain is
interrupted or reduced, depriving the brain of oxygen and nutrients,
which can cause brain cells to die. A stroke may be caused by a blocked
artery (ischemic stroke) or the leaking or bursting of a blood vessel
(hemorrhagic stroke).During sessions held in English and Arabic, family members were taught the benefits of stroke management at home. They listened to lectures from healthcare professionals and were encouraged to ask questions.
The workshop covered a range of topics that are important for the ongoing care and treatment of stroke patients, including speech therapy, physiotherapy, and occupational therapy – all of which were designed to aid the patient in regaining faculties that may have been impaired as a result of a stroke. The educational event was organised by the HCCS’s Education Department and led by its education director, Fatima al-Haddad and her team.
“The main purpose of organising this workshop for family members who look after their loved ones that have suffered a stroke is to equip them with the right skills and expertise that will help the patients toward their rehabilitation. We also want to highlight that patients have options – they can live at home and receive rehabilitation services from visiting professionals or if they are well enough, from outpatient clinics. An important advantage of home programmes is that patients learn skills in the same, familiar place where they will use them,” stated al- Haddad.
Also included in the workshop was an introduction to improving the quality of care of people who had a stroke; learning more about the risk factors and how to manage them; explanations of the current guidelines to achieve best practice in lifestyle and pharmacological interventions, and discussing the importance of integration with private nursing agencies.
Presentations were given by Gehan Mohamed, a nursing educator and Daniel Kelly, director of nursing education. Similar activities are planned for the future.
Sunday, September 10, 2017
Effects of home-based supportive care on improvements in physical function and depressive symptoms in patients with stroke: A meta-analysis
Nothing to say on this.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J76709&phrase=no&rec=134451&article_source=Rehab&international=0&international_language=&international_location=
Archives of Physical Medicine and Rehabilitation , Volume 98(8) , Pgs. 1666-1677, 1677.e1.
NARIC Accession Number: J76709. What's this?
ISSN: 0003-9993.
Author(s): Huang, Hui-Chuan; Huang, Yi-Chieh; Lin, Mei-Feng; Hou, Wen-Hsuan; Shyu, Meei-Ling; Chiu, Hsiao-Yean; Chang, Hsiu-Ju.
Publication Year: 2017.
Number of Pages: 13.
Abstract: This literature review examined the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after stroke. Seven electronic databases and 4 Chinese databases were fully searched for all relevant articles up to June 25, 2016. Randomized controlled trials examining the effects of home-based supportive care on physical function and depressive symptoms in home-dwelling patients after stroke were included. Sixteen articles, including 4 in Chinese and 12 in English, met the inclusion criteria. Two reviewers independently extracted data on patient characteristics, study characteristics, intervention details, and outcome; and assessed methodological quality using the Cochrane risk of bias tool. Home-based supportive care had a small size effect on physical function and a moderate size effect on depressive symptoms in home-dwelling patients after stroke. The moderator analysis revealed that some components of study participants and intervention programs improved the effects on physical function and depressive symptoms; however, no significant moderators were further identified to have superiorly improved physical function and depressive symptoms. The findings provide further evidence with which to design appropriate supportive interventions for home-dwelling stroke survivors. Regular performance of home-based supportive interventions should be considered for inclusion as routine care for managing and improving physical function and depressive symptoms in home-dwelling patients after stroke.
Descriptor Terms: CAREGIVERS, COMMUNITY RESOURCES, COUNSELING, DEPRESSION, FAMILY-CENTERED CARE, FUNCTIONAL STATUS, HOME BASED, INTERNATIONAL REHABILITATION, INTERVENTION, LITERATURE REVIEWS, OUTCOMES, PATIENT EDUCATION, PHYSICAL FITNESS, STROKE.
Can this document be ordered through NARIC's document delivery service*?: Y.
Citation: Huang, Hui-Chuan, Huang, Yi-Chieh, Lin, Mei-Feng, Hou, Wen-Hsuan, Shyu, Meei-Ling, Chiu, Hsiao-Yean, Chang, Hsiu-Ju. (2017). Effects of home-based supportive care on improvements in physical function and depressive symptoms in patients with stroke: A meta-analysis. Archives of Physical Medicine and Rehabilitation , 98(8), Pgs. 1666-1677, 1677.e1. Retrieved 9/10/2017, from REHABDATA database.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J76709&phrase=no&rec=134451&article_source=Rehab&international=0&international_language=&international_location=
Archives of Physical Medicine and Rehabilitation , Volume 98(8) , Pgs. 1666-1677, 1677.e1.
NARIC Accession Number: J76709. What's this?
ISSN: 0003-9993.
Author(s): Huang, Hui-Chuan; Huang, Yi-Chieh; Lin, Mei-Feng; Hou, Wen-Hsuan; Shyu, Meei-Ling; Chiu, Hsiao-Yean; Chang, Hsiu-Ju.
Publication Year: 2017.
Number of Pages: 13.
Abstract: This literature review examined the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after stroke. Seven electronic databases and 4 Chinese databases were fully searched for all relevant articles up to June 25, 2016. Randomized controlled trials examining the effects of home-based supportive care on physical function and depressive symptoms in home-dwelling patients after stroke were included. Sixteen articles, including 4 in Chinese and 12 in English, met the inclusion criteria. Two reviewers independently extracted data on patient characteristics, study characteristics, intervention details, and outcome; and assessed methodological quality using the Cochrane risk of bias tool. Home-based supportive care had a small size effect on physical function and a moderate size effect on depressive symptoms in home-dwelling patients after stroke. The moderator analysis revealed that some components of study participants and intervention programs improved the effects on physical function and depressive symptoms; however, no significant moderators were further identified to have superiorly improved physical function and depressive symptoms. The findings provide further evidence with which to design appropriate supportive interventions for home-dwelling stroke survivors. Regular performance of home-based supportive interventions should be considered for inclusion as routine care for managing and improving physical function and depressive symptoms in home-dwelling patients after stroke.
Descriptor Terms: CAREGIVERS, COMMUNITY RESOURCES, COUNSELING, DEPRESSION, FAMILY-CENTERED CARE, FUNCTIONAL STATUS, HOME BASED, INTERNATIONAL REHABILITATION, INTERVENTION, LITERATURE REVIEWS, OUTCOMES, PATIENT EDUCATION, PHYSICAL FITNESS, STROKE.
Can this document be ordered through NARIC's document delivery service*?: Y.
Citation: Huang, Hui-Chuan, Huang, Yi-Chieh, Lin, Mei-Feng, Hou, Wen-Hsuan, Shyu, Meei-Ling, Chiu, Hsiao-Yean, Chang, Hsiu-Ju. (2017). Effects of home-based supportive care on improvements in physical function and depressive symptoms in patients with stroke: A meta-analysis. Archives of Physical Medicine and Rehabilitation , 98(8), Pgs. 1666-1677, 1677.e1. Retrieved 9/10/2017, from REHABDATA database.
Friday, November 4, 2016
Home care for stroke survivors
Nothing in here mentions results so they have no idea if home care gets the same results as in hospital care. Either way if they meet the average only 10% of survivors will almost fully recover. That is an unacceptable rate of failure. Throw that in your stroke managements face and watch them sputter.
http://www.thehealthsite.com/diseases-conditions/home-care-for-stroke-survivors-b1116/
If you have undergone a surgery or are on medications to deal with stroke and wondering what’s next, then, rehabilitation is one of the effective ways to help you improve cognitive and physical function. However, in some cases, you might be recommended home care with a few visits to rehab centres. So if your doctor has advised regular visits to rehab centres for physiotherapy exercises and occupational therapies, then taking care at home is the next big step. And to help you out, our expert Dr M Udaya Kumar Maiya, Medical Director, Portea Medical shares a few tips that can help caregivers look after a stroke survivor at home. Also read about can you suffer a STROKE without even knowing it?
Rehabilitation centres provide an efficient care option for stroke survivors but a majority of patients and families prefer at-home care. Stroke survivors have a better chance of recovery in the comfort of their home. Thus, it is important that a comprehensive plan for recovery and rehabilitation at home be included for the patient’s benefit. The various types of home healthcare services include the following:
1. Skilled home health care and rehabilitation services:
It offers some of the treatment options available in the outpatient
rehabilitation setting, and helps them learn in a safe and comfortable
home environment.
2. Home modification solutions: These help to make life easier and safer for the survivors. Simple modifications such as handrails on stairs, uncluttered hallways, proper lighting and fall prevention strategies can go a long way to help the survivors.
3. Nonmedical at-home care: These services are available at a cheaper cost than medical home healthcare, to help recovery among the survivors of stroke. It includes counselling and support for the patients. Here’s more on rehabilitation tips for stroke patients.
Caregivers not only help in keeping a tab on doctor’s appointments, medications, rehabilitation visits but also supervise improvement in the patient. they can assist them to work in accordance with the needs of the stroke survivors helping them to recover quickly. Some of the key points include -
http://www.thehealthsite.com/diseases-conditions/home-care-for-stroke-survivors-b1116/
If you have undergone a surgery or are on medications to deal with stroke and wondering what’s next, then, rehabilitation is one of the effective ways to help you improve cognitive and physical function. However, in some cases, you might be recommended home care with a few visits to rehab centres. So if your doctor has advised regular visits to rehab centres for physiotherapy exercises and occupational therapies, then taking care at home is the next big step. And to help you out, our expert Dr M Udaya Kumar Maiya, Medical Director, Portea Medical shares a few tips that can help caregivers look after a stroke survivor at home. Also read about can you suffer a STROKE without even knowing it?
Rehabilitation centres provide an efficient care option for stroke survivors but a majority of patients and families prefer at-home care. Stroke survivors have a better chance of recovery in the comfort of their home. Thus, it is important that a comprehensive plan for recovery and rehabilitation at home be included for the patient’s benefit. The various types of home healthcare services include the following:
2. Home modification solutions: These help to make life easier and safer for the survivors. Simple modifications such as handrails on stairs, uncluttered hallways, proper lighting and fall prevention strategies can go a long way to help the survivors.
3. Nonmedical at-home care: These services are available at a cheaper cost than medical home healthcare, to help recovery among the survivors of stroke. It includes counselling and support for the patients. Here’s more on rehabilitation tips for stroke patients.
Caregivers not only help in keeping a tab on doctor’s appointments, medications, rehabilitation visits but also supervise improvement in the patient. they can assist them to work in accordance with the needs of the stroke survivors helping them to recover quickly. Some of the key points include -
- Care coordination and transportation: Caregivers can help patients to keep track of appointments, transportation to and from the healthcare setting, doctor’s office and support group meetings. This reduces the overall anxiety and allows patients and caregivers to focus solely on recovery.
- Supervision during home rehabilitation: They provide regular reminders, encouragement and supervision to help the patient adhere to the rehabilitation program.
- Assistance with day-to-day activities: Caregivers can help clients with daily activities like bathing, grooming, dressing, using the toilet while preserving the dignity of clients at such a challenging time.
- Companionship: They can help combat loneliness and inactivity that may lead to increased risk of post-stroke depression. Here’s everything you should know about stem cell therapy for stroke
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