This is all dependent on the patient doing all the work. The doctors and therapists really seem to have no responsibility for anything that actually helps survivors. Nothing on stopping the neuronal cascade of death.
Nothing on the doctor having a protocol to enhance either neuroplasticity or neurogenesis. What the fuck is the doctor for anyway?
http://medicalxpress.com/news/2016-03-patients-heart-rethinking-hospital.html
Stroke patients and their families are to
play a pivotal role in finding creative ways to embed rehabilitation in
every aspect of a stroke unit, to improve the pace and extent of
patients' recovery before leaving hospital. New research by Kingston
University and St George's, University of London aims to identify small
environmental and organisational changes that can be made on a unit that
may cost very little, but have the potential to significantly improve
rehabilitation.
Funded by the
National Institute for Health Research (NIHR), the study will be led by
Professor Fiona Jones, rehabilitation expert from the Faculty of Health,
Social Care and Education, run jointly by Kingston and St George's. "We
want to create an environment within a stroke unit that is therapeutic
and where patients can play a full role in driving their recovery,"
Professor Jones said. "While there have been big improvements in saving
lives after stroke, there are still more than 150,000 incidences in the
United Kingdom every year and many of the country's 1.2 million stroke
survivors have to spend time on a stroke unit. We know from research
that people can be inactive for long periods in hospital, sitting in bed
with little stimulation. With some creative thinking, this time could
be far better used to aid recovery."
The unit setting can feel quite medicalised and therapy pigeon-holed
as something only delivered by therapists, Professor Jones explained.
"People should not be waiting for therapy sessions to take place. Social
and cognitive activity is just as vital for recovery as more
traditional physical rehabilitation ¬- and this is something patients
can really take charge of themselves if given the right facilities and
opportunities," she said.
Simple ideas like having activities such as playing cards or daily
newspapers available around the unit, or changing visiting hours so
families and friends to visit at different times throughout the week,
could help to encourage social interaction and provide more
opportunities for cognitive stimulation, Professor Jones explained. She
described one instance where wheelchairs were being stored in a
bathroom. This had the unintended consequence of meaning patients had to
be washed at their beds, rather than being encouraged to go to the
bathroom - something that could have helped promote independence, build
confidence and aid recovery.
The study will be carried out in conjunction with experts from the
University of Leeds, King's College London, St George's Hospital,
Tooting and The Glasgow School of Art. Led by Professor Jones in London
and Dr David Clarke in Leeds, researchers will work with staff, former
patients and families from two stroke units in St Helier Hospital,
Carshalton and York District Hospital in North Yorkshire. The three
groups from each hospital will meet separately to talk about their
experiences on the stroke unit. They will explore what activities and
facilities were most useful in supporting their rehabilitation and
develop ideas of how their time could have been made more stimulating.
The process will be supported by Professor Alastair McDonald, an
expert in healthcare design from The Glasgow School of Art. Participants
will be encouraged to think creatively about what changes could have a
real impact on recovery. Short films of each session, designed to be
really powerful insights into what life is like on a stroke unit, will
then be shared between the groups to stimulate more discussion and
ideas.
Researchers will also spend time observing how things work on the
units in Carshalton and York. Using the group feedback and their own
observations, they will develop a toolkit of ideas that can be used to
help maximise the potential for recovery in any stroke facility. This
will be rolled out in two further units to test and refine.
"The number one thing we hope to achieve through this research is to
ensure people are more active on a stroke unit," Professor Jones said.
"Being on a unit should be a positive experience and should set patients
on the path back to independent living, wherever possible. The more
people do ¬- the more active they are - the faster and better their
recovery."
This research builds on Dr Jones' previous work leading the
development of a programme to help stroke survivors back on the road to
greater confidence and independence after leaving hospital. Called
Bridges Self-Management, the programme was the culmination of an
eight-year project that empowered stroke survivors
to become more involved in their own rehabilitation. It was officially
launched as a social enterprise in 2013 and has already been adopted by
healthcare providers across the United Kingdom and has even been rolled
out as far afield as New Zealand.
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