Stroke victim’s family: system falls short - Bermuda

With no stroke protocols out there this is what can be expected. Failure to recover. 
http://www.royalgazette.com/health/article/20170821/stroke-victims-family-system-falls-short
A stroke victim’s once promising recovery is faltering in the absence of comprehensive follow-up services, according to her loved ones.
As The Royal Gazette explores healthcare deficiencies for the disabled, one anonymous family have credited the early support they received — but said they were now struggling to keep the ailing woman out of a home.
“My intent is not to discredit or demoralise the Government’s helping agencies, but to bring to attention where the system falls short in the hope of improving it,” her brother said. “We are grateful for the services that were provided, although they were limited.”
Exactly what struck her remains unknown: ten years ago, the woman had a stroke at the same time as a traffic accident.
“We never found out which came first,” he said.
“We took her to Boston for treatment. Then she was in the hospital here for a few months. After they felt they could not do any more with her, she was brought home.
“At that stage, she was walking with a cane, and able to get out of bed, clean her teeth, wash her face, get breakfast.”
Rehabilitation restored much of her speech, he added: “She came back a long way. But then she started falling in the house, losing her balance a lot.
“That was about a year and a half ago. She lost her confidence.
“We were finding her with bruises and bumps on her head. Eventually, as a family, we decided to put her in a wheelchair. We were concerned she might hurt herself.”
That decision was “probably the wrong thing”, he admitted: his sister’s muscles began to seize up.
So far, she has spent 2017 confined to her chair.
But when her family sought additional rehabilitation and physiotherapy at the hospital, they were told to keep her at home.
“This is where the downfall starts,” he said. “There was a shortage of personnel. They could come once a week or every two weeks. They did their best, but obviously that was not enough for her. Another thing I must point out is that she was her own worst enemy. She was not forthcoming in doing her part.”
The family believe that the stroke damaged the woman’s ability to reason, leaving her “argumentative”.
“She went to Ageing and Disability Services, and to the Mid-Atlantic Wellness Institute. We were concerned about her mental health. The services provided were minimal. I was expecting her to be put in some sort of programme. But the only advice from the doctor at MWI was for family members to stay away and let the caregivers deal with her. That really discouraged me.”
As the woman’s speech declined, becoming slurred, she was brought before a hospital therapist who, after ten minutes, told her brother to practise with her at home.
“That was it,” he said. “I expected more.”
He commended Financial Assistance and Government health insurance for helping with daycare and nursing.
“The Government agencies prefer to have families care for their loved ones. That’s what I am trying to do. But it gets difficult without proper professional care. It is obvious that there is insufficient personnel and money available. We may have to put her in a home. I don’t wish to fully blame the system for my sister’s position.
“She has to take some blame for her failure — and also me, I guess. I didn’t challenge it. I accepted it and moved on.
“Her failure to recover is partly due to her negativity and not putting in the work. I do have to commend the physiotherapy staff for their time and professionalism. But my frustration is still there.”
A spokeswoman for the Bermuda Hospitals Board said that patient confidentiality prohibited comment on individual treatment. “We do have a Patient Advocate on staff who can be contacted to investigate any concerns and who will also work to implement changes where necessary,” she added. “We invite the gentleman quoted in this article to contact our patient advocate by calling 236-2345 or by e-mailing feedback@bhb.bm.”