Nursing homes may be underused in stroke recovery; new research urges better guidelines

 Guidelines don't guarantee recovery; you need EXACT PROTOCOLS FOR THAT!

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY! 

Our non-existent stroke leadership should be demanding RECOVERY NOT 'CARE'!

My god, anyone in the business world would be fired immediately for managing or caring about something rather than delivering RESULTS. And this is why this is a complete fucking failure! This does nothing to guarantee recovery for survivors!

If your hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital! Anytime I see the word 'care' associated with a stroke hospital; I immediately think fucking failure!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE!

GET THERE!

Nursing homes may be underused in stroke recovery; new research urges better guidelines

Hospitals are referring a larger share of stroke patients to inpatient rehabilitation facilities, which typically favor home health as the provider of any additional step-down care(NOT RECOVERY!), a recent study finds.

More than one-third (35%) of patients received no post-acute care(NOT RECOVERY!) after being hospitalized for stroke. But 28% were sent to an IRF within 10 days, followed by 24% admitted directly to a SNF after hospitalization, and another 13% referred directly to home care(NOT RECOVERY!).

The analysis of Medicare Part A claims from nearly three years ending in September 2019 additionally found that 14.6% of SNF and IRF patients also were referred for home care(NOT RECOVERY!) later in their recovery.

Researchers said the new data could inform new guidance regarding post-stroke care(NOT RECOVERY!) transitions, noting wide variability in post-acute care(NOT RECOVERY!) access by geography and patient demographics. 

“Our findings could help develop strategies to improve the continuity of care(NOT RECOVERY!) in patients with stroke with the goal to improve poststroke rehabilitation care(NOT RECOVERY!) and services,” they wrote in the November issue of JAMDA. “Current stroke care(NOT RECOVERY!) guidelines do not emphasize the comprehensive nature of the continuity and transition of care(NOT RECOVERY!). In the absence of clear guidelines on the transition of care(NOT RECOVERY!), there is a probability of patients who may underuse or overuse the services, and nonclinical factors might be associated with the decision of post-acute services use.”

The team, led by Amol Karmarkar of the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University, noted the important role of post-acute care(NOT RECOVERY!) across the phases of stroke recovery.

This map included in the study shows how stroke patients have typically progressed through post-acute care settings. (Screenshot)

Within 90 days of a stroke, patients experience a high risk of developing medical complications, which can adversely impact recovery, they wrote. But some 80% of patients in the study period received no secondary post-acute care(NOT RECOVERY!) after their first move, the study showed. 

“Patients may be deemed appropriate to continue requiring additional care(NOT RECOVERY!) services and rehabilitation following discharge from the first institutional post-acute care(NOT RECOVERY!), either in IRF or SNF,” said the authors, who identified and measured the prevalence of seven post-acute referral patterns and related trajectories.

Across the entire nation, only one small area in the Mountain West region saw IRF providers routinely send stroke survivors on to nursing homes for additional care(NOT RECOVERY!). On the East and West coasts, most patients went from home health care(NOT RECOVERY!) to no services or from SNF to no further services. Post-acute care(NOT RECOVERY!) across more than one setting was generally lower in rural regions.

“This finding may be related to differences in state policies and post-acute care(NOT RECOVERY!) market availability,” the researchers wrote. “Future studies are recommended to study the impact of these seven patterns on patient short-term and long-term outcomes to better address the appropriate level of care(NOT RECOVERY!) and the need for multiple post-acute care(NOT RECOVERY!) transitions.”