Rehabilitation after stroke. Financial implications for survivors of stroke

Hope Olivia Ward, Beth McIldowie, Sarah Kibble, Amanda Squire, Andrew Carson-Stevens

Research output: Contribution to journalLetterResearchpeer-review

Abstract

The new National Institute for Health and Care Excellence
guidelines on stroke rehabilitation recognise that high quality
stroke care services should include physical rehabilitation, as
well as specialist psychological and emotional support to
survivors1 2. However, the financial burden of long term care
can cause considerable anxiety and stress to stroke survivors
and their families during rehabilitation.
In Wales, we have formed a multi-professional student group3,
as a collaboration between Institute for Healthcare Improvement
open school chapters4, to work with higher education, healthcare,
and volunteer organisations, including the Stroke Association
and patients themselves.
We meet monthly to learn about the role of each healthcare
professional in the stroke care pathway through peer led
teaching. We also run group activities such as identifying the
“top five basic care needs” that all students can help stroke
patients with while on placement.
Stroke patients share their stories at our meetings, and their
experiences consistently highlight the harsh realities of “life
after discharge.” Recurring themes include frustration with the
lack of available psychological support and anxiety caused by
the financial burdens associated with long term care needs
during rehabilitation. Patients highly rate the support provided
up to six weeks after discharge, but NHS and local authority
funded care can diminish rapidly after this point, leaving many
patients without access to full rehabilitation services or having
to fund rehabilitation themselves5.
One patient had saved his whole life for early retirement. After
his stroke, he was unable to return to work and his wife gave
up work to help him with activities of daily living. They have
since endured nearly a decade of financial hardship, living off
their savings. Only now that their savings are depleted, are they
entitled to help in adapting their home. There is a huge
discrepancy between the level of care available acutely and in
the rehabilitation phase. Many stroke survivors are forced to
spend their life savings before they can access even basic care
funded by the NHS and social services.

1 National Institute for Health and Care Excellence. Stroke rehabilitation. CG162. 2013.
www.nice.org.uk/CG162.
2 Dworzynski K, Ritchie G, Fenu E, MacDermott K, Playford ED; on behalf of the Guideline
Development Group. Rehabilitation after stroke: summary of NICE guidance. BMJ
2013;346:f3615. (12 June.)
3 Squire A, Carson-Stevens A, Jones A, Hearle A, Evans E. 2013. Joined up
care—interprofessional approaches to improving patient care [poster]. Learning and
working together to improve safety through better prescribing. 17 May 2013, Cardiff.
4 Institute for Healthcare Improvement. Open school. Overview. 2013. www.ihi.org/offerings/
IHIOpenSchool/overview/Pages/default.aspx.
5 Stroke Association. Struggling to recover. 2012. www.stroke.org.uk/sites/default/files/
Struggling_to_recover_report.pdf.
LanguageEnglish
Article numberf4999
Pages1-1
Number of pages1
JournalBMJ (Clinical research ed.)
Volume347
DOIs
Publication statusPublished - 2013

Fingerprint

Survivors
Stroke
Rehabilitation
Delivery of Health Care
National Institutes of Health (U.S.)
Anxiety
Students
Psychology
Posters
Frustration
Return to Work
Stroke Rehabilitation
Retirement
Wales
Long-Term Care
Financial Management
Activities of Daily Living
Spouses
Volunteers
Patient Care

Cite this

Ward, H. O., McIldowie, B., Kibble, S., Squire, A., & Carson-Stevens, A. (2013). Rehabilitation after stroke. Financial implications for survivors of stroke. BMJ (Clinical research ed.), 347, 1-1. [f4999]. https://doi.org/10.1136/bmj.f4999
Ward, Hope Olivia ; McIldowie, Beth ; Kibble, Sarah ; Squire, Amanda ; Carson-Stevens, Andrew. / Rehabilitation after stroke. Financial implications for survivors of stroke. In: BMJ (Clinical research ed.). 2013 ; Vol. 347. pp. 1-1.
@article{b4878ab62d574df7a9b0f3ea200ee1ef,
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abstract = "The new National Institute for Health and Care Excellenceguidelines on stroke rehabilitation recognise that high qualitystroke care services should include physical rehabilitation, aswell as specialist psychological and emotional support tosurvivors1 2. However, the financial burden of long term carecan cause considerable anxiety and stress to stroke survivorsand their families during rehabilitation.In Wales, we have formed a multi-professional student group3,as a collaboration between Institute for Healthcare Improvementopen school chapters4, to work with higher education, healthcare,and volunteer organisations, including the Stroke Associationand patients themselves.We meet monthly to learn about the role of each healthcareprofessional in the stroke care pathway through peer ledteaching. We also run group activities such as identifying the“top five basic care needs” that all students can help strokepatients with while on placement.Stroke patients share their stories at our meetings, and theirexperiences consistently highlight the harsh realities of “lifeafter discharge.” Recurring themes include frustration with thelack of available psychological support and anxiety caused bythe financial burdens associated with long term care needsduring rehabilitation. Patients highly rate the support providedup to six weeks after discharge, but NHS and local authorityfunded care can diminish rapidly after this point, leaving manypatients without access to full rehabilitation services or havingto fund rehabilitation themselves5.One patient had saved his whole life for early retirement. Afterhis stroke, he was unable to return to work and his wife gaveup work to help him with activities of daily living. They havesince endured nearly a decade of financial hardship, living offtheir savings. Only now that their savings are depleted, are theyentitled to help in adapting their home. There is a hugediscrepancy between the level of care available acutely and inthe rehabilitation phase. Many stroke survivors are forced tospend their life savings before they can access even basic carefunded by the NHS and social services.1 National Institute for Health and Care Excellence. Stroke rehabilitation. CG162. 2013.www.nice.org.uk/CG162.2 Dworzynski K, Ritchie G, Fenu E, MacDermott K, Playford ED; on behalf of the GuidelineDevelopment Group. Rehabilitation after stroke: summary of NICE guidance. BMJ2013;346:f3615. (12 June.)3 Squire A, Carson-Stevens A, Jones A, Hearle A, Evans E. 2013. Joined upcare—interprofessional approaches to improving patient care [poster]. Learning andworking together to improve safety through better prescribing. 17 May 2013, Cardiff.4 Institute for Healthcare Improvement. Open school. Overview. 2013. www.ihi.org/offerings/IHIOpenSchool/overview/Pages/default.aspx.5 Stroke Association. Struggling to recover. 2012. www.stroke.org.uk/sites/default/files/Struggling_to_recover_report.pdf.",
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Ward, HO, McIldowie, B, Kibble, S, Squire, A & Carson-Stevens, A 2013, 'Rehabilitation after stroke. Financial implications for survivors of stroke', BMJ (Clinical research ed.), vol. 347, f4999, pp. 1-1. https://doi.org/10.1136/bmj.f4999

Rehabilitation after stroke. Financial implications for survivors of stroke. / Ward, Hope Olivia; McIldowie, Beth; Kibble, Sarah; Squire, Amanda; Carson-Stevens, Andrew.

In: BMJ (Clinical research ed.), Vol. 347, f4999, 2013, p. 1-1.

Research output: Contribution to journalLetterResearchpeer-review

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T1 - Rehabilitation after stroke. Financial implications for survivors of stroke

AU - Ward, Hope Olivia

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AU - Squire, Amanda

AU - Carson-Stevens, Andrew

PY - 2013

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N2 - The new National Institute for Health and Care Excellenceguidelines on stroke rehabilitation recognise that high qualitystroke care services should include physical rehabilitation, aswell as specialist psychological and emotional support tosurvivors1 2. However, the financial burden of long term carecan cause considerable anxiety and stress to stroke survivorsand their families during rehabilitation.In Wales, we have formed a multi-professional student group3,as a collaboration between Institute for Healthcare Improvementopen school chapters4, to work with higher education, healthcare,and volunteer organisations, including the Stroke Associationand patients themselves.We meet monthly to learn about the role of each healthcareprofessional in the stroke care pathway through peer ledteaching. We also run group activities such as identifying the“top five basic care needs” that all students can help strokepatients with while on placement.Stroke patients share their stories at our meetings, and theirexperiences consistently highlight the harsh realities of “lifeafter discharge.” Recurring themes include frustration with thelack of available psychological support and anxiety caused bythe financial burdens associated with long term care needsduring rehabilitation. Patients highly rate the support providedup to six weeks after discharge, but NHS and local authorityfunded care can diminish rapidly after this point, leaving manypatients without access to full rehabilitation services or havingto fund rehabilitation themselves5.One patient had saved his whole life for early retirement. Afterhis stroke, he was unable to return to work and his wife gaveup work to help him with activities of daily living. They havesince endured nearly a decade of financial hardship, living offtheir savings. Only now that their savings are depleted, are theyentitled to help in adapting their home. There is a hugediscrepancy between the level of care available acutely and inthe rehabilitation phase. Many stroke survivors are forced tospend their life savings before they can access even basic carefunded by the NHS and social services.1 National Institute for Health and Care Excellence. Stroke rehabilitation. CG162. 2013.www.nice.org.uk/CG162.2 Dworzynski K, Ritchie G, Fenu E, MacDermott K, Playford ED; on behalf of the GuidelineDevelopment Group. Rehabilitation after stroke: summary of NICE guidance. BMJ2013;346:f3615. (12 June.)3 Squire A, Carson-Stevens A, Jones A, Hearle A, Evans E. 2013. Joined upcare—interprofessional approaches to improving patient care [poster]. Learning andworking together to improve safety through better prescribing. 17 May 2013, Cardiff.4 Institute for Healthcare Improvement. Open school. Overview. 2013. www.ihi.org/offerings/IHIOpenSchool/overview/Pages/default.aspx.5 Stroke Association. Struggling to recover. 2012. www.stroke.org.uk/sites/default/files/Struggling_to_recover_report.pdf.

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