“Of more than 2,700 people surveyed at the end of last year, 79 per cent claimed to have received no information or advice on how to cope with the emotional consequences of strokes.”
“The damage caused by a stroke can be widespread and long-lasting. Many people need to have a long period of rehabilitation before they can recover their former independence.
The process of rehabilitation will be specific to you, and will depend on your symptoms and their severity. A team of specialists are available to help, including physiotherapists, psychologists, occupational therapists, speech therapists and specialist nurses and doctors.
The damage that a stroke causes to your brain can impact on many aspects of your life and wellbeing, and depending on your individual circumstances, you may require a number of different treatment and rehabilitation methods. These are discussed in more detail below.”
A seeming massive disconnect between the NHS aspiration and intention and the reality of the ‘patient experience’. The NHS says it is aware of the enduring consequences of strokes and that it offers on-going treatment, help, support and advice. Patients, however, are reporting that they hear little or nothing from the NHS about what their needs are likely to be – physical, mental, psychological or emotional – and what the NHS can do, either directly or indirectly by referral to external agencies such as the Stroke Association.
A question then – one to which no ready answer emerges – why is this so, what is causing the disconnect? Does the NHS, for example, see itself as the provider of initial medical treatments and first-phase rehabilitation/re-enablement, after which the burden and baton passes to Social Services [where eligible] or to the voluntary sector? Is there a failure of a person-centred ‘whole systems’ approach, replete with organisational boundaries, with restricted funding or ring-fenced budgets, or with professional fiefdoms that control who or what is in and who or what is out?
Assuming the validity of the disconnect it would be worth finding out the causes, not least because longer-term failures to deal with the consequences of strokes will, eventually, be more costly for the public purse: increased risks of further, catastrophic strokes; family breakdowns; financial consequences of not being able to work; carers having to give up jobs; stroke patients needing treatment for depression, etc.
In the absence of knowing the cause/s it would be facile to recommend action, beyond perhaps a mandatory one-year follow-up for all stroke admissions to hospital in order to learn from real patient experience what happens to people after discharge. What the Vanguard method would call the necessary first step of ‘Check’. Find out what’s really there, not what is planned, intended or believed to be the case.