‘Fundamental for all patients’: Exploring the benefits of palliative care for stroke survivors

 

If your hospital has to put you in pallative care then your incompetent hospital completely failed at getting you 100% recovered. If they didn't do an analysis to see where they failed they are worse than worthless and the complete hospital needs to be started over.

‘Fundamental for all patients’: Exploring the benefits of palliative care for stroke survivors

Palliative care is known to help stroke survivors manage the long-term physical, mental and emotional challenges associated with recovery. It is consistently underutilized, however, prompting the American Heart Association (AHA) to share a new scientific statement focused on both its benefits and ways it can improve in the years ahead.

The document is available in full in Stroke, a journal distributed by both the AHA and American Stroke Association.[1]

“Stroke is often thought of as an event that is over quickly, but that is not true,” Claire J. Creutzfeldt, MD, chair of the statement’s writing group and an associate professor of neurology at the University of Washington in Seattle, said in a statement. “Even though the majority of strokes are not immediately life-threatening, every stroke is life-altering, and every stroke requires high-quality, person-centered care. Integrating palliative care principles into stroke care is fundamental for all patients and at every stage after a stroke.”

The AHA estimates that approximately 800,000 strokes occur each year in the United States alone. Most people survive, due in part to key advances in patient care over the years, yet survivors often go forward without receiving the help they need. 

This new scientific statement represents an update of AHA recommendations published back in 2014, building on that prior document while highlighting key updates from the last decade and detailing what healthcare providers can do to integrate palliative care principles into day-to-day patient care. The statement also examines healthcare inequities that remain and what care teams can do to help make them a thing of the past. 

Another key takeaway is the fact that stroke survivors need many kinds of support—it’s not just about making sure they take their medications or tracking their symptoms; it’s also about providing both emotional and spiritual support in a way that considers each stroke survivor as their own person with their own wants and needs. 

“It’s essential to recognize the impact of illness and disability on someone’s quality of life and understand that treatment decisions will vary from patient to patient, based on their values, their beliefs and their culture,” Creutzfeldt said. “An individualized and culturally sensitive approach to assessment and management is always best. Additionally, the palliative care needs of patients and their families or care partners after a stroke fluctuate over the course of their illness based on events, symptoms, changes in function and stage of the illness.” 

The new scientific statement covers much more ground. Click here to read the full document.

This underused type of care can help in stroke recovery, report says

 Survivors don't want 'help'; THEY WANT EXACT 100% RECOVERY PROTOCOLS! GET THERE!

If your hospital has to put you in pallative care then your hospital completely failed at getting you 100% recovered. If they didn't do an analysis to see where they failed they are worse than worthless and the complete hospital needs to be started over.

This underused type of care can help in stroke recovery, report says

Stroke survivors and their family members could benefit from palliative care, which focuses on easing pain and other symptoms once they leave the hospital, but the approach is widely underutilized, especially among Black, Hispanic and Asian patients, according to a new science report from the American Heart Association.

The scientific statement, published Monday in the AHA journal Stroke, encourages integrating palliative care into all stages of post-stroke care, including strategies for psychosocial health, how to navigate complex health care systems and how to prepare for end-of-life care when necessary.

"Stroke is often thought of as an event that is over quickly, but that is not true," Dr. Claire J. Creutzfeldt, who led the statement writing group, said in a news release. Creutzfeldt is an associate professor of neurology at the University of Washington in Seattle. "Even though the majority of strokes are not immediately life-threatening, every stroke is life-altering, and every stroke requires high-quality, person-centered care. Integrating palliative care principles into stroke care is fundamental for all patients and at every stage after a stroke."

Every year, nearly 800,000 people in the U.S. have a stroke, which occurs when a blood vessel to the brain ruptures or becomes blocked by a clot, interrupting blood flow and causing brain cells to die. Stroke is a leading cause of disability and the fifth-leading cause of death in the U.S., contributing to the deaths of about 160,000 people each year.

Advances in treatment have allowed stroke survivors to live longer, but they often face long-term challenges, such as cognitive and physical disabilities along with psychosocial problems. The added responsibility of providing care to stroke survivors can be overwhelming for family members.

The new statement said palliative care efforts should include strategies to improve communication about prognosis and care goals, navigate complex health systems, address psychosocial needs such as coping with loss, and prepare for death with end-of-life care when necessary. The statement also highlights the need to reduce sociodemographic and regional care disparities.

The statement suggests a holistic approach to palliative care that goes beyond physical symptoms and pain to include emotional, psychosocial, spiritual and existential distress and takes the family's expectations, values and goals into consideration. It highlights the importance of emotional, spiritual and psychosocial support in high-quality stroke care for survivors and their care partners. It also outlines the phases that follow a severe stroke, provides a palliative care checklist and screening tools to recognize and manage patient and family needs.

"It's essential to recognize the impact of illness and disability on someone's quality of life and understand that treatment decisions will vary from patient to patient based on their values, their beliefs and their culture," Creutzfeldt said. "An individualized and culturally sensitive approach to assessment and management is always best." The care needs of survivors and their families or partners, she added, can change over time depending on events, symptoms, changes in function and the stage of the illness.

There is limited research on palliative care for stroke survivors and wide variation in the type of care they receive, the statement notes. Important symptoms, such as pain, may be undertreated. For example, post-stroke pain may be greatest four to six months and two years following a stroke, but it is often underdiagnosed. Research shows up to 45% of stroke survivors leave the hospital with no plan for additional services, such as home health care or hospice services, and referrals for palliative care often don't occur until the end of life.

Black and Hispanic people, who face disproportionately higher stroke rates and poorer outcomes, are less likely to receive acute treatments such as intravenous therapy or surgery to treat blood clots, the statement said. And they are substantially less likely than white people to have "do not resuscitate" orders or advance directives in place. Black, Hispanic and Asian stroke patients also are less likely to be discharged to hospice care than white patients.

The statement noted that while some disparities may be attributed to cultural differences, other factors, such as the hospital where the patient was treated, have been associated with the likelihood of receiving palliative care, suggesting system-level inequities may play a role. A 2023 AHA scientific statement on ways to address racial and ethnic disparities in stroke treatment highlights the need to better understand how clinicians, hospitals, systems and others influence these care patterns and explores ways to correct them.

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Orange Hospital(Orange NSW,Australia) wins gold award for high standard of stroke treatment and care

Nothing here gives me any sense that they are talking about delivering 100% recovery, treatment and care do not mean recovery. They mean the tyranny of low expectations is being applied.  You'll need to have this hospital reconstituted until it delivers recovery.

Orange Hospital(Orange NSW,Australia) wins gold award for high standard of stroke treatment and care