- Stroke Recovery Association of BC is the largest provincial association devoted to Stroke Recovery in Canada.
- We have developed a definition of Stroke Recovery and wish to achieve consensus with key stakeholders on what is required in order to develop and promote Stroke Recovery programs in the Province of BC.
What is a Stroke?
- A stroke is a brain injury caused by blood flow to the brain being blocked or a blood vessel bursting in the brain.
- The brain is the most complicated organ in your body. It is a network of special cells that are constantly sending signals and messages from one part to another. It controls everything you do.
- When blood stops getting to your brain, the brain cells don’t get the oxygen they need. Bleeding in the brain also damages brain cells. Blockages and bleeding cause brain cells to stop working properly or to die.
Impact of Stroke
Having a stroke can affect you in many different ways. It all depends on:
- Which part of your brain is damaged
- How serious the damage is
Some common ways in which stroke can affect a person are:
- Physical Effects e.g. paralysis, numbness, pain, fatigue
- Cognitive Effects e.g. impaired memory, difficulty understanding and learning
- Communication Effects e.g. inability to use or understand words, slurred speech
- Emotional Effects e.g. loss of emotional control, depression, anxiety, anger
- Personal and Social Effects e.g. inappropriate behavior, isolation, change in roles
What is Stroke Recovery?
- Stroke Recovery is the process by which people who have had a stroke recover to the best of their ability; improve their independence and quality of life and have respect, inclusion and support as they become reintegrated into their home community.
- This requires long-term community based support and the availability of Stroke Recovery programs which fulfill the essential requirements for optimal community reintegration as outlined in the current literature e.g. BC Stroke Strategy Service Delivery Framework. There is a prevailing need to define best practices in Stroke Recovery as part of an organized approach to stroke community reintegration.
- Stroke survivors and their families/caregivers should be offered education and supportive counseling to help them cope with the burden of stroke and role changes, post discharge.
- Since much of this work is accomplished by volunteers, education and support of volunteer leaders is a necessary component in promoting Stroke Recovery.
- Physical recovery is still often used as the criterion for discharge from hospital with less attention being given to issues like speech and emotional state.
- Social and learning skills are dependent on receptive and expressive language. Aphasia and other speech, language and communication problems require special attention.
- The goal is to generate positive outcomes related to motor recovery but also to include an emphasis on areas such as memory, communication, socialization and productivity.
Stroke Recovery Programs – Recommended Program Goals
- Maintain and improve mobility.
- Maintain and improve communication and memory.
- Provide an accepting environment for social interaction and recreation.
- Create opportunities for professional and peer support including peer to peer sharing and peer-led groups. Focus should be on areas such as behaviour changes; mood, thought and perception; stress management; changing roles in relationships and dealing with emotions: anger, grief and loss.
- Support stroke survivor caregivers through education and individual and group support programs.
- Increase awareness of stroke risk and impairment after stroke, stroke prevention and treatment.
- Provide system navigation services to stroke survivors and caregivers including peer visiting in the hospital and peer mentoring in the community.
Outcomes of Stroke Recovery Programs
The key benefits of Stroke Recovery Programs are:
- Increased awareness that many stroke survivors go on to have successful and enjoyable lives
- Access to support
- Ability to set goals
- Improvement in quality of life for stroke survivors and caregivers
- Improvement in levels of independence
- Inclusion and support in the home community
- Increased knowledge of stroke prevention
Towards a Model for Community Stroke Recovery Programs
- The transition from specialized medically-based stroke services to the community where the survivor lives, works, and socializes marks the true beginning of life after stroke.
- Community re-integration represents the longest period of stroke survivorship when viewed from the perspective of the whole continuum of stroke.
- There is new evidence for investment in rehabilitation and reintegration emerging out of current work on the BC Stroke Strategy Cost Avoidance Model. This information is pointing to the need to focus stroke rehabilitation investment on early supported discharge and community transition for eligible clients.
- Improvement in service delivery and stroke survivor outcomes through the provision of Community Stroke Recovery Programs is believed to have the potential for significant cost avoidance.
- The transition process for stroke survivors and caregivers back into BC’s communities is informal with no established and proven pathways.
- The development of a model for community Stroke Recovery programs will add to the national body of stroke care research and field work in community reintegration for stroke survivors.
- Promising research is currently underway to investigate the effectiveness and measure outcomes of increased community reintegration/navigation support through innovative use of health and community based resources.