Stroke survivors and their families are being denied the opportunity to live well after stroke because they don't have access to the high-quality rehabilitation and supports they need and deserve
The National Stroke Audit Rehabilitation Service Report 2018, released by Stroke Foundation today, showed mental health continued to be ignored despite it being recognised by experts as a crucial element of stroke recovery for more than a decade.
Audit data showed one third of rehabilitation services did not have access to clinical or neuropsychologists. This was despite the Audit finding 50 percent of patients had problems with mood.
Stroke Foundation Clinical Council Member Associate Professor Natasha Lannin said mood changers, such as depression, anxiety, emotional, personality and behavioural changes were common post stroke.
"A stroke attacks the brain, the human control centre, and its impact extends well beyond the physical,'' A/Prof Lannin said.
"Our rehabilitation health system is currently designed to focus on the physical, and while I recognise learning to walk and talk after stroke is vitally important there is more to enabling patients to live well after stroke.
"Families are suffering because stroke survivors are being denied the specialist mental health assessment, information and care they need to maximise their recovery."
A/Prof Lannin added the rehabilitation system's heavy focus on immediate physical recovery was illustrated throughout the Audit Report, with carer support and education on prevention of recurrent stroke also largely forgotten.
Further key findings of the audit included:
- Only 51 percent of services delivered the recommended two plus hours of rehabilitation daily.
- Four in 10 patients received no information explaining their stroke and what to expect.
- Four in 10 patients were not provided with education on how to prevent having another stroke – almost half of stroke survivors will go on to experience another stroke within 10 years, yet most strokes can be prevented.
- One in five patients received information about intimacy after stroke.
- One in four carers were not provided with training and support.
- One in five patients were discharged without a plan to continue their recovery.
- Almost half (41 percent) of survivors who worked prior to stroke were not offered assistance to return to work. In contrast 91 percent of survivors were provided with assistance to return to driving.
- 94 percent of patients were involved in their own goal setting
A/Prof Lannin said health professionals were doing their best and there had been small improvements in most areas of the Audit.
For the first time, four services achieved all ten elements of the National Rehabilitation Stroke Services Framework 2015. The elements include delivering patient care within a dedicated stroke unit, involving patients in goal setting and delivering follow up care. However, in shocking contrast, 25 services (21 percent) met less than half of the elements.
Stroke Foundation Chief Executive Officer Sharon McGowan said more must be done and we must do better to help stroke survivors and their families live the best life possible after stroke.
"Stroke strikes every nine minutes in this country (56,000 strokes annually). It can strike any one at any time and changes lives of the patient and their loved ones forever,'' Ms McGowan said.
"Advancements in stroke treatment mean more Australians are surviving stroke than ever before. International evidence also indicates more Australians are set to experience stroke at younger ages.
"The role of rehabilitation in stroke is increasing in importance. We know what world-class stroke care looks like, now we must ensure all Australian stroke patients have access to it."
In response to the Audit, Stroke Foundation is calling for clinicians, healthcare administrators and governments to come together and improve the quality of care provided. To address system-wide issues and ensure all stroke survivors are provided with the world-class care they deserve.
About the audit
The National Stroke Audit Rehabilitation Services Report 2018 provides a rigorous and representative assessment of inpatient rehabilitation services in Australia. The Audit highlights areas where the system is working well and reports on improvements and changes needed. It is the only report of its kind in Australia, tracking the performance of stroke care against evidence-based Clinical Guidelines for Stroke Management and the Rehabilitation Stroke Services Framework 2013. More than 120 services participated, accounting for 92 percent of all patients who were provided with rehabilitation.In addition, the Audit highlights progress that has been made over time.
For key findings and recommendations of the National Stroke Audit Rehabilitation Services 2018: For the full report