Your patient has survived a stroke and presents at your surgery a week after discharge. Where do you start?
- To optimise a stroke survivor’s quality of life it is important to become re-acquainted with the patient and to be aware of all aspects of his or her new care infrastructure.
- As stroke survivors have a 6 to 10% yearly risk of recurrence, secondary prevention is essential. Tight control of blood pressure and diabetes, the use of antiplatelet agents (or warfarin in those with atrial fibrillation), cholesterol level reduction, smoking cessation, a healthy diet and avoiding excessive alcohol intake are all important.
- Daily exercise is central to maintaining mobility and quality of life in stroke survivors.
- General deterioration in a stroke survivor is not always ‘the final curtain’ once acute causes have been excluded; quite often some simple rehabilitation is all that is required.
- Stroke rehabilitation helps patients maximise their potential for recovery and provides practical ways of dealing with ongoing disability. It involves an intense multidisciplinary program that can be undertaken in the community or as an inpatient.