Caregiver Involvement in Post-Stroke Care

" Hi and welcome to our webcast on doctor David mark. When someone close to your upper -- emotional impact can be tremendous. There's anyone caring for a loved one after a stroke -- psychological challenges are only half of the story. Responsibility of helping I want to recovery and rehabilitation. Can be extremely demanding and a lot to learn -- you call an emergency situations. How you find the right kind of carefree loved -- have you paid for at all those are just some of the questions. Joining us today to talk about these and other questions are -- expert. For -- doctor Richards or what he's the director of stroke rehabilitation at the university Pennsylvania welcome back. We also have doctor David Alexander he's in medical director of the Daniel Freeman rehabilitation. Center which is in Los Angeles, California thanks for being here. Thanks for inviting me. And we involvement is crucial. But when there's a dark. -- generally start. Often start read the times broken -- family member who who. The covers -- help patients that are having a stroke get emergence can get the hospital. And it continues really sent it through the whole process. Through thick and out of hospitals and as well into the rehabilitation training and of course the arrest patients like. There comes a point when a person with a stroke goes home. How do you know that the care if the person there who post acute care actually can be an effective caregiver. "

" Well first. On the acute in the acute care hospital -- we have determined functionally how to patient is managing and then we have to go on interviews with family and you whether or not. They can care for that patient at that particular level at ten. The patient probably go home. If they can't stand we probably will consider them -- in rehabilitation once they're in the rehabilitation. Hasn't intentions. After we have a chance to evaluate them won't get the family come in to participate in therapies. Learn what patient and learn what the patient can't do learn what they should do and learn what they should not do. In order to help that much further training. A -- patience van -- and be cared for by the family and my and we feel that everybody is eighth in the and we feel that there. Comfortable with the patient on the patient and go home when you say we who's actually making that determination. We really -- the team. The real patient physician. But it refers to our nurses at her purse and physical therapy occupational therapy speech pathology. Her ecologists recreational purpose. And I anybody else that we -- have. You mentioned it."

" Training. Staff Alexander what kind of training -- a family member actually have to after scanning the four that are ready. To take an airlock long lost friend or camera number home with them. Who we train families in the -- right things the proper technique of how to help them either walk or make Katrina her from the wheelchair to the bed. We train them and all recovery if the patient to fall how to help get them out. We train them and how to help the patient help themselves but their daily activities of getting dressed."

" Getting the bathroom. Giving in to the toilet. And we train of handling any kind of therapy techniques they mean either through their language function or for physical therapy techniques."

" A big responsibility. And very well. Is there anything you do otherwise to prepare person for the but we try to give them as much training as we can in the -- and quality. But we also do is we -- on have been coming in if we out if we see that there is potential servers. That might need care difficult. -- have -- start seeing via colleges in every politician absolutely so we can start dealing with some of those things. Are what we can also do is make. -- of them to go to support groups both foreign patients our troops were -- there as well as some caregiver support groups. So that when the patient in the Stanley go home. He cared to figure doesn't believe that there are by themselves can be with other people this is a wonderful way to network. Of that out you can find out what is that other people are dealing with some of the industries that they are doing -- What about the incidence of depression. Interrogators and do you either a lot yeah it's a very stressful job."

" Being caregiver and there is hiring of depression. And higher instance of medical problems people tend to. Take excellent care of the patient who had that they neglect their own -- you don't get to the doctor. Don't take medications are completely over. Stress themselves physically. And -- and there are more frequent oppress another people because they're dealing with -- news cancel might change the them."

" So what's even more interest in his that there are some recent studies even suggest that. Caregivers worst -- In the ways that doctor Alexander referred to actually might even have a higher rate of death. And patient error caregivers who are around. Taking care of themselves in dealing with on the describe her. Caring for somebody with a disability -- some recent studies that are coming out about that -- And the question is with all this B support groups. What comes down to -- caregivers still there. Is there a way to get them out how -- way to get him released. Sort of taken taken out or go shopping or we're doing everything they need to do. Well we encourages respite. From the we do you do you caregiver. There are many organized programs that can do things like that. But obviously the larger the social net applications more friendly and they have that are willing to. Be helpful. The primary curator or should try to take a break and try to get out the end and take care of them -- But the cost. It was caring for someone. -- can be somewhat prohibitive. Were forced some of these patients whether it -- first several hours and days have been included in the help. All of the cost and they don't have the financial resource as. Bob -- and make much much more difficult. Sometimes. -- patients and families can reach out may be too there are churches or synagogues and try to find more informal network and which maybe they can hire somebody. I didn't -- for some but for somewhat less expensive than it might be through a home health agency but remember. That if you do just that these are people who cannot really be as well trained. And the caregiver that comes from these agencies they have called that into consideration as well and training would be important aren't covered at all. And that is really considered custodial care are usually it -- Does seem like a big gap in our you know our coverage scheme and our insurance scheme they're a lot of patients who have broke out there. Who needs support and help and there aren't -- of a major shock to gambling when they realized. That a lot of these things aren't covered. -- Medicare or other current and things can be a very big financial burden. But I think is really very -- things that under Medicaid you might be able to get paid to be in a nursing home let's get into the home which really is a lot let's expand. Usually what the family. Here's an interesting question what about long term care insurance. The takeover something like that. I would it would be a patient long term care. Spotting many more people in it and that I don't know that much about it but I believe that and that there is insurance you can buy -- of that gap that we're talking about where they may need. That's us and at home things that are traditionally covered by insurance. And that they bought insurance at a time that -- be helpful. However potential but however it's important this matron and read through what they're purchased thing because -- not being necessarily what do you expect it to be. It -- caregiver is having trouble. Psychologically. Physically emotionally where we -- turn for help. They can probably turn back to -- the rehabilitation team that served the patient. Because we will have some of those resources. That the age of the patient caregiver might need it might mean going with -- columns and trying to deal with some of those issues themselves it might mean going to -- Support group for caregivers. In order that they can network with other people. But I I think there's a good place start. In order that we can identify what is the problem and now we can turn this off. Are there any national organizations that they can call. To try to find maybe a local chapter or people who are in the situation. Yes there are national stroke association has won the American Association an -- and -- Plays have either local chapters for example work that there's Southern California or association. Or hospitals. Rehabilitation facilities often have their own -- groups. Another place that they might want to look at is an organization called -- which is based here in New York. That may actually have some chapters nationwide. -- caregivers. Didn't speak part of thank you both for being here. Buried under appreciated problem I think it could get a word out. Thank you for joining our webcast I'm doctor David marks but hopefully provide you with and very helpful information. About."