AS well as the third major cause of death in Scotland, strokes are the leading cause of severe disability.
This year another 13,000 Scots will have their first stroke. Of the two-thirds who survive and join the other 110,000 Scottish stroke survivors, half will have a long-term or permanent impairment. Not enough is being done to support them and their families. Often the old attitude persists that little can be done.
That is the message of the largest ever survey by the Stroke Association. Published today, it reveals a pattern of lost opportunities for rehabilitation, poor co-ordination between the NHS and social care services, a lack of trained staff and families feeling abandoned. The situation is exemplified by the case of Eric Sinclair from Aboyne, who learned to walk again and has even returned to work but only after spending savings on a private physiotherapist.
In one sense this is a good problem to have. A generation ago many of those who now survive strokes would have died. But the encouraging survival statistics have implications for rehabilitation. And this challenge is likely to increase along with Scotland's ageing population and as a consequence of the numbers who drink to excess, eat badly and exercise too little. The rising levels of obesity, high blood pressure and type 2 diabetes are going to be reflected in more Scots suffering strokes, unless there is more emphasis on prevention.
There has been plenty of discussion and planning around these issues. The Scottish Government's Heart Disease and Stroke Action Plan considers how to support long-term recovery and the Exercise After Stroke programme aims at making recovering stroke patients more active. But worthwhile aspirations and initiatives are of limited value when services are being cut back and there is a disconnect between health and social services.
It is particularly worrying that nearly one in five of those surveyed reported after-care services being withdrawn even though their needs had stayed the same or increased. Intervention by a properly trained professional can make a major difference to a patient's chances of returning to a full, productive life. This is particularly important for those of working age. Yet the provision of physiotherapy and occupational therapy remain patchy. Communication problems can compound problems accessing public services and yet speech and language therapy is often in short supply. A stroke can have a major emotional impact, creating anxiety, frustration and fear, which can crystallise into depression without proper psychological support. More needs to be done.
Every stroke survivor has the right to make the best possible recovery whether the summit of their ambitions is climbing Mount Kilimanjaro or climbing the stairs.
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