Palliative Care for Elderly Stroke Patients
When someone suffers a stroke, their whole world changes rapidly. It is a frustrating event – to say the least. One day you can walk and talk and the next, you are clinging to life and often cannot talk or walk. Palliative care approached the treatment of stroke victims by being supportive, respectful and offering dignity. This is a form of treatment that helps to improve the quality of life of people who have had a stroke or who face another life-ending illness.
What is a Stroke?
A stroke is a disruption, using in the form of a blood clot, to the blood supply to the brain. The brain has many areas and each area is fed by specific blood vessels. When one of those is occluded either by a blood clot or a piece of arterial plaque the blood flow to that area of the brain stops and that portion of the brain dies or becomes damaged. Each part of the brain does specific tasks that help our body to function. These include making the heart beat, helping our muscles to move, keeping us balanced, interpreting noise, allowing is to speak. When a section of the brain is damaged so is our ability to do the things that portion of our brain handles.
Many stroke patients have a hard time talking, using extremities on one side of the body or the other, and maintaining balance. Some strokes damage key parts of the brain and there is no way to recover from those. When the brain stem is damaged it is catastrophic because is the part of our brain that runs all of our autonomic – automatic – functions. It is where we are reminded to breathe, for the heart to beat, and other key functions that help us to live. For those of us who have strokes and survive, care is needed. Sometimes the stroke is small and the damage overcome. At other times, the damage is permanent and the road back to recovery is difficult. People who have had strokes go from the ICU to a Med/Surg ward to a nursing home, and sometimes from there, they go home with home care.
Why are Elders Susceptible to Strokes?
Because strokes deal with the vascular system elderly people are more susceptible to stroke than are other age demographics. The reason is, is that by the time we are older our lifestyle has begun to catch up with us. What this means is that our diet and exercise routine has either kept us healthy or led to other diseases such as high blood pressure, clogged arteries, heart disease, lung disease, and disease that affect other organs. A good example of this is when we have high cholesterol and the plaque in our arteries has caused the blood vessels to become hard. That process makes it easier for a tiny blood clot to form and then travel to the brain. This is a process that is most likely attributed to our diet and one that takes years and decades to occur.
For many older people, smoking was a way of life. This was before all of the warnings and the push to get people to stop smoking. Those sorts of habits lead to a greater risk of stroke as we get older. It is situations like these that make elderly people more prone to strokes than any other group of people.
How Can Stroke Patients Benefit from Palliative Care?
Palliative care is about creating the best possible situation for the patient. It addresses quality of life issues while you either endure treatment or under hospice care. That is an important distinction because not all palliative care is administered by a hospice. Hospice, while very beneficial, is not about the aggressive treatment of a disease. It is about end-of-life care and focuses on the last six months of a person's life. Palliative care can begin as soon as you have a debilitating disease or one that is life-threatening. Palliative care teams work with the patient and their doctors to solve complex problems such as pain, emotional stress, and physical issues.
Palliative care is good for people who have had strokes because it helps them address their needs, which can range from pain to mobility to eating. If you are a person who has had a stroke and at the end of your life, then palliative care in conjunction with hospice can keep you comfortable and free of pain while addressing your daily needs. It is also very capable of helping the family with emotional turmoil and grief.
In short, palliative care helps with:
- Pain management
- Emotional turmoil and grief
- Physical limitations such as loss of strength or balance
- Nutrition and nutrition disorders caused by stroke
It is a program that addresses the quality of life from the beginning of a terminal illness to the end and beyond.
When Should Palliative Care be Considered for Strokes?
Palliative care should be started as soon as someone is diagnosed with a terminal disease or when a life-changing event occurs, such as a stroke.
While there are many hospices that have palliative care, you do not have to wait until hospice care is needed to begin palliative care.
What Should be Expected in Palliative Care?
The focus of palliative care is to improve the quality of life of those under its care. This means treating people with respect, understanding the patients and families wishes, and taking the time to provide quality care and treatments that help to relieve or reduce pain, increase mobility, improve nutrition, and to address psychological and social needs of the patient and often the family.
Expect a professional team that includes doctors, nurses, therapists, and caregivers and a team that works with your existing doctors and healthcare team. This is not an either/or type of organization and they do a great job of blending care between practitioners so that the patient benefits.
How much does Palliative Care for Stroke Patients Cost?
The cost of palliative care ranges from one patient to the next as each patient has a unique level of care and services that they need.
In general, most insurances will cover palliative care and Medicare and Medicaid cover most of the costs of palliative care.
There are out of pocket expenses such as co-pays and deductibles that need to be reached before some services begin.
How Do You Pay for Stroke Related Palliative Care?
Most stroke patients are old enough to receive Medicare or Medicaid and the bulk of care is covered under those programs. Supplemental insurance, or a gap policy, can cover the portion of care that Medicare does not cover, such as co-pays.
Long-term care insurance is another way to pay for palliative care and these types of policies help to cover palliative care for stroke patients and those who suffer from debilitating diseases.
As a last resort, there is always cash. If you do not have a gap policy or long-term care policy, then you will have to cover the balance of care with cash. Some palliative programs are covered under Hospice care and may have a reduced cost associated with them.
Where Can I Find Palliative Care for Stroke Patients?
Most hospitals have associations with palliative care organizations and the discharge planner can help set up those arrangements or provide you with greater details about the options available in your area. Your primary care doctor can be another source.
Search the internet for palliative care in your area. Many national organizations have zip code searches that help you locate care based on where you are. For example, you can use our senior care directory to find the best options near you.
Talk with your local hospice, even if the patient is not ready for hospice, they are a great resource and have access to care options that might help.
Dealing with a stroke is already a difficult process, but palliative care helps make the quality of life better either by addressing pain or therapy issues and helping people find the treatment that improves their quality of life while treating them with respect and dignity.