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Caregiver Involvement in Post-Stroke Care
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Christina Baldasari L.P.T., William Bulman MD
This year over 300,000 people in the United States will suffer a stroke, many of whom are elderly. Following the immediate crisis there are long term health care issues that their families face. Join our panel of experts as they discuss what every family should know about taking care of a recovering stroke survivor.
LISA CLARK: Thanks for joining us for our webcast. I am Lisa Clark. This year nearly three quarter of a million people in the United States will suffer a stroke. In fact, strokes are the third leading cause of death in this country behind heart disease and cancer. Still roughly 75% of those who suffer a stroke survive it though most are left with permanent impairment. Many of these stroke victims are elderly and following the immediate crisis there are long term health care issues that their families face.
For families who choose in home care for these relatives, there are many practical and emotional questions to address. Joining us for the next few minutes to discuss home care for elderly stroke victims are two health professionals who do a lot of work with elder care. Dr. William Bulman, a general internist in the Department of Medicine at Columbia Presbyterian Medical Center. He is also a clinical instructor of medicine at the Columbia College of Physicians and Surgeons. He also maintains a private practice in internal medicine in Manhattan. Welcome.
Also joining us is Christian Baldasari, a licensed physical therapist on staff at the Doylestown Hospital in Doylestown, PA. In addition to many years experience in in-patient therapy, out-patient rehab, and home care, Ms. Baldasari also runs aquatic physical therapy programs and has done much work with brain injury patients including stroke victims I presume.
CHRISTINA BALDASARI, LPT: Yes.
LISA CLARK: Welcome to you.
CHRISTINA BALDASARI, LPT: Thank you.
LISA CLARK: First, Dr. Bulman can you give us a brief description of what actually happens during a stroke and what makes it such a debilitating event.
WILLIAM BULMAN, MD: A stroke is an injury or damage that occurs in a portion of the brain as a result of disruption of blood flow to the brain. That occurs either as a result of a blood clot coming from another portion of the body, the heart usually or one of the large arteries in the neck. The blood clot breaks off and blocks a smaller blood vessel in the brain causing the portion of the brain normally supplied by that blood vessel to die.
The second way a stroke can occur is a small blood vessel can rupture in the brain causing bleeding and then death of the tissue that that blood vessel was suppose to supply.
LISA CLARK: Now you want to mention how crucial immediate intervention is.
WILLIAM BULMAN, MD: What can be confusing for some individuals that a stroke can be a very variable, acute illness. It depends entirely on the portion of the brain that is affected and the size of that area of the brain that is affected. A stroke can cause as most people are commonly familiar with a weakness of one side of the body, either weakness of an arm and leg. It can also manifest as isolated weakness of just one side of the face. It can also result in difficulty speaking, difficulty swallowing, or blindness of one or both eyes. A stroke is a very varied thing.
If a person has acute onset of symptoms that suggests to them that they might be having a stroke, any weakness or loss of sensation in a body part, or any sudden change in their ability to speak or comprehend, they should seek medical care immediately. The reason being that in the last several years, we have developed acute treatments for stroke. If the stroke has occurred because of a blood clot we can dissolve the blood clot immediately and perhaps save the portion of the brain that was affected by the stroke.
The reason that I stress the word immediate is that there is a window of about six hours in which we can give this therapy to people if they are a candidate for it.