Road To Recovery

It did not take long for Anita Bramwell to realise that her husband James had suffered a stroke. A previous marriage to a doctor and time spent as an occupational therapy worker armed her with enough knowledge to recognise the signs when she found him lying on their bed.

But while she was able to keep calm at this crucial time and make sure help came quickly, it didn't take long for the gravity of the situation to hit home. "I tend to cope well in a crisis and crumble when the crisis is over," Anita said. "I called an ambulance straight away."

It is when the initial crisis begins to subside that a whole range of care and support services in West Hertfordshire for people who have suffered strokes really comes to the fore to help people like Anita and James.

James' stroke was severe. It paralysed his right side, he couldn't speak, and he had to spend nine weeks in hospital. But these days, care for stroke patients does not revolve around treating people for long periods on the wards of busy acute hospitals.

Ginny Riley, of West Herts Community NHS Trust, runs some of the services which offer people who have had strokes and long term illnesses like multiple sclerosis the high quality care they need outside hospital.

She said "People who have disabilities prefer to get the treatment they need outside hospital. We are working to get rid of the notion they are still ill but recognise they need help to live with their disability."

The key word in this situation is rehabilitation. A stroke happens when the blood supply to the brain is disrupted, mostly as in James' case as a result of a blood clot. Some strokes are fatal while others cause permanent or temporary disabilities.

At the moment there is no treatment that can cure a stroke and every person will be affected differently. But plenty can be done to get people back on their feet to enjoy an improved quality of life.

Ginny explained: "The purpose of hospitals is to get people better and get them out as quickly as possible. There isn't the time or facilities for long term rehabilitation. We try to get people to adjust to being at home again as soon as possible. The emphasis is on enabling them to do things for themselves - returning their confidence and independence."

At the rehabilitation centre at Garston Manor near Watford, specially trained rehabilitation nurses care for patients for up to six weeks. This service also gives patients the crucial support and comfort of being among people in a similar situation.

Once this patient returns home that high quality hospital care continues in the shape of the Hospital at Home service. This provides exactly the same level of care in their own homes as patients would have in hospital, provided by a team including hospital consultant, district nurse, physiotherapist and occupational therapist. The only difference is that the patient receives care in the comfort and familiar surroundings of their own home where they are most likely to make a speedy recovery.

James was encouraged to begin doing things for himself such as making tea and getting dressed at an early stage but it wasn't until he returned home to Anita that the enormity of the situation hit him.

"Being in hospital isn't real life. It's only when you get home that you discover you can't do so many of the things you used to do without thinking," said Anita.

James visited a day centre where he received physiotherapy and speech therapy. He had regular visits at home from an occupational therapist and was supported by his local GP, all of which helped Anita too in her role as carer. Today James is much improved and can both walk and talk again.

Anita is also involved in setting up self help groups to help carers cope with all the hard work and often emotional turmoil that is involved in recovery from a stroke.

Older people are more likely to suffer a stroke but nobody should be complacent. James was only 41 when he had his stroke. Taking moderate exercise, not smoking, not drinking too much, cutting down on salt and fatty foods and regular blood pressure checks can all help reduce the risk.

The Stroke Association has recently opened an information centre in Harpenden offering a whole range of support, advice and information for people who have had strokes, and those caring for them in Hertfordshire, Bedfordshire, and Buckinghamshire. They can be contacted on 01582 769 389.

Converted for the new archive on 30 June 2000.Some images and formatting may have been lost in the conversion.