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Showing posts with label Dr Lee Tze Yan. Show all posts
Showing posts with label Dr Lee Tze Yan. Show all posts

Tuesday, 26 September 2023

The financial impact of having a stroke

 

One way to alleviate some of the costs incurred after a stroke is to review your health insurance to ensure you are getting all the benefits you are entitled to. — Freepik

A big financial impact

The aftermath of a strokr can be expensive with medicines, assistive devices, home modifications, and caregiver costs, coupled with potential loss of income. 


The financial impact of a stroke can be overwhelming and unpredictable.

The lifetime cost of ischaemic strokes – which comprise over 80% of strokes and are caused by blockage of blood vessels supplying part of the brain – were estimated at US$140,481 (RM659,698).

This includes the cost of inpatient care, rehabilitation and follow-up care.

A study that looked at the cost of post-stroke outpatient care in Malaysia in 2015, found that the average total cost incurred was US$547.10 (RM2,569.18).

Of this figure, 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses.

The main factor in the cost of post-stroke outpatient care was the severity of the stroke.

Increased costs was also associated with a haemorrhagic stroke – the other main type of stroke, which is caused by the bleeding, or haemorrhage, of a blood vessel in the brain.

Leading a safe and cost-effective life post-stroke requires a combination of self-care, medical management and lifestyle adjustments.

Here are some steps that can help:

> Follow medical advice

It’s important to follow your healthcare provider’s advice on medication, rehabilitation and lifestyle modifications.

This may include taking medication as prescribed, attending rehabilitation sessions, and making changes to your diet and exercise routine.

> Manage chronic health conditions

If you have other chronic health conditions such as high blood pressure or diabetes, it’s important to manage these conditions to reduce the risk of future strokes and other health complications.

> Make home modifications

Consider making modifications to your home to reduce the risk of falls and improve your safety.

This may include installing grab bars, non-slip mats and handrails.

> Use assistive devices 

Assistive devices such as canes, walkers and wheelchairs, can help you maintain your mobility and independence.

> Adopt healthy habits

Adopting healthy habits such as eating a balanced diet, exercising regularly and getting enough sleep, can help you maintain your overall health and reduce the risk of future strokes.

> Stay socially active

Staying socially active and engaged can help reduce the risk of depression and improve your overall quality of life.

Consider joining a social group or doing volunteer work.

> Manage finances

Stroke can have a significant financial impact on the family, especially if the stroke patient is the sole breadwinner.

So it’s important to manage your finances carefully.

By following these steps and working closely with your healthcare team, you can lead a safe and cost-effective life post-stroke.

Managing the financial impact


As mentioned above, no doubt, one of the biggest challenges post-stroke would be the financial impact on the patient and their dependents.

Financial burdens following a stroke may be due to medical expenses and decreased income because of the inability to work, whether it is the patient themself or a family member who has to quit their job to become a full-time caregiver to the patient.

Addressing financial needs post-stroke can be challenging, but here are some strategies that can help:

> Review your insurance coverage

Examine your insurance coverage to make sure it includes all the necessary benefits and services, such as rehabilitation and home healthcare.

Consider speaking with an insurance specialist to ensure you are getting the most out of your coverage.

> Explore disability benefits

If you are unable to work because of stroke, you may be eligible for disability benefits.

Socso provides a range of benefits for employees, including medical treatment, rehabilitation and financial assistance.

There are also many NGOs (non-governmental organisations) that offer financial assistance to stroke patients and their families, including the National Stroke Association of Malaysia (Nasam), Stroke Care Malaysia, etc.

These organisations can help with medical bills, transportation costs and other expenses related to stroke care.

> Create a budget

You and your dependents should review your daily expenses and financial commitments to see what can be adjusted to compensate for the decrease in income and increase in stroke-related expenses.

A leaner budget might have to be created for the family to follow, to ensure that you don’t go into unsustainable debt, or even bankruptcy.

What’s good for yourself

It is also important, though challenging, to develop a sense of what is good for oneself after a stroke.

Here are some methods that can help:

> Listen to your body

Pay attention to your body and how it responds to different activities and situations.

Take note of what makes you feel better or worse. and adjust your routine accordingly.

> Set realistic goals

Set achievable goals that are tailored to your abilities and interests.

This can help you build confidence and a sense of accomplishment, which can improve your overall well-being.

> Prioritise self-care

Make self-care a priority, including getting enough rest, eating a healthy diet, and engaging in physical activity, as recommended by your healthcare providers.

> Seek support

Connect with others who have experienced stroke or other health challenges.

Consider joining a support group or seeking individual therapy to help you process your emotions and develop coping skills.

> Practice mindfulness

Mindfulness practices such as meditation, yoga or deep breathing, can help you become more aware of your thoughts and feelings, and develop a greater sense of inner calm and well-being.

> Experiment and adjust

Be willing to experiment with different approaches to self-care and self-discovery, and be open to adjusting your routine as needed.

By focusing on self-care, seeking support, and staying open to new experiences and perspectives, stroke patients can develop a greater sense of what is good for themselves and their overall well-being.

In a nutshell, it is not impossible for a person to regain a normal life after a stroke.

The real challenge lies in how stroke survivors can manage their post-stroke life and deal with the challenges from then on effectively.

Remember, there will always be light at the end of the tunnel for stroke survivors!

Dr Lee Tze Yan is a senior lecturer in molecular medicine at Perdana University. Matthew Teo Yong Chang is an occupational therapist specialising in stroke rehabilitation and senior lecturer at Manipal University College Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.


Monday, 18 September 2023

Life after a stroke, post-stroke care crucial


The after-effects of a stroke – whether physical, emotional or psychological – are challenging to navigate. 

STROKE, sometimes called a brain attack, occurs when there is a blockage of blood supply to part of the brain or when a blood vessel in the brain ruptures.


Star Graphic: Vecteezy

Stroke survivors have a wide range of long-term healthcare needs.

After the stroke, they often experience a variety of cognitive, psychosocial and physical difficulties.

The most challenging problems post-stroke are usually physical and cognitive impairment, depressive symptoms, and fatigue.

Even survivors of a mild stroke struggle to regain full independence due to persistent symptoms.

A stroke survivor’s ability to carry out activities of daily living is likely to still be impaired even a year after they had their stroke.

As survivors work towards recovery, they may experience times when they feel like they have taken two steps forward, only to end up taking one step back.

This is normal and to be expected as rehabilitation gains often occur more slowly as time goes by.

Survivors with communication disorders like aphasia (which is caused by damage to the part of the brain that controls language expression and comprehension), would face even more challenges on top of their physical difficulties.

Maintaining basic communication would be a challenging task, let alone engaging in social networks and meaningful activities to reintegrate into their communities.

Unmet needs

After a stroke, survivors often experience emotional and behavioural changes.

The reason is simple: Stroke impairs our brain’s control over our behaviour and emotions.

You or your loved one may experience feelings of irritability, forgetfulness, carelessness or confusion.

About a third of survivors report depressive symptoms and one in five report anxiety in the first months or years after the stroke.

Many stroke survivors and their caregivers also feel abandoned and marginalised by community health services.

Inadequate post-stroke care can create unmet needs for survivors and their caregivers, which are often associated with poor quality of life for the survivor.

These unmet needs can include:

> Rehabilitation and recovery

Stroke patients often require long-term rehabilitation to regain lost function and mobility.

Many patients require ongoing physical, occupational and speech therapy, but may not have access to these services or the financial resources to cover the costs.

> Mental health support

Stroke patients may experience depression, anxiety and other mental health issues because of the physical and emotional challenges of recovery.

Access to mental health services can be limited, and there may also be stigma associated with seeking mental health care.

> Caregiver support

Caregivers play a critical role in supporting stroke patients, but may themselves experience significant stress and burnout.

They may also lack the training and resources needed to provide effective care.

> Social support

Stroke can be a life-changing event that can result in significant changes to a survivor’s social support network.

They may need help rebuilding their social connections and may benefit from peer support groups.

> Education and information

Many stroke survivors and their families have reported feeling overwhelmed and underinformed about the condition and its treatment.

Therefore, they may benefit from access to educational materials, support groups and resources to help them navigate the recovery process. 

> Access to healthcare

Stroke patients may face barriers to accessing healthcare, particularly if they live in rural or remote areas.

They may also face challenges in accessing specialised care, such as neurology and rehabilitation services.

Beyond a year

It is a common belief that a survivor’s physical recovery will plateau a year after the stroke.

In the early stages of rehabilitation after a stroke, you can often recover quickly.

However, after a few months, your progress may slow or stagnate – therapists call this the plateau phase. It is a stage most survivors experience.

But contrary to widespread belief, it doesn’t mean that you can no longer recover any further.

In fact, it is possible to get through the plateau phase and recover even more function.

The goal of rehabilitation is to maintain your function and prevent any deterioration, as well as to better adapt to your longterm limitations.

Maximising physical independence may indeed turn out to be a lifelong task.

The best way to overcome this challenge is to make sure things at home are adapted as necessary to help you get back to your daily life safely.

You may seek advice from a healthcare professional, specifically an occupational therapist, to prescribe customised assistive devices and assistive technology for home modification.

Emotional impact

A stroke is sudden and shocking, and can affect every part of your life, including your emotional well-being.

Every stroke experience is unique, but to most survivors, it feels like a loss of life.

Most survivors come to accept their physical disability, but many remain emotionally vulnerable years after their stroke.

The loss of physical independence may result in a loss of sense of identity, as well as guilt over the burden they are now posing to their family members.

Hence, ongoing psychological support from family, friends and/or healthcare professionals may be needed.

Providing flexible psychological support for stroke survivors can be achieved through a variety of approaches, including:

> Individual therapy

Stroke survivors may benefit from individual therapy sessions with a licensed therapist.

These sessions can be tailored to the person’s specific needs. 

> Teletherapy

Teletherapy allows stroke survivors to receive psychological support remotely, via video conferencing or phone calls.

This can be particularly helpful for patients who are unable to travel to the counselling centre, or who live in rural or remote areas.

> Group therapy

In addition to providing therapy in a group, group therapy sessions can give stroke survivors the opportunity to connect with others who have had similar experiences.

This can help survivors realise they are not alone, as well as both receive from and give support to their fellow survivors in the process of undergoing the therapy.

> Peer support

Stroke survivors may benefit from peer support groups, which provide a supportive and empathetic environment for survivors to share their experiences and learn from others who have been through similar challenges.

While group therapy is led by a healthcare professional and aims to bring about a change in mindset or behaviour, peer support groups comprise only of fellow survivors and are meant to help their members cope with their situation.

> Caregiver support

Providing psychological support for caregivers can also benefit stroke survivors, as it can help reduce caregiver stress and improve the quality of care they provide.

This support can be provided through individual or group therapy sessions, or through educational programs designed specifically for caregivers. 

> Online resources

There are many online resources available for stroke patients and their caregivers, including educational materials, support groups and forums.

These resources can provide flexible support for patients who may have limited access to in-person services.

It’s important to note that psychological support for stroke survivors should be tailored to the individual’s needs and preferences, and should be provided in a flexible and compassionate manner.

See next Sunday’s Starhealth for managing finances and self-care for stroke survivors.

By Dr Lee Tze Yan,  a senior lecturer in molecular medicine at Perdana University. Matthew Teo Yong Chang is an occupational therapist specialising in stroke rehabilitation and senior lecturer at Manipal University College Malaysia. For more information, email starhealth@thestar.com. my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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