Stroke: Care with Stumbling Blocks (Part 2)

by Wiebke Heiss / MEDICA.de15/08/2009

Part 2: Experts to the Front

The competence network criticizes a further problem connected to the management of stroke patient: „Many problems occur at intersection points where information gets lost“, Nolte explains. The transfer from the acute to the rehabilitation to the stationary phase are badly coordinated due to facts such as a lack of standards in measuring life parameters, due to different funding services and experts for each stage. „Often it is easier in Germany to just do an x-ray instead of ordering the recently made one from another place“, the neurologist says. This experience had also be made by Walter Steiner: „A lot of information was lost when I had to change wards or hospitals - the examinations always started from scratch again and again.“

The 71 year old points out another stumbling block concerned with stroke care: „Once you are released from rehabilitation you truly are on your own.“ Nolte confirms that the interface between rehabilitation and general practitioner is one afflicted with trouble. „Patients should be able to turn a specialist, a stroke expert. A general practitioner is not an expert for neither the disease nor the post treatment of it“, Nolte stresses. „Either we are going to train general practitioners to be stroke experts or we are going to provide for specialists in stroke patient care.“ A study undertaken by the competence network showed that mainly the general practitioner is the main point of contact after rehabilitation. That is an even more surprising fact since "the situation of stroke patients after stationary treatment is considered to be complex, problematic and marked by psychological problems.“ Nonetheless, an interdisciplinary approach is not common. A further and more detailed study will give more information by 2010.

Walter Steiner, by now, feels more than well: „Sometimes I joke a bit and say that I would like to suffer another stroke because I seem to be able to think and also write better with my new brain cells.“ It is a bit like feeling better with the "new" brain than with the "old" one. "Nobody told me something like this would be possible." Mostly Walter Steiner came across one attitude during rehabilitation: „They keep telling you just one thing: they keep telling you what you will not be able to do anymore after a stroke.“ Nolte knows about the problem with this kind of negative approach and agrees with Walter Steiner: "We know from didactic methods that the key to success is a positive approach and positive backing." This knowledge has arrived in seminars for managers already years ago.

Wiebke Heiss
MEDICA.de

- Part 1: Care with Stumbling Blocks
- Part 2: Experts to the Front