Comparison of Stroke Care Now and in the Past

The last few decades have seen essential changes in the diagnosis and management of acute stroke. The changes include patients’ chain of care modifications for various reasons, including better diagnostic processes, new therapeutic targets, and stronger support care systems. This article compares stroke care today and in the past to reveal any changes in outcomes and recovery.

1. Demographics
   A Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) compared stroke trends over time by sex (overall and age-stratified). The conclusion was that overall stroke incidence decreased between the 1990s and 2015 for both sexes. However, the 20-to-44-year and over-85-year age groups require more studies and close surveillance.
   
   
2. Functional Outcome
   In rehabilitation therapy, functional outcome refers to a measurable goal that helps patients perform specific daily living activities. Today, it is easier to assess and determine a stroke survivor’s functional outcomes, and patients have better results than a decade ago. A study of ischemic and hemorrhagic stroke survivors after inpatient rehabilitation revealed better functional prognosis in the latter, but more studies are needed.
   
   In another study of stroke rehabilitative care outcomes, most survivors made good functional recovery, while 20% remained ADL (activities of daily living) dependent upon discharge. Additionally, acute stroke patients have a higher likelihood of surviving and achieving independence (positive functional outcomes) if they receive treatment in a stroke unit.
   
   Proper care in a stroke unit and rehabilitative therapy have improved survivors’ functional outcomes and made them more likely to achieve independence than in the past.
   
   
3. Survival Rates
   Stroke mortality rates have declined in the U.S. over the past several decades, although the decline rate has not been constant. The absence of apparent advances in stroke therapy in the 1980s and 1990s resulted in bleaker survival rates among stroke patients. The last decade has seen better supportive and rehabilitative post-stroke care, which has played a significant role in improving stroke survival rates.
   
   Unfortunately, despite the declining mortality rate, stroke still has a relatively high morbidity rate, with up to 50% of survivors becoming chronically disabled.
   
   
4. Stroke Trends and Occurrences
   According to a study, stroke incidences fell by 32% between the early 1980s and late 2010s for both men and women. The proportion of fatal or disabling stroke incidences also decreased over time. Unfortunately, despite the progress made in stroke prevention and medical care improvements, it remains a leading cause of long-term disability and death in adults in the U.S.
   
   There is an improvement in addressing stroke-related complications with better treatment care and rehabilitation (physical, occupational, and speech therapy).
   
   
5. Community Education
   Community education aids in stroke prevention and treatment efforts across the globe. It can help reduce the risk factors associated with stroke and ensure timely implementation of appropriate therapies to aid recovery. After years of studies, researchers have uncovered a lot of pertinent information about strokes and other brain attacks, which means that there is better community education available today than in the past.
   
   
6. Caregiver Responsibilities
   Despite the increase in stroke-related knowledge and the critical importance of caregiver support in aiding recovery, many caregivers today feel inadequately prepared to handle the challenges (mental, emotional, and physical stress) of caring for a stroke survivor. However, today there are more support groups and support in general compared with decades ago. Caregiver responsibilities have grown to offer:
   
   
   • Emotional support
   • Personal care
   • Meal planning and food preparation
   • Transportation
   • General health care
   • Medication management
   • Companionship and family support

History of the Stroke Support Association

In 1979, stroke support groups did not exist outside of V.A. Hospitals. The Stroke Support Association (SSA) started as a combined effort of people who recognized early the importance of a group support system in aiding stroke recovery and rehabilitation. The SSA began as the United Stroke Program’s Long Beach Chapter in 1980. The group’s success inspired the founders to establish a broader and more formalized program.
Today, SSA offers weekly support groups and other stroke-related resources.

Categorized in: Studies