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Stroke Awareness Week – the work of the Stroke Foundation of New Zealand

Dorothy - 15/09/06

"Strokes are the third highest cause of death in New Zealand each year, and the highest cause of ongoing disability," says Mark Vivian new CEO of the New Zealand Stroke Foundation.

Those who survive strokes often have a greater level of ongoing disability than survivors of heart attacks.

September 11 – 17 2006 is Stroke Awareness Week and the Foundation believes it is important to highlight the incidence and impacts of strokes.

Stroke "a brain attack"
Strokes are caused by a blockage or rupture of an artery in the brain. The Stroke Foundation refers to a stroke as a brain attack.

"If we think of a stroke as a brain attack we'll start to realise they are as serious as heart attacks," says Mr Vivian. "It's absolutely critical we promote the urgency of brain attacks if we're going to reduce their occurrence and realise their impacts. As well as the high death rate from brain attacks, it's important we take account of the role strokes play in ongoing disability in New Zealand."

Role of the Stroke Foundation
The Stroke Foundation is the national charity working to:

  • educate the public about ways to reduce the risk of strokes
  • improve health services in acute and rehabilitation medicine
  • provide services for stroke survivors and caregivers in the community.

The Foundation has been instrumental in developing guidelines for hospital services and is working with District Health Boards throughout NZ to implement these as best practice standards. "This work has been pioneered by the Foundation and driven by the former CEO, Brian O’Grady. It has been absolutely critical to improved clinical outcomes and is ongoing. We're fortunate to be able to retain Brian in a part-time capacity to continue these projects," says Mr Vivian.

"The NZ Stroke Foundation is concerned that the incidence of new strokes continues to rise annually. Current figures suggest 20 New Zealanders suffer a new stroke each day, but that rate is increasing. Current trends suggest that if more isn't done to prevent strokes, the rate of increase will increase three-fold over the next thirty years. That's 60 new strokes per day, over 20,000 new strokes annually. This incidence is simply not acceptable. Neither those who suffer strokes nor our economy can afford that level of stroke incidence."

Currently NZ spends $138M per year for stroke hospital services alone. Recognising a stroke
Prompt action can speed recovery

Recognition of the signs of a stroke by anyone experiencing or seeing them can make a huge difference to the rate of recovery. A patient may well recover at an incredible pace when someone seeing problems develop asks the three key questions.
Can the patient smile?
Can the patient raise both arms?
Can the patient speak a simple sentence?

If the answer is NO call an ambulance.

Sometimes symptoms of a stroke may be difficult to identify.
Unfortunately, lack of public awareness (OUR AWARENESS) can spell disaster.
The stroke person may suffer extended brain damage when people nearby fail to recognize the symptoms.

Now doctors say a bystander can recognize a stroke by asking the three simple questions. After discovering that a group of non-medical people could identify facial weakness, arm weakness and speech problems, researchers urged the general public to learn the three questions. Widespread use of this test could result in prompt diagnosis and treatment of the stroke and reduce brain damage.

The F.A.S.T. card a Foundation initiative to reduce impacts of stroke
Late in 2005 the Stroke Foundation began distributing a business card with four simple pictures on it and the barest minimum text. The pictures show:
a face - F
someone holding their arms out – A
someone speaking – S
a timepiece - T
. The card provides a test to possibly identify if someone may be having a stroke.

Give a donation and receive a F.A.S.T. card
"In the past year we have been told repeatedly that these cards have saved lives and limited the impacts of strokes," says Mark Vivian. The Foundation has distributed more than 250,000 of these FAST cards. Everyone who donates to the Foundation's street appeal this week will be given a FAST card.

The FAST card may save your life or someone else's. The message is simple.

"If you think you or someone else is having a stroke get a medical assessment fast. The quicker someone gets to a doctor the less likely the stroke is to be fatal, and the less likely the long term impacts," says Mr Vivian.

"The evidence suggests that since we started distributing these cards, the impacts of stroke have been reduced. People who otherwise would have delayed getting to a doctor have received help quickly, and the effects of a stroke have been reduced."

"All our material is developed in consultation with New Zealand's leading neurologists and geriatricians. "We are extremely lucky with the support we receive from our medical advisors," says Mr Vivian.

Life After Stroke
A feature of the Foundation's work has been its emphasis on Life After Stroke. The most recent data suggests approximately 56,000 New Zealanders are living in the aftermath of at least one stroke.

Strokes affect people's abilities to look after themselves, their employment and lifestyle, and their physical and mental capacities. "The Foundation is concerned to support people affected by strokes. This is the focus of our regional Field Officer service, which provides support and information for stroke survivors and caregivers throughout New Zealand," says Mr Vivian.

"The Stroke Foundation is pivotal in helping people who have had a stroke to get on with their lives back home. The Foundation's Field Officers help bridge the difficult time between leaving hospital and returning home. This transition is a stressful time for everyone," says Dr Carl Hanger, geriatrician at Christchurch's Princess Margaret Hospital.

"The impacts of stroke are completely underestimated," says Pete Carpenter, South Island Stroke Foundation Regional Councillor and a stroke survivor himself. "My family has had to change just about every part of our life after my stroke, and there aren't the supports available to people after hospital other than what the Stroke Foundation does," he says.

More financial support needed
The death of a woman in a house fire in Porirua during the weekend highlights the difficulties faced by survivors of strokes, according to the Stroke Foundation. "Yvonne Moore's death highlights the paucity of services for survivors of stroke," says Mark Vivian. "I am appalled at the level of supports available to many with ongoing disabilities resulting from strokes.

"In the Central Region, the only financial help we get from the DHB's is a total of $40,700 per year for information services." The Foundation's contract with the DHB excludes the provision of support services and they must fundraise for this aspect of their work with the stroke affected community.

"It is a very real concern that most of our new clients are referred to us by hospital services, but we receive very little funding to provide the services we provide. In our Central region, this last year our field officer service received from the DHB's $5.56 per Field Officer hour worked. We received no assistance with associated costs of the service, for example the 33,000 kilometres staff travelled to provide the home based services."

Strokes are the highest cause of ongoing disability in New Zealand. "I don't think people realise the effects and impacts of stroke," says Mr Vivian. "For many survivors there are ongoing challenges managing self-care, accessibility and mobility difficulties, and often mental health difficulties. Many of our members are extremely reliant on family and unpaid carers, and this puts an enormous strain on relationships and carers’ own health and supports. There is simply not the commitment from the health sector to provide the necessary paid supports post-hospital."

The Stroke Foundation began with aftercare stroke clubs because there was no follow-up service available for survivors or their families and celebrated its 25th anniversary last year.

Strokes can affect people at any age
Approximately 30 people under the age of fifteen have a stroke each year in New Zealand.

Young people suffering a stroke, their families, their friends and their teachers all need special help in understanding and coping with what has happened. Sometimes the emotional after-effects of a stroke can be wrongly interpreted as naughtiness or tantrums. People wanting help with this situation can contact the Stroke Foundation or go to their website for guidance.

Young adults (20-39 years)
These patients need to be in a familiar environment in their own community wherever possible. They need to be given access to information, consultation with the appropriate range of health professionals and all possible rehabilitation in a setting for younger people, not with geriatric patients. They also have to cope with the effects of job loss and changes in career prospects. Their families including the children need guidance in their changed situation.

Middle age (40-60 years)
Many people in their fifties start making plans for their later years. 25% of strokes happen to people before retirement age. After a stroke retirement plans all have to be put aside as they cope with the results of the stroke. Research on the social consequences of stroke shows that even though there is now more support from social workers, better information and more help from voluntary services, there is a lot of unhappiness and difficulty in adjusting to the changes for both the patient and the partner. Here again the Stroke Foundation offers support to them and to the family.

Stroke Awareness Week Appeal
This week Foundation members and volunteers will stand on street corners for a street appeal in order to raise money to provide support services. "We provide a service that would not otherwise be available for vulnerable people living in their own homes whose everyday needs are so often ignored," says Mr Vivian. "I certainly hope the public support us with their donations.”

"The quality and breadth of resources that the Stroke Foundation has produced for people with stroke in New Zealand is simply amazing when you consider the absolutely meagre budget that they have to work with. Imagine what they could achieve with better funding," says Dr Harry McNaughton, the Foundation's Honorary Medical Director.

The Foundation has set up a texting facility this year in addition to street collectors throughout the country. "People can text the word STROKE to 469 to make a $3 donation, or phone our 0800 78 76 53 number, or donate to a street collector."

Remember the help and advice that is available on the Stroke Foundation of New Zealand website.

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