Stroke Guidefor patients, carers and relatives
This is a document produced in colaborance by NHS Milton Keynes, Milton Keynes Hospital NHS Foundation Trust , Milton Keynes Community Health Services and Milton Keynes Council.
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1.1. WHATISASTROKE1.2. TYPESOFSTROKE1.3. THEBRAIN1.4. EFFECTSOFASTROKE1.5. MEDICALTESTSANDINVESTIGATIONS1.6. WHATTOEXPECT1.7 WILLIHAVEANOTHERSTROKE?1.8 REAL-LIFEEXPERIENCES1.9 WHOMAYBEINVOLVED
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2. WHILSTINHOSPITAL2.1. THEACUTESTROKEUNIT2.2. THETEAM2.3. WARDINFORMATION2.4. FREQUENTLYASKEDQUESTIONS2.5. DIARYOFPROGRESS2.6. ADDITIONALINFORMATION2.7 BEFORERETURNINGHOME- ASKTHESTAFF2.8 COMPLAINTSANDPALSTEAM
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3. RETURNINGHOME- WHATWILLITBELIKE?3.1. COPING3.2. RELATIONSHIPSANDFAMILY3.3. SOCIALLIFEANDHOBBIES3.4. GETTINGBACKTOYOURDAILYROUTINE3.5. INTIMACYFOLLOWINGASTROKE
4. HEALTHSERVICEFACILITIES4.1. IN-PATIENTSERVICES4.2. COMMUNITYSERVICES4.3. MILTONKEYNESSOCIALSERVICES4.4. SOCIALSUPPORT4.5. FINANCIALSUPPORT4.6. OUTANDABOUT4.7. HOLIDAYS4.8. USEFULWEB-RESOURCES
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Further information
This document has been produced in collaboration between NHS Milton Keynes, Milton Keynes Community Services and Milton Keynes Hospital Foundation Trust.
Special thanks to the group of the patients and carers who have given their time to enrich this document with their knowledge and experience.
Translations,Brailleandaudiotape
Upon request, we have access to interpreters who can speak other languages. This leaflet can also be made available in large print, Braille, different languages or on audiotape. Please contact 01908 278801.
For general health information and more about the NHS, including the complaints procedure, call NHS Direct (calls are free on 0845 4647), or go to www.nhs.uk
© NHS Milton Keynes Sherwood Place, Sherwood Drive, Bletchley, MK3 6RT
Telephone: 01908 278660Email: [email protected]
An electronic version of this document is available on our web-site and can be printed in large font size.www.miltonkeynes.nhs.uk
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BACKGROUND1. INTRODUCTION
1.1. What is a stroke
Astrokeoftenhappenssuddenly,withoutwarningandcanaffectpeopleofanyage.Itisabrainattack.Itcanhappenwhenthebloodsupplytopartofthebrainisdisrupted.Thesymptomsdependonthepartofthebrainaffectedandtheextentofthedamageincurred.Thisiswhynotwostrokesarethesameandwhyrecoveryissovariable.
1.2. TYPES OF STROKE
Therearetwomaincausesofastroke,whichrequiredifferenttypesoftreatment:
Ischaemic stroke (infarction)Moststrokes(accountingforover80%ofallcases)occurwhenthebloodsupplytothebrainisstoppedduetoabloodclot.Thisbloodclotrestrictstheflowofbloodtothebrain.
A TIA (Transient Ischaemic Attack) or ‘mini-stroke’ : Thisiswherethesupplyofbloodtothebrainistemporarilyinterrupted.Thesymptomsareverysimilartothoseofastroke,butthedifferenceisthattheyresolve.Thiscanmeananepisodecanlastasshortasafewminutestohours,butnolongerthan24hours.TIAsshouldbetreatedveryseriouslyastheyareoftenawarningsignthatafullstrokeiscoming.
Haemorrhagic stroke (haemorrhage)Thistypeofstroke(upto20%ofallcases)iscausedbybleedinginoraroundthebrainfromaburstbloodvessel.
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1.3. THE BRAIN
Thebrainisdividedintotwohalves–therightandtheleft.Thelocationofthestrokeisespeciallyimportantinunderstandingwhichpartsofthebodywillbemostaffected.
Theleftsideofthebraincontrolstherightsideofthebody…andviceversa.Eachsideofthebrainhasdifferentfunctionsandthiswilldictatewhataffectthestrokehas,orwhatsymptomsthepersonexperiences.
Inthemajorityofpeople,theleftsideofthebrainisresponsibleforlanguage(reading,writing,speakingandunderstanding),andtherightsideofthebraincontrolsourabilitytomakesenseofwhatwesee,hearandtouch;ourabilitytojudgesize,speed,distanceandpositioninspace.
Memory,vision,movement,sensation,andhearingarecontrolledbybothsidesofthebrain.Thereforethesefunctionscanbeaffectedwhicheversideofthebrainisdamaged. BA
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the right hemisphere
the left hemisphere
Front
Back
The Hemispheres of the brain (topview)
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1.4. EFFECTS OF A STROKE
Itisimportanttorememberthatnotwostrokesarethesame.Howyourstrokeaffectsyoudependson:
1. Theareaofthebraindamaged2. Theseverityofthestroke 3. Yourageandgeneralhealth
Themostcommoneffectsofstrokeare:
Weakness,clumsiness,heavinessorparalysisdownonesideSwallowingdifficultiesDisturbedvisionLossofbladder/bowelcontrolTirednessanddifficultysleepingNumbness/alteredsensationPainLossofbalanceCommunicationdifficulties:writing,speaking,reading,calculatingPsychologicaleffects:moodswings,anxiety,depressionReducedconcentration,memory,abilitytoprocessinformationDifficultyrecognisingandknowinghowtousefamiliarobjects
1.5. MEDICAL TESTS AND INVESTIGATIONS
Belowaresomeofthetestswhichmaybeofferedtoyou.Itisunlikelyforsomeonetoneedallthesetests–yourdoctorwilldecidewhichonesareappropriateforyou.
Blood tests:Thesecanbeusedtocheckforcertainconditionsthatmayhavecontributedtoyourstroke,suchasbloodsugarlevelandcholesterollevel.Highlevelscanincreasetheriskforfurtherstroke.
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Echocardiogram (or cardiac ultrasound scan):Thismaybeusedtolookforanyheartproblemsthatmayhavecontributedtoyourstroke.
Electrocardiogram (ECG):Thishearttracingtestmeasurestherhythmandactivityofyourheart.Irregularheartrhythmscancausestrokesandneedtobetreated.
Chest X-ray:Thislooksforunderlyingconditionssuchasheartorlungcomplaintsthatmayhavecontributedtothestroke.
CT (Computed Tomography) scan:Thisisthetypeofbrainscanwhichidentifieswhatkindofstrokeyouhavehadandtheextentofthedamagethestrokehascaused.Itisalsousedtoexcludeothertypesofillnessthathavesimilarsymptomstoastroke.Ascanshouldbedonewithin24hoursofhavingastroke.
MRI (Magnetic Resonance Imaging) scan:ThisisanothertypeofbrainscanwhichgivesamoredetailedpicturethanaCTscan.
Carotid Doppler or Duplex ultrasound scan:Thisisusedtofindoutwhethertherehasbeenanarrowingofthebloodvesselsintheneck(thecarotidarteries),whichsupplybloodtothebrain.Thisnarrowingcancauseastroke.
1.6. WHAT TO EXPECT
Thereisnowayofpredictinghowapersonwillbeaffectedlongterm.Youhavetowaitfortimetopassand B
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allowtheinitialhealingprocesstotakeplace.Sometimesthisfeelslikeno-oneistellingyouwhatisgoingon,butthisisnotthecase–itisjusttooearlytoknowwhattheoutcomewillbe.
Thiscantakeseveralweekstomonths,butduringthistimeyoumaynoticeimprovementinsomeofyoursymptomsortheeffectsofthestroke.Whenthisimprovementslowsdownitmaybeclearerwhatthelongtermeffectsofthestrokearegoingtobe.
Mostusefulrecoveryhappensinthefirstfewmonths,butpeoplecancontinuetorecoverforseveralyearsafterthestroke.
1.7 WILL I HAVE ANOTHER STROKE?
Havingastrokeincreasesyourriskofhavinganother.Howeverthereisalotthatcanbedonetohelpsuchastakingmedicationtothinyourblood,controllinghighbloodpressure,cholesterolanddiabetesandalteringyourlifestyletoreduceknownriskfactors(secondaryprevention).
Youwillneedthehelpofdoctorsandnursestoidentifyindividualproblemsandmakesuretheyarewellcontrolled.Morecomplexsituationsmayneedaccesstospecialistservicessuchaspreventativesurgery.
What can I do to help myself?
Youcanmakechangestoyourlifestylewhichwillimproveyourhealthandreduceyourriskofstroke.
StopsmokingEatahealthyvarieddietControlweightKeepactiveModeratealcoholintake
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1.8 REAL- LIFE EXPERIENCES
IhadalreadyguessedI’dhadastroke.Idon’tknowhowIknew.Whenitwasconfirmed,Iwasquitedistraughtatfirst
thengraduallyIacceptedit.
R.F. - Weston Underwood
IwastakenintoA&E,feelingbewilderedbutcalm.
J.B. – Stony Stratford
Ifeltannoyedandbewildered,butwithverygoodcareIhaveacceptedmydisabilities.Can’twritewellnow,sodon’twrite
anymore.
G.H. – Bletchley
IwastoldI’dhadmeningitisandalsoastroke.Bothofthesediseaseswerenotonmyagenda!Stroke!!Whyandhowdidit
happen?
B.M.W. – Blakelands
WhenIrealisedhowillIhadbeen,Idecidedtoenjoytherestofmylife.
R.B. – Oldbrook
1.9 WHO MAY BE INVOLVED
Hereisalistofthepeoplewhomaybeinvolvedinyourcare/recovery.Notallwillbeapplicabletoyou. BA
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A. Health Service Facilities
1. In-patientServicesAcuteStrokeUnitHospitalSocialServiceTeam
2. CommunityServicesGeneralPractitionerIntermediateCareServices
RapidAccessInterventionTeamIntermediateCare
EarlySupportedStrokeDischargeTeam
SpecialistServices
StrokeClinicalSpecialistStrokeSocialWorkerandSocialWorkAssistant
Out-patientServicesMiltonKeynesNeuro-RehabilitationUnitSpeechandLanguageTherapyTeam
OtherServicesCommunity(District)NursingContinenceServicePodiatry
B. Milton Keynes Social Services
AdultSocialCareAccessTeam(ASCAT)CommunityOccupationalTherapyMiltonKeynesCentreforIntegratedLiving(MKCIL)
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2. WHILST IN HOSPITAL
2.1. THE ACUTE STROKE UNIT
“TheStrokeUnitcareisthesinglebiggestfactorthatcanimproveaperson’soutcomefollowingastroke.”
(Stroke Strategy 2007).
“Thereisoverwhelmingevidencethatrehabilitationinaspeciallydesigned‘strokeunit’benefitsnearlyallpatients
whohavehadastroke.Thisbenefitisgreatestinthefirstfewweeksandmonthsoftheillness.”
(In accordance with National Clinical Guidelines for Stroke, Royal College of Physicians, March 2000).
TheAcuteStrokeUnitinMiltonKeyneshasbeenestablishedtoprovideaco-ordinatedteamwithspecialistexpertiseinstrokerehabilitationaspartofthein-patientservice.Atthishospital,theDepartmentofMedicineaimstoprovideasmanystrokepatientsaspossiblepromptaccesstotheAcuteStrokeUnit.
ItistheaimoftheUnitto:
Provideeducationalprogrammesforstaff,patientsandcarersProvidespecificinterventionsfrominvolvedprofessionsDevelopanindividualrehabilitationprogrammeforeachindividualFacilitatedischargetoanappropriatedestination
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2.2. THE TEAM
DoctorsWhilstontheAcuteStrokeUnit,yourmedicalcarewillbemanagedbytwoconsultantsDrDuoduandDrBehnam.Bothdoctorsaresupportedbyateamconsistingofprofessionalswithspecialistknowledgeinstrokes.
Thedoctorswillensurethatyouaremedicallystableand,wherepossible,willaimtominimisetheamountofdamagetoyourbrainandmakesureyougetappropriatesecondarypreventionmedication.Attheirearliestopportunity,theywilldiscuss(withyou,thepatient,andyourfamily)thenatureandseverityofyourstrokeaswellasyourpotentialprospectofrecovery.Thisgivesyouandyourfamilytheopportunitytofindoutasmuchasyoucanaboutyourcondition.Itisimportanttobeawarethatthedoctorswillbeaskingyouandyourfamilytoconsiderlong-termdischargeplans.Discussionswilloccuronaregularbasisatdifferentstagesofyourrehabilitation.Meetingwiththedoctorsisbyappointmentonly–pleasespeaktothewardclerkoramemberofstaff.
The Nursing TeamTheWardSisterleadsateamofnursesexperiencedincaringforpeoplewhohavehadastroke.Thenursesaredividedintotwoteams:RedandBlue.Onarrivaltotheward,youwillbeallocatedtooneoftheteams.
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Youwillalsomeetyour‘namednurse’whowillberesponsibleforassessingyourindividualneedsandplanningyournursingcare.Intheabsenceofyournamednurse,thenurseinchargeofthewardshouldbeabletohelpyouwithanyparticularquestionsorconcerns,butifnot,appropriatehelpwillbesought.
Ifyouwouldliketocommentonanyaspectoftheservicethewardprovides,pleaseasktospeaktoamemberofstaff.Alternatively,youmaywishtomakeanappointmenttoseetheWard
Managerortelephonethewardon01908243202.TheWardManagertypicallymeetswithfamilymembersonTuesdayafternoons.
Occupational Therapists (OTs)Havinghadastrokeyoumayexperiencedifficultyincarryingouteverydaytasks.Youmayalsoexperiencechangesinthewayyouthinkandreact.TheOTwillhelpyouidentifyareasofdifficultyandworkalongsideyoutopracticealternativewaystoundertakethesetasks.
Assessmentsandtreatmentwillusuallytakeplaceinthehospitalsetting,butwithyourpermissionan‘access’visitor‘home’visitmaybenecessarytoseeifanychangeswouldbehelpfultoincreasesafetyandindependenceinthehome.
Physiotherapists (Physios)Astrokecanoftenlimitmovementononesideofthebody,thustheothersidetriestocompensateforthis.Weaimtohelpyouregainmovement,balanceandstamina,aswellasmanageweaknessorlossoffeelingofthelimb.
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Thephysiotherapistwillhelppreventmusclesfrombecomingtoolooseortight,whichwillinturnminimisefuturecomplications.
Yourphysiotherapistwilladviseoncorrectpositioningandwaysofmovingonthewardtoenhancerecoveryandpreventsecondarycomplicationssuchasmuscle/jointstiffnessandpain.
DieticiansWeightlossandmalnutritionoftenoccurinstrokepatientswitheatingandswallowingdifficulties.Goodnutritionisessentialinyourrecoveryandrehabilitation,andouraimistoensurethedietyouarehavingisadequateforyourneeds.AnypatientexperiencingnutritionalproblemswillbereferredtotheDieticianforsupportandadvice.
Speech and Language TherapistsYourspeechandlanguagetherapistwillsupportyouandyourfamily/carerswhenswallowingand/orcommunicationdifficultiesoccur.
Swallowing:Astrokemayaffectthenervesandmusclesinvolvedinswallowing.Wewillassessyourswallowingandadviseyouonhowtobestmanagethis.Sometimesapersonmayneedtobe‘NilByMouth’foraperiodoftimeandalternativewaysoffeedingmaybeneeded.Therewillberegularreviewsofyourswallowingduringthistime.
Communication:Difficultieswithtalking,understandingspeech,readingorwriting.Weworkcloselywithyou,yourfamilyandcarerstoensurethatyouareabletocommunicateaseffectivelyaspossible.
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Social WorkersWeaimtohelpyoureturnhomeandstaytheresafelysothatyoucanliveyourlifeasindependentlyaspossiblefollowingyourstroke.Wecandothisbyarrangingasocialcareassessment.Ifitisnotpossibleforyoutocarryonlivinginyourownhome,wewilllookatalternatives,suchasshelteredhousingoraresidential/nursingcarehome.AssessmentismadeonanindividualbasisandreferralswillbemadebyTheTeamasappropriate.
Stroke Clinical SpecialistHavinghadastroke,youmaybenefitfromconsistentsupportinaccessinginformation,andknowinghowtoaccessafullrangeofservices.TheStrokeClinicalSpecialistprovidesadvice,information,supportandreferralontoappropriateservicesforallthosewithaGPinMiltonKeynes.(SeealsoSection7.2)
2.3. WARD INFORMATION
Meals and Drinks TheHospitalTrustoperatesa‘ProtectedMealtime’policy.Thisallowsyou(thepatient)toeatyourmealsatyourownpace,withoutinterruptions,thereforeimprovingyournutritionalintake.Ifyourequiresupportwithyournutrition/eating,thiswillbeidentifiedandyourmealswillbeplacedontoaredtray.This‘RedTrayProject’willalertmembersofstaffthatyouneedassistanceorthatyoumayrequiresupervisioninfinishingyourmeal.
Aspartofyourrehabilitationprogrammewemayencourageyoutoeatyourmealsinthedayroom.Visitorsarediscouragedfromvisitingatmealtimesunlesstheyare HO
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assistingyou(thepatient)toeatanddrink.Duetohealthandsafetyregulations,weregretthatitisnotpossibletoreheatfooditemsbroughtinbyfamily/friends.
VisitorsForsafetyreasonsandthecomfortofallpatients,thereisalimitoftwovisitorsatthebedside.Askthewardstaffaboutvisitingtimes.
2.4. FREQUENTLY ASKED QUESTIONS
What items will I need in hospital?Aselectionofdayclothes.For example:tracksuitsorloosefittingclothingandapairofshoes/trainers.Youwillbeencouragedtodressinnormaldayclothes;thiswillenableyoutofeelmorecomfortableduringrehabilitationandwillhelpmaintainyourdignity.
Youwillneedtohaveaselectionoftoiletriestouse.Thehospitalprovidestowelsanddisposablewipes(flannels)tohelpwithinfectioncontrol.Pyjamasandnightdressesareavailable;however,youmayprefertowearyourown.
Pleasemarkallyourpossessionswithyourname.WeregretthattheTrustcannottakeresponsibilityforanypersonalitemsunlesstheyarehandedtothestafftobeplacedinthehospitalsafe.
How will I know who carries out what role?Thenursingstaffandsometherapystaffwearuniformsforwork,othersweartheirownclothes.Everymemberofstaffshouldbewearinganidentificationbadgeandthiswillhavetheirjobtitlewrittenonit.
How long will I be in the Acute Stroke Unit?Theaveragestayforstrokepatientsisvaried.Asstrokesaffecteveryonedifferently,youmaybeinforoneweek,orsometimesmuchlongerthan4weeks.Onceyouhavebeenonthewardforaboutaweektheteamshouldhaveagoodideaofhowlongyouwillneedtoremainhere.Pleasebe
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awarethatfollowingaTeamdecision,youmaybemovedofftheunitifyouhavereachedyourfullpotentialandareeitherreadytogohomeorwaitinganalternativepackageofcare.
How will I know how I am doing?WhenadmittedtotheAcuteStrokeUnityouareassignedaSpecialistConsultantandaNamedNursewhowillprovideyourcarewhilstyouareontheAcuteStrokeUnit.Inaddition,ifyourequiretherapyyouwillhaveaccesstoOccupationalTherapy,Physiotherapy,Speech&LanguageTherapy,aDieticianandaSocialWorker,ifappropriate.Thestaffacrossthesedisciplinesinvolvedinyourcareareknownasyourmultidisciplinaryteam(MDT).YourmultidisciplinaryteamwillmeettwiceaweekontheAcuteStrokeUnittoensureyourhealthcareneedsaremettoenableyoursafedischarge.Youandoryournextofkinwillbeprovidedregularupdatesfromyourmultidisciplinaryteam.Ifyoudonotfeelinformedorhavequestionsorconcernsduringyourstayinhospital,donothesitatetospeaktoyournamednurseoramemberofyourmultidisciplinaryteamwhowillendeavourtohelpinanywaytheycan.
How can family/friends get involved in my rehabilitation?Familyandfriendsoftenaskwhattheycandotohelptherecoveryprocess.Everyonehasanimportantparttoplayinyourrehabilitationandthisincludesnotonlythephysicalaspects,butalsosocial,emotionalandpsychologicalelementstoo.FamilyandfriendsareencouragedtoattendrehabilitationsessionssuchasPhysiotherapyandOccupationalTherapy;aslongasyouareinagreement.
Gettingoutandabout.Onceyourconditionallows,youmaywishtoleavetheward(withfamily/friends)forshortperiods.Initially,thismaybearoundthehospitalgroundsortotherestaurant.Lateronthismaybefurtherafield,perhapstothecitycentreforlunch.AfterdiscussionswiththeTeam,homeleavemaybegranted.Inthisinstance,adviceontravelarrangementswillbediscussedwithyou.WillIhaveongoingrehabilitationafterdischarge? HO
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Everyoneisdifferent,soyourrehabilitationneedswillbespecifictoyou.Thereareseveraldifferentkindsofrehabilitationonceyouaredischargedandthiswillbediscussedwithyoupriortoleavingthehospital.
Ifyouareunsureaboutanything,donothesitateaskastaffmemberforclarification.
2.5. DIARY OF PROGRESS
Youmaynotrememberyourtimeinhospitalclearly,andthiscanbeconfusingandfrightening.Itmayhelptotalktoyourfamilyaboutwhattheyrememberaboutyourstayinhospital,howtheyfeltwhenyouwereillandthethingsthathappenedwhileyouwerethere.Ifyourrelativekeptadiarywhileyouwereinhospital,itcanbehelpfultolookatthiswiththemandcarryitonintoyourrecovery.
Mum’s Diary of EventsMonday 21-12-09Mum and Brenda spoke on the phone around mid-day. Mum said “I have craked it” and was looking forward to Christmas and Boxing Days. More snow in the evening.
Tuesday 22-12-09I phoned Mum at about 08.00 to suggest she didn’t go shopping because of the snow. Mum was incoherent, so I went to the bungalow.I did a FAST test and phoned the Surgery. Dr. Bunting phoned back and explained the situation, Mum’s Face OK, Arms OK, Speech not slurred, but incoherent. He said to ring 999. Paramedics and ambulance came quickly and did tests. Mum taken by ambulance to hospital about 09.15ish.
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2.6. ADDITIONAL INFORMATION
Carparking–yourvisitorscanapplyforatemporaryparkingpermit,iftheyplantovisitthesiteonaregularbasis.Foranapplicationform,askamemberofstaff.
2.7 BEFORE RETURNING HOME - ASK THE STAFF
Don’tbeafraidtoaskyourdoctorornamednurseanythingyouareunsureabout.Rememberallthestaffaretheretohelp.
Uponleavingthehospitalyoushould:
Askforacopyofyourcarerecord
CheckyourmedicationHaveyougotwhatyouneed?Doyouknowwhatitisfor?Doyouknowwhenandhowtotakeit?
Knowwhatsupportyouwillhavewhenyouleavethehospital
MakeanappointmentwithyourGPtodiscussongoingtreatment
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2.8 COMPLAINTS AND PALS TEAM (PATIENT ADVICE AND LIAISON SERVICE)
TheComplaintsandPALSTeamprovidesconfidentialadviceandsupporttopatients,familiesandtheircarers.Theservicecanalsohelpwithanyissuesorconcernsaboutstandardsofcarepatientsandtheircarerswishtoraise.
PALScanhelpby:
Advisingandsupportingpatients,theirfamiliesandcarers
ProvidinginformationonNHSservices
Listeningtoconcerns,suggestionsorqueries
Helpingtosortoutproblemsquickly.
When is the PALS team available?Openinghours:9am-5pm,MondaystoFridays,notincludingpublicholidays.
Anout-of-hoursanswerphoneserviceisavailable.Messageswillnormallybereturnedwithin24hours.
How do I contact the PALS team?Telephone: 01908243633or01908243181E-mail: [email protected]
[email protected]: MiltonKeynesPCTHQ,HospitalCampus,
StandingWay,MiltonKeynes,MK65NG
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3. RETURNING HOME – WHAT WILL IT BE LIKE?
Leavinghospitalandreturninghomeisamajorstepinyourrecoveryandislikelytohavebeenagoalyou’vebeenworkingtowardsforsometime.Itisaverypositivestepbutitwilltaketimeandefforttogetbacktoanormallife.Youwon’thavethesamesupportyouhadinhospitalanditcanbeadifficulttimeforyouandforyourrelatives.
It’snormaltogothroughtimeswhereyoufeeldepressedorfrustratedbecauseyoudon’tseemtobegettingbetter.Settingsmallgoalsinyourdailyroutinecanhelpyourecoverandshowyouthatyouareimproving.Asmallgoalcouldbesomethingassimpleasmakingadrinkforyourself,orwalkingafewstepsfurtherwithoutneedingarest.
Don’tpushyourselftoohardasthiscanendupmakingyourrecoverytakelonger.
Afteryouhavehadastroke,you’llprobablyfeelverytiredandwon’thavemuchenergy.Itwilltaketimebeforeyoufeelwellenoughtocopewitheverydaylifeandmanymoremonthstogetbacktofullstrength.
Setyourselftargetstohelpyougetbacktonormal,andkeepdoingtheexercisesyouhavebeenshown.Don’toverdoyourexercisesasthiscansetyourrecoveryback.
Youwillneedtoslowlyincreaseyouractivitytobuildupyourstrength,butmakesurethatyourestwhenyouneedto.Youwillneedtotakethingsveryslowly.Makesureyouincorporateregularrestinyourdailyroutineanddon’tfeelguiltyaboutit.
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3.1. COPING
Whenyou’vehadastroke,youmayfeeldifferentlyaboutthingsandmaynotwanttodothingsyouusedtoenjoy.Forexample,youmaynotfeellikeseeingalotofpeopleatonce,sostartbyseeingoneortwofriendsatatimeforshortperiods.
Yourrecoverymaytakealongtimeandasyougetbetterandbegintodomore,youmayfindthatthingsgetontopofyou.Duringthistimeyoumaylackconfidence,worryaboutyourrecovery,orevenfeeldepressed.Talkingaboutthistoyourfamilyoraclosefriendcanhelp.
3.2. RELATIONSHIPS AND FAMILY
Afteryou’vehadastroke,youandthepeoplearoundyoumayseemtochange.Yourfamilymaymakeafussandmightnotunderstandwhyyou’renotkeenonthehobbiesandinterestsyouusedtoenjoy.
Yourfamilyandfriendswereafraidyoumightdie,sotheymaywanttodoeverythingforyouwhenyougethome.Ifthisannoysyou,talktothemcalmlyabouthowyoufeel.Don’tbottlethingsupandgetangry.
Ifyouhaveyoungchildrenyoumayfeelunderevengreater
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pressuretogetbacktonormal,dotheimportantthingsfirst–otherjobscanwait.Takeanapatthesametimeasthechildrenanddon’tbeafraidtoaskyourfriendsandfamilyforhelp.
3.3. SOCIAL LIFE AND HOBBIES
Therearemanythingsyoucandoyourselftoimproveyourpsychologicalwell-being.Meetingpeopleregularly,everydayifpossible,isanimportantsourceofwell-being.Talkingtootherscanbeabighelp.Manypeoplefindsupportgroups,suchasstrokeclubs,useful.(seesection7.4SocialSupport)Theyprovideachancetomeetpeoplewhohavebeenthroughasimilarexperience.
Returningtohobbiesandinterestsisalsoanimportantpartoftherecoveryprocess.Youcouldevenlookattryingnewthings.Trynottobeputoffbythoughtsthatyouareunabletodothingsaswellasyoucouldbefore.Manyactivitiescanbeadaptedtoenableyoutocarryonenjoyingthem.
3.4. GETTING BACK TO YOUR DAILY ROUTINE
Lotsofpeopleworryaboutcominghomefromhospitalorreturningtoworkafteracriticalillness;itisnormaltowonderwhetheryou’llbeabletocope.
Talkaboutitwithyourfamilyandthinkabouthowyoucanadaptthingsathometohelp.
Ifyouusedtowork,youmaynotbewellenoughtoreturnfull-timestraightaway.Whenyou’refeelingbetter,it’sagoodideatoarrangetogobackandseeyourcolleaguesandtalktoyourboss.Dependingonyourjob,youmaybeableto PA
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doafewhoursadayatfirst.
Ifyoudon’tdependonpaidemploymentyoucouldalwaysdosomevoluntarywork.Manypeoplefinditworthwhileandcanmeanyouhaveareason
togetupinthemorningandyouarenotthentiedtothenecessitytogettoworkwhenyoureallydon’tfeelwellenough.
3.5. INTIMACY FOLLOWING A STROKE
Dependingontheareaofthebrainaffected,astrokecancausephysicalandemotionalchangesthataffectaperson’ssexlife.Theseissuescanbeshort-termandrelativelyeasytoovercome,butforothers,theyaremoreseriousandlonglasting.
It’snormaltobeworriedaboutwhenit’ssafetostarthavingsexagain.Yourpartnerislikelytobeworriedaboutthistoo.
Mostpeoplefinditdifficulttotalkaboutsex,buttrytorelaxandkeepasenseofhumour.Cuddlesarereallyimportant.Takethingsslowlyandseewhathappens.
Sometimes,medicalproblemssuchasimpotence(beingunabletogetandkeepanerection)canaffectsex.Ifyou’reworried,talktoyourGP.
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USEFUL CONTACTS 4. HEALTH SERVICE FACILITIES
4.1. IN-PATIENT SERVICES
Acute Stroke UnitMilton Keynes Hospital Foundation TrustStanding WayEaglestone, Milton KeynesMK6 5LD
Telephone: 01908 243202
TheAcuteStrokeUnitaimstoprovideaco-ordinatedteamapproachwithspecialistexpertiseinstrokerehabilitationaspartofthein-patientservice.
4.2. COMMUNITY SERVICES
Notallcommunityservicesareappropriateforeveryone.Patientneedswillbeassessedinhospitalbythemembersoftheteamandreferralswillbemadebyeachmemberasappropriate.Ifacommunityserviceisrequired,speaktoahealthorsocialcareprofessionalwithwhomyouhavemostcontact,forexampleyourGP.
GENERAL PRACTITIONEROndischargefromhospitalyouwillreceiveacopyofyourdischargesummary.ItisrecommendedthatyoumakecontactwithyourGPsoonafteryouhaveleftthehospitaltoarrangeanappointment.
INTERMEDIATE CARE SERVICESRapid Assessment and Intervention Team (RAIT)TheMiltonKeynesRapidAssessmentandInterventionTeam(RAIT)providesuptosixweeksintensive,integratedcareand
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rehabilitationtosupportindividualsintheirownhomeorenableindividualstoreturntotheirownhomeafteranillnessoraccident.
Intermediate Care (IC)TheIntermediateCarerTeamprovidesashort-termserviceforclientswhorequirehelpwashinganddressing;thiscanbeforaslittleasonedayuptoamaximumofsixweeks.Theserviceaimstosupportclientstobecomeasindependentaspossible.Carefocusesonencouragingclientstodoasmuchforthemselvesaspossible,workingatalltimestowardsjointlyagreedrehabilitationgoalsandobjectives.
Telephone Single Point of Access: 01908 363070 (24 hours)Fax: 01908 363097
IntermediateCareServicesareonlyaccessiblebyhealthorsocialcareprofessionals.AllreferralstoIntermediateCarearemadethroughtheSinglePointofAccess.Atrainedoperatorwilltakethereferral.
EARLY SUPPORTED STROKE DISCHARGE TEAM (ESSDT)TheMiltonKeynesEarlySupportedStrokeDischargeTeam(ESSDT)providesuptosixweekstherapyandrehabilitationtostrokepatientsintheirownhomesorasclosetohomeaspossible,bycoordinatinganearlyandsafedischargefromtheAcuteStrokeUnit.
Telephone: 01908 363076
SPECIALIST SERVICESTheimpactofastrokecanbequitesignificantnotonlyonthepersonbutalsoonfamily,friendsandcarers.Itcanoftenfeellikeatimeofabandonment,whenitishardtoaccesshelp,adviceandsupport.
Stroke Clinical SpecialistNeurological Clinical Specialist TeamMilton Keynes neuro.rehabilitation unitWhalley Drive, BletchleyMilton Keynes, MK3 6EN
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Telephone: 01908 650424Team Administrator Telephone: 01908 650447Web: www.mkpct.org.uk
TheStrokeClinicalSpecialistaimstoprovidein-depthknowledgeandexpertise;consistenteducation,supportandadviceinaccessinginformationandafullrangeofservicesfromtheNHS,socialcareandothers.Thisserviceisavailabletopeoplewhohavehadastroke/TIA,theirrelativesandcarers,membersofthegeneralpublic,professionalsandvoluntaryorganisations.
Stroke Social Worker and Social Work AssistantThesemembersoftheteamworkinpartnershipwithfamilymembersandhealth,socialandlocalcommunityorganisations.Theiraimistoimproveservicesforpeoplewhohavehadastroke,byencouragingthemtoparticipateincommunitylifeandreturntowork,whereappropriate.
Telephone: 01908 363076
OUTPATIENT SERVICESMiltonKeynesNeuro-RehabilitationUnitisamulti-disciplinaryteamwhichaimstosupportpeopletoachievetheirgoalsintheirhome,social,workandcommunitylives.Ithelpstoassistpeopleandfamiliestounderstand,adjusttoandmanagetheirdisability.
Milton Keynes Neurological Rehabilitation UnitBletchley Community Hospital Site Whalley Drive, BletchleyMilton Keynes, MK3 6EN
Telephone: 01908 379440
Outpatient PhysiotherapyHeldatMiltonKeynesHospital;yourGPwillberequiredtoreferyouontothisservice.
Youmayrequirecontinuedsupportforyourcommunicationand/orswallowingwhenyouleavehospital.TheSpeechand
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LanguageTherapist(SLT)willliaisewithyourwardstaffandCommunitySLTservicestoarrangeappropriatefollow-up.
Speech and Language Therapy TeamSpeech and Language Therapy Department Milton Keynes Hospital Foundation TrustStanding WayEaglestone, Milton Keynes MK6 5LD
Telephone: 01908 243095
OTHER SERVICESDistrict Nursing ServiceTheDistrictNursingServicemightbeinvolvedwithyouafteryourdischarge.Ifyouarehouseboundandhaveanursingneed,thenadistrictnursewillvisityouathometocarryoutwoundcare,medicationmanagementandcontinenceissues.Thiswillbediscussedwithyouandarrangedasnecessary,otherwisespeaktoyourGP.
Continence ServiceContinence ServiceWhalley Drive Clinic, Whalley DriveBletchley, Milton KeynesMK3 6EN
Telephone: 01908 650401
Fax: 01908 650470
Problemswithbladderand/orbowelcontrolareverycommonafterastroke.Thoughthiscanbeextremelydistressing,manyoftheseproblemswillresolveovertime.Bladder/bowelcontrolcanoftenberegained,butifnot,theproblemsassociatedwiththiscanbemanagedeffectively.ThiswillinitiallybeaddressedbynursingstafforyourStrokeClinicalSpecialist.Dependingontheoutcome,areferralmaybemadetoalocalcontinenceadvisororspecialist,suchasaurologist,gastroenterologist,gynaecologistorgeriatrician.
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Podiatry/Chiropody ServicePodiatristsspecialiseintheassessment,diagnosis,treatmentandmanagementofabroadrangeoffootproblemsandpathologies.
Ifyouhaveamedicalneedforchiropody/podiatryyouwillprobablybereferredtoanNHSchiropodistbyahealthprofessional.Alternatively,youcanreferyourselftothisservice.However,ifyourchiropodyneedsaremainlycosmeticyoumightnotbeacceptedbytheservice,anditwouldbequickerperhapstocontactaprivatechiropodistfromtheYellowPages.Ifdoingsoitisadvisabletomakesurethatthechiropodistyouengageisstateregistered.
Anapplicationform/furtherinformationaboutlocalNHSchiropodyservicescanbeobtainedfrom:-
South House1 Block DBond AvenueMilton Keynes
Telephone: 01908 363066
Community Occupational TherapyTheCommunityOccupationalTherapyUnitprovidesanassessmentofserviceusersintheirownhomes;supplyingequipmentandadaptationsasappropriate,toenablemoreindependentliving(and/orassistingofcarers).
Ifyouarehavingdifficultieswithdaytodayactivitiesforexampledressing,movingaroundyourhomeorcooking,thenaCommunityOccupationalTherapistmaybeabletoassessyourneedsandgiveadviceorsuggestappropriateadaptationsandequipment.
ReferralisthroughAdultSocialCareAccessTeam(ASCAT)
CommunityOccupationalTherapyServicesTherapy Unit, Whalley Drive, Bletchley, Milton Keynes, MK3 6EN Direct Telephone: 01908 253772
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4.3. MILTON KEYNES SOCIAL SERVICES
Adult Social Care Access Team (ASCAT)ThisMiltonKeynesCouncilserviceassessesforandarrangesawiderangeofsocialcareservicesforpeopleaged18andoverwhoaredisabled,frail,haveasensoryimpairmentormentalillnesstoenablethemtoliveasindependentlyaspossible.Supportcanalsobeprovidedforthosewhocareforothers.
Theyprovidehelpinmanydifferentways,whichincludes:-
Careathome
Daycare
Respitecare
Residentialcare
Mealdeliveryservices
Equipmentandadaptations
PersonalBudgettopurchasecare/services
UponcontactingASCATaCustomerLiaisonOfficer(CLO)willgatherbasicinformationandifappropriatearrangeforasocialworkertomeetwithanindividualtocompleteanassessmentoftheirneeds.ThisinvolvesestablishingwhethertheirneedsmeetMKCouncil’seligibilitycriteria,formalisingacareplan(ifeligibilitycriteriaismet)anddiscussingfinancestoassesswhetheranindividualwillberequiredtopaytowardsthecostoftheservices.
Adult Social Care Access Team (ASCAT) Neighbourhood Services, Neighbourhood Services Milton Keynes Council, Civic Offices,1 Saxon Gate East, Central Milton Keynes, MK9 3EJ
Tel: 01908 253772 /253773 (9.00 to 5.00pm Mon-Fri) Fax: 01908 253185
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Text: 07903 324175Minicom: 01908 253394 Email: [email protected] Web: www.milton-keynes.gov.uk/socialcare-health/
ForanemergencyoutsideofofficehourscalltheEmergencySocialWorkTeam(ESWT)on:
Tel: 01908 265545 Fax: 01908 265543
IfapersonisinhospitalthentheywillneedtocontacttheHospitalSocialWorkTeam(HSWT)on:
Telephone: 01908 253223 Fax: 01908 243672
4.4. SOCIAL SUPPORT
Milton Keynes Centre for Integrated Living (MK CIL)TheMiltonKeynesCentreforIntegratedLiving(MKCIL)canprovidethefollowingservices;
Awiderangeofinformationonlocalandnationalsupportgroups,benefits,equipment,transportandmobility,statutoryandvoluntaryorganisations,leisure,holidaysandcare.
Equipmentdisplayareas
Helpwithfirsttimeapplicationsfordisability-relatedbenefits(e.g.DisabilityLivingAllowance{DLA}andAttendanceAllowance{AA})
RADARkeysforaccessiblepublictoilets
ApplicationformsforDisabledParkingBadges(BlueBadges)
DisabilityAwarenessTraining
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Milton Keynes Centre for Integrated Living (MK CIL) 330 Saxon Gate West, Central Milton Keynes, MK9 2ES
Telephone: 01908 231344Minicom: 01908 231505 Fax: 01908 231335 Email: [email protected] Times: 10.00am to 4.00pm (For enquiries and drop-in)
Age UK Milton KeynesAgeUKMiltonKeynesworkswithandforlocalolderpeopletomakearealandpositivedifferencetotheirwell-beingandqualityoflife.Inparticularwerunahomesittingserviceforcarersandprovidehomevisitingandbefriending,shoppingandlighthousework,adviceandinformation.
Age UK Milton KeynesThe Peartree Centre, 1 Chadds Lane,Peartree BridgeMilton Keynes, MK6 3EB
Telephone: 01908 550700 Web: www.ageconcernmk.org.uk Registered charity 1079773
Carer SupportCarersMKstaffcanassistbyprovidinginformation,advice,andhelptosecuretheservicesyoumayneed.Theywillalsoprovideemotionalsupportandalisteningear,giveadviceonhowtoprotecthealth,offertrainingtohelpcarersintheirrole,provideaccesstotherapysessionsandlinkstootherfamilycarersandsupportgroups.
Carersshouldbelivinginorcaringforsomeonelivingin,theMiltonKeynesBorough.
Carers Milton Keynes The David Baxter Centre, 63 North Seventh Street, Central Milton Keynes, MK9 2DP
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Telephone: 01908 231703 Fax: 01908 660867 Email: [email protected] Opening hours: Monday - Friday 8.30am to 4.30pm
Different Strokes Milton KeynesDifferentStrokesisanationalcharitywhoofferssupportandadviceforyoungerstrokesurvivorsofworkingagetooptimisetheirrecovery,takingcontroloftheirownlivesandtoregainasmuchindependenceaspossiblebyoffering‘rehabilitationservices’andinformation.
ThegroupmeeteveryTuesdayformostoftheyear2pm–4pmatShenleyLeisureCentre.Theclassisdesignedtoencourage,mobility,confidence,fitnessandself-esteemandalsotomeetotheryoungsurvivorsinsimilarsituations.
Partnersandfamilies,whohavealsohadtosurvivethestroketraumaarewelcometoobtainhelp,adviceandmutualsupportandjoinintheexerciseclass.Volunteersarealsowelcome.
Contact: Val Price (01908 610752)
Different Strokes Head Office9 Canon Harnett Court, Wolverton Mill, Milton Keynes, MK12 5NF
Telephone: 0845 130 7172Web: www.differentstrokes.co.ukEmail: [email protected]
Stroke drop-inTheStrokeClinicalSpecialistrunsadrop-insessiononthefirstTuesdayofeverymonth.Thedrop-inenablesthosewhohavehadastrokeandtheirfamilytodiscussanyqueriesorconcernstheymighthaveregardingthestroke,noworinthefuture.ThedropinisheldattheofficesoftheMiltonKeynesCentreforIntegratedLiving(MKCIL)
Time:Between10.00am–12.15pm(thereisnoneedtobook)
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Contact: Stroke Clinical Specialist (01908 650424)
Monday ClubTheMondayClubisforanyonewhohasrecentlyhadastroke,theirpartnerorfamilymember.Itisthechancetomeetwithpeopleinasimilarposition,haveachatandlistentoguestspeakersoneverydaytopics.
Time:ThegroupusuallymeetsonthesecondMondayinthemonth2.00pm–4.00pmattheMiltonKeynesCentreforIntegratedLivingoffices.Thereisnoneedtobook–justgoalong.
For more information please contact the Stroke Clinical Specialist – 01908 650424.
Talkback ClubMiltonKeynesTalkBackClubwelcomespeoplewhohaveaphasiaduetoStroke.Theaimistohelpmemberstoincreaseconfidenceandcommunicationskillsinarelaxedatmosphere.Activitiesforallabilitiesareorganisedaswellasoccasionalwheelchairfriendlyoutingsandlunches.
Meeting: Friday9.30amto12noonatthePeartreeCentrePeartreeBridge
Contact: Gill Norris (Chairwoman) 01908 672615or Barbara Powell (Secretary) 01908 321476
Milton Keynes Council – Passport to LeisureThepassporttoLeisureSchemeprovidesdiscountedaccessforresidentsofMiltonKeynestoavarietyofleisurefacilitiesinthearea.YouwillqualifyforthisschemeifyouaretobearesidentintheboroughofMiltonKeynesandareinreceiptoftheappropriatecriteria(DisabilityLivingAllowance,IncapacityBenefit,InvalidCareAllowance,…).Forafulllistoftheeligiblecriteriaandforanapplicationformvisityourlocalcounciloffice,locallibraryorhousingofficealternativelyyoucanaccessthiselectronicallyviatheMKcouncilweb-site.
Web: www.milton-keynes.gov.uk/passporttoleisure/
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4.5. FINANCIAL SUPPORT
Citizen Advice Bureau (CAB)MiltonKeynesCABoffersfree,independentandconfidentialadviceonanysubjectincludingwelfarebenefits,face-to-face,byletter,fax,emailandphone.Theyalsoofferabenefitchecktoclientsinordertomaximizeincome.Theyprepareappealcases,representattribunallevelandhaveourownspecialistsinwelfarebenefitsandtaxcredits.
Togetfurtherdetails(includingappointmentandoutreach),pleasecontactthem.
Telephone: 01908 604475Fax: 01908 545199 Web: www.mkweb.co.uk/citizens_advice
Independent Benefits Advice Welfare Rights GroupYoucangetfreeandindependentadviceonallstatebenefitsfromWelfareRights.Youcangetadviceonwhatyoucanclaim,howtoclaim,writinglettersandcompletingforms.AWelfareRightsAdvisercanevenrepresentyouatanAppealsTribunalifyouneedit.
Independent Benefits Advice Welfare Rights GroupAcorn House, 373 Midsummer Boulevard, Central Milton Keynes, MK9 3HP
Openingtimes:TheadvicelinesareopenMon–Thurs10.00am–12.00pm.Pleaseringforanappointment.
Telephone: 01908 200900Web: [email protected]
Help with NHS costs Abookletcalled“AreyouentitledtohelpwithNHScosts?”isavailablefromtheMKCentreofintegratedLiving(CIL),anyJobCentrePlusoffice,pharmacy,doctor’ssurgeryorthePost
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Office.AskforbookletHC11toseeifyouareeligibleforanyhelpwithhealthcosts.
4.6. OUT AND ABOUT
DRIVING ADVICEYou must not drive after a stroke until you have had confirmation/ advice from your consultant. and informed the DVLA at Swansea and your insurance company. TheDriverandVehicleLicensingAgency(DVLA)willoftencontactyourconsultantbeforetheydeterminewhetherornotyouarefittodrive.TheDVLAalonehavetherighttograntorrevokelicences.It is the patient or their representative’s responsibility to notify the DVLA and the insurance company about the stroke.Failuretodosoisanoffenceandtheconsequenceofinactionmaybethattheinsuranceisinvalidated.
DVLADrivers Medical GroupSwansea SA99 1TU
Telephone: 0300 790 6806Times: Monday to Friday 8.00 am - 5.30 pm Saturday 8.00 am - 1.00 pmFax: 0845 850 0095Web-site: www.dft.gov.uk/dvla
THE BLUE BADGE AND DISABLE PARKING SCHEMETheBlueBadgeisadministeredbyMiltonKeynesCouncil.Forfurtherinformationand/oranapplicationformcontactMiltonKeynesCouncilortheMiltonKeynesCentreforIntegratedLiving(MKCIL).
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Blue Badge Scheme Application Milton Keynes Council, Civic Offices 1 Saxon Gate East, Central Milton Keynes, MK9 3HG
Telephone: 01908 253449
PUBLIC TRANSPORTConcessionarybusfaresareavailablefordisabledresidentslivingintheMiltonKeynesarea.Inordertoqualify,disabledpeopleneedtogettheirapplicationformssignedbytheirGP.ApplicationformstojointheconcessionaryschemeareavailablefromtheCivicOfficesinCentralMiltonKeynes.
Concessionary fares in Milton Keynes Milton Keynes Council, Bus Card Section, 113 Civic Offices, Central Milton Keynes, MK9 3HN
Telephone: 01908 252558
Royal Association for Disability and Rehabilitation (RADAR) TheRoyalAssociationforDisabilityandRehabilitation(RADAR)isanationalorganisationofandfordisabledpeople.TheNationalKeySchemeoffersindependentaccessfordisabledpeopletolockedpublictoiletsaroundthecountry.
ARADARkeycanbepurchasedfromMKCIL(CentreforIntegratedLiving).
You’llhavetoprovidesomeproofthatyouareaBluebadgeholderorpaperworktoshowthatyouhaveadisability.
4.7. HOLIDAYS
Holidaysareanimportantpartoflife,butafterastrokeitcanbemoredifficulttofindsomewheresuitable.Thereareavarietyofusefulorganisationsthatcanhelppeoplewithdisabilitiestoarrangeaholiday,includingbreaksintheUKandabroad,holidayswithassistance,andrespitebreaks.
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Flying:Peopleoftenaskwhetheritissafetoflyafterastrokeorwhetherthereareanyspecialprecautionstheyshouldtake.Theredon’tseemtobeanyreasonswhypeoplewhohavehadastrokeshouldn’tfly,butitisalways
advisabletospeaktoyourowndoctoraboutthis,asstrokescanhappenfordifferentreasons.
TRAVEL INSURANCETheStrokeAssociationInsuranceServices,runbyHeathLambert,hascreatedtravelinsurancethatcatersforstrokesurvivorsandfortheirfamiliesandfriendstravellingwiththem.
Someofthebenefitsinclude:allpre-existingmedicalconditionsarecovered
noupperagelimitsonoursingletrippolicies
annualmulti-trippolicieswithintheEUareavailableuptoage69(worldwidepoliciesuptoage64)
purchasingyourcoverisquickandeasyandnoseparatecallstomedicalscreeningcompaniesarerequired
coverisavailablewithintheUK,Europeandworldwide.
Telephone: 01603 828396Email: [email protected]: www.stroke.org.uk/shop/insurance_and_ finance/insurance_services/travel_insurance.html
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4.8. USEFUL WEB-RESOURCES
Information for stroke survivors, carers and members of the public
NHS Choices - stroke http://www.nhs.uk/pathways/strokeNHS information resource on stroke and TIA
The Stroke Association http://www.stroke.org.uk/Information, support and news from The Stroke Association
Telephone: 0845 3033100
Different Strokes http://www.differentstrokes.co.uk/Information and support for stroke survivors
Connect http://www.ukconnect.org/Information and support for people with aphasia
Crossroads Care http://www.crossroads.org.uk/Information for carers and stroke survivors about practical help at home
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YO
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ABOUT YOUR NOTES
Wehaveincludedthesepagesforyoutorecordanythingthat
mayberelevanttoyou.
Herearesomesuggestionsonhowyoumightwanttouseit;
• Recordsdetailsaboutyourstroke
• Writeadiaryofevents
• Questionstoaskthemedicalstaff
• Informationaboutyourmedication
• Anyotherusefulcontact,…