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Chapter 16 - Transition to Outpatient Stroke Care

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny ,
Ahmad Riad Ramadan ,
Sean I. Savitz  and
James Grotta
Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
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Summary

It is never too early to begin to educate the patient and family about lifestyle changes and medical treatments to prevent another stroke. These need to be reinforced throughout the hospital and rehabilitation stay, and in the outpatient stroke clinic.

After a major stroke, both the family and the patient go through a grief reaction that at first includes denial and disbelief, and sometimes anger. In particular, the need to insert a PEG is often a crisis point when the family finally comes to terms with the severe disability and prolonged recovery that lies ahead. At this stage, which is usually when the patient is in the acute stroke unit, mainly supportive measures are indicated.

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Chapter
Information
Acute Stroke Care , pp. 237 - 240
Publisher: Cambridge University Press
Print publication year: 2019

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References

Condon, C, Lycan, S, Duncan, P, et al. Reducing readmissions after stroke with a structured nurse practitioner/registered nurse transitional stroke program. Stroke 2016; 47: 1599–604. doi:10.1161/STROKEAHA.115.012524.CrossRefGoogle ScholarPubMed
Webster, F, Saposnik, G, Kapral, MK, et al. Organized outpatient care: stroke prevention clinic referrals are associated with reduced mortality after transient ischemic attack and ischemic stroke. Stroke 2011; 42: 3176–3182.CrossRefGoogle ScholarPubMed
Hackett, ML, Pickles, K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke 2014; 9: 1017–1025.CrossRefGoogle ScholarPubMed
Ayerbe, L, Ayis, S, Wolfe, CD, Rudd, AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry 2013; 202: 14–21.Google Scholar
Jorge, RE, Robinson, RG, Arndt, S, et al. Mortality and poststroke depression: a placebo-controlled trial of antidepressants. Am J Psychiatry 2003; 160: 1823–1829.Google Scholar
del Ser, T, Barba, R, Morin, MM, et al. Evolution of cognitive impairment after stroke and risk factors for delayed progression. Stroke 2005; 36: 2670–2675.CrossRefGoogle ScholarPubMed
Rockwood, K, Mitnitski, A, Black, SE, et al. Cognitive change in donepezil treated patients with vascular or mixed dementia. Can J Neurol Sci 2013; 40: 564–571.Google Scholar
Chang, WH, Park, YH, Ohn, SH, et al. Neural correlates of donepezil-induced cognitive improvement in patients with right hemisphere stroke: a pilot study. Neuropsychol Rehabil 2011; 21: 502–514.Google Scholar
Cumming, TB, Packer, M, Kramer, SF, et al. The prevalence of fatigue after stroke: a systematic review and meta-analysis. Int J Stroke 2016; 11: 968–977.Google Scholar
Wu, S, Kutlubaev, MA, Chun, HY, et al. Interventions for post‐stroke fatigue. Cochrane Database Syst Rev 2015; (7): CD007030.Google Scholar

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