Stroke survivors and their families can greatly benefit from palliative care, which focuses on relieving pain, managing symptoms, and providing emotional and practical support after leaving the hospital.
Despite its potential, this approach remains underused, especially among Black, Hispanic, and Asian patients, according to a recent report from the American Heart Association (AHA).
Published in the AHA journal Stroke, the report emphasizes the need to include palliative care throughout a stroke survivor’s journey, addressing both medical and emotional challenges.
This care should help patients navigate complex healthcare systems, cope with changes in health and life circumstances, and, when necessary, prepare for end-of-life care.
“Stroke is not just a one-time event—it’s life-altering,” said Dr. Claire J. Creutzfeldt, a neurology professor at the University of Washington and lead author of the report.
“Even if a stroke is not immediately life-threatening, every stroke requires high-quality, person-centered care. Integrating palliative care is essential at all stages after a stroke.”
The Challenge of Stroke Recovery
Each year, nearly 800,000 people in the U.S. experience a stroke, which occurs when blood flow to the brain is disrupted due to a blocked or ruptured blood vessel.
Stroke is the fifth-leading cause of death and a major cause of long-term disability, contributing to 160,000 deaths annually.
While advances in treatment have allowed many survivors to live longer, they often face lasting challenges, including cognitive and physical disabilities and emotional struggles.
For families, caring for a stroke survivor can be overwhelming. The added responsibility may lead to stress, exhaustion, and financial strain.
The report highlights that palliative care can ease these burdens by addressing not only physical symptoms like pain but also emotional and spiritual needs, creating a more holistic approach to recovery.
A Holistic Approach to Palliative Care
The AHA statement calls for a broad view of palliative care, focusing on more than just medical treatment. It emphasizes:
- Communication: Helping patients and families understand the prognosis and set realistic care goals.
- Emotional and Spiritual Support: Addressing feelings of loss, grief, or existential distress that may arise after a stroke.
- Cultural Sensitivity: Tailoring care to match the values, beliefs, and cultural backgrounds of patients and their families.
- Practical Guidance: Assisting with navigating complex healthcare systems and providing referrals to appropriate services, such as home care or hospice.
The report also provides a palliative care checklist and tools to identify and manage the needs of both patients and families. It highlights that these needs often evolve over time, depending on the stage of recovery, changes in function, or new health challenges.
Addressing Disparities in Care
The report sheds light on significant racial and ethnic disparities in stroke treatment and palliative care.
Black, Hispanic, and Asian patients are less likely to receive acute treatments, such as clot-removal surgery, and are also less likely to be referred to hospice care or have advance directives, such as “do not resuscitate” orders, in place.
While cultural differences may play a role, the report points to systemic inequities, including variations in hospital practices, as key contributors.
For example, hospitals that serve more diverse or lower-income populations may be less likely to offer comprehensive palliative care services.
A 2023 AHA statement on addressing racial disparities in stroke care suggests that improving equity will require changes at multiple levels, from individual clinicians to hospital systems. Understanding how these factors influence care patterns is essential to closing the gap.
The Need for Research and Action
Despite its importance, palliative care for stroke survivors is not well-studied, and significant gaps in care persist. Nearly half of stroke survivors leave the hospital without a plan for additional services, such as home health care or pain management.
Pain, which often peaks months or even years after a stroke, is frequently underdiagnosed and undertreated.
The report underscores the need for better research into the long-term needs of stroke survivors and how palliative care can help meet them.
It also calls for greater awareness among healthcare providers and policymakers to ensure that all patients, regardless of race or ethnicity, have access to high-quality, person-centered care.
By addressing these gaps and integrating palliative care into all stages of stroke recovery, the healthcare system can better support survivors and their families, improving both quality of life and long-term outcomes.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more information about health, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
The research findings can be found in the the AHA journal Stroke.
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