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: mail@miltonkeynes.nhs.uk

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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ISCHAEMIC STROKE

HAEMORRHAGIC STROKE

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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: complaints@mkhospital.nhs.ukor

pals@mkhospital.nhs.ukWriteto: 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: ascat@milton-keynes.gov.uk 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: info@mkcil.org.uk 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: mail@carersmiltonkeynes.org 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: info@differentstrokes.co.uk

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: mkwr@gotadsl.co.uk

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: stroke@heathlambert.comWebsite: 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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Wehaveincludedthesepagesforyoutorecordanythingthat

mayberelevanttoyou.

Herearesomesuggestionsonhowyoumightwanttouseit;

• Recordsdetailsaboutyourstroke

• Writeadiaryofevents

• Questionstoaskthemedicalstaff

• Informationaboutyourmedication

• Anyotherusefulcontact,…

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