20130501 Stroke Association Logo

I woke up next to my partner, to a spokesperson from the Stroke Association talking about their new report, “Feeling overwhelmed: The emotional impact of stroke”:

“Are you listening to this?” I asked Madame Oui.


My wife had a stroke in February 2012. Her remarkable recovery is a long story, one which we are currently co-writing a book about.

Since her injury, I have been so impressed with the quality of health care, from the Intensive Care Unit at the Royal Hospital literally saving her life, to the integrated in-patient rehabilitation services at the Regional Acquired Brain Injury Unit (RABIU) at Musgrave Park Hospital, continuing to the Community Stroke Team at Bangor Community Hospital. There are so many professionals to thank.

This is reflected quantitatively by the “Feeling overwhelmed” report, which had 1,774 responses from stroke survivors and 937 from carers. The much smaller segment of responses from Northern Ireland creates statistical caution. Yet it is still worth examining our variances with the rest of the UK, in this case favourably in regards to care in hospital, where 9 out of 10 Northern Ireland stroke survivors agreed or strongly agreed that they were well looked after in hospital (in contrast to about 70% from the rest of the UK):

Q. When in hospital I felt well looked after and cared for by hospital staff:

Strongly disagree Disagree Neither Agree Strongly agree #
Northern Ireland 0.0% 10.0% 0.0% 70.0% 20.0% 10
Scotland 7.8% 8.7% 17.5% 36.9% 29.1% 103
Wales 7.1% 13.3% 19.4% 38.8% 21.4% 98
England 7.2% 10.7% 12.5% 39.1% 30.4% 1,341

However, in the area of psychological services and emotional support, there is far from coherent or comprehensive provision, at least from what Madame Oui and I have experienced.

From stroke survivors, Northern Ireland’s variance from the rest of the UK indicates that something is clearly not right, with half “strongly agree” that their emotional needs are not as well looked after:

Q. My emotional needs are not looked after as much as my physical needs:

Strongly disagree Disagree Neither Agree Strongly agree #
Northern Ireland 9.1% 9.1% 27.3% 9.1% 45.5% 11
Scotland 3.0% 9.0% 29.0% 42.0% 17.0% 100
Wales 2.0% 5.0% 20.8% 51.5% 20.8% 101
England 3.8% 9.6% 23.7% 41.4% 21.4% 1,306

Madame Oui and I have been fortunate to avail of emotional support from a variety of local charities: counselling services from Headway; a self management course from Chest, Heart & Stroke; and a befriending service from the Stroke Association.

But it is the time that she had to wait that concerns me. While RABIU has an in-house clinical psychologist, it was only when Madame Oui was discharged did more practical, non-hospital services become available. That was five months from injury and a lot of ground lost. Indeed, within our wider family she was the last person to receive formal emotional support; obviously she should have been the first.

So, I support the recent health consultation in Northern Ireland, Transforming Your Care (2011), which includes recommendations around promoting mental health and wellbeing.

Yet “Feeling Overwhelmed” shows how much more needs to be done in regards to addressing the emotional impact of stroke, for both survivors and their carers.

Its recommendations include:

  • Recognise that emotional support is just as crucial for recovery as physical rehabilitation
  • Survivor’s emotional wellbeing should also be a key part of their health and social care plans
  • Increase investment in provision of clinical psychologists, both in hospital and in the community
  • Ensure the monitoring and publishing of data on the long-term emotional experiences of survivors, carers and families
  • Ensure that health and social care providers share best practice

For me, I am supporting the Stroke Association’s campaign efforts with this declaration that I will be pursuing this specific issue of emotional support with appropriate organisations and elected representatives at all levels, to improve the quality of provision and recovery outcomes.

20130501 Stroke Association Action