Stroke: Hospital Stay and Care Experience

Care for stroke patients in the hospital can be beneficial for post-stroke support. Learn what to expect from your care experience during this time.

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Stroke Hospital Care: What to Expect 

Stroke hospitalisation is usually recommended for patients who require monitoring and treatment. The Stroke Unit is a designated area in the hospital managed by a specialised, multidisciplinary stroke care team, where stroke treatment in hospital can be provided.

Stroke Care Team

The members of the stroke care team may include:
Doctor
Nurse
Physiotherapist
Occupational therapist
Speech therapist
Dietitian
Pharmacist
Medical social worker
Neuropsychologist

Monitoring

Regular monitoring is a crucial part of care for stroke patients in the hospital. This may include periodic checks of blood pressure and assessment of the patient’s condition every few hours.

Screening

Patients will be assessed by various stroke care team members followed by an appropriate intervention or referral to any necessary healthcare professionals.


Screening Checklist 

Investigation

You will undergo various tests which may include:

Brain Scan

Brain Scan 

  • Either Computerised tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan.
  • This will help to identify the type, location and size of the stroke area.

Ultrasound

Ultrasound  

  • Ultrasound of the neck and brain blood vessels to assess the blood supply in the brain.

Heart Tests

Heart Test 

  • Electrocardiogram (ECG) checks for any abnormal heart rhythm.

  • Echocardiogram is an ultrasound to check for the presence of any clots or abnormal communications between the chambers of your heart.

  • Holter monitors the heart rhythm with continuous ECG over 24 or 48 hours to detect any heart rhythm abnormalities.

Blood Tests

Blood Test 

  • To screen for new risk factor(s) or measurement control of existing risk factor(s).

  • To measure your blood counts and check the function of your other organs such as kidneys and liver.


Medication

Your doctor may prescribe medication for stroke treatment in hospital. These may be taken orally or given by injection. Do inform your stroke care team if you are taking any medication(s), over-the-counter drug(s) or traditional Chinese medications (TCM). It is best not to self-medicate before speaking to your doctor.

Early Mobilisation

Your stroke care team will encourage early mobilisation once it is safe. This is to promote smooth recovery and prevention of complications. Your safety is priority, so always ask your stroke care team for assistance if needed.

Screening and Prevention of Post-stroke Acute Complications

You will be monitored closely for any post-stroke acute complications during your hospital stay.

Planning for Rehabilitation

Your stroke care team will assess your mobility function and social situation. Rehabilitation planning will be a team-based decision together with you and your family.

Your caregiver may be required to undergo caregiver training depending on your care requirement.

Discharge Care Plan

Starting a discharge plan as soon as possible is important. If needed, the stroke hospital care team will help to organise services and make contact with key providers before you leave the hospital.

Discharge planning may include:
Written communication to your primary care doctor at the General Practitioner/Polyclinic
Referral to Agency of Integrated Care (AIC) to arrange for services at community hospitals, day rehabilitation centres, day care centres, home nursing, home medical programme and nursing homes
Recommendation of medical equipment, mobility equipment and home modifications
Coordination of outpatient medical clinic appointments after discharge

Treatments to Reduce the Risk of Another Stroke

Following stroke hospitalisation, your doctor may recommend the following strategies to reduce the risk of suffering another stroke:

Anti-Platelet Medication

E.g. Clopidogrel, Aspirin, Dipyridamole
An anti-platelet makes the blood "less sticky" by preventing blood cells called platelets from sticking together to form a blood clot

Anticoagulant Medication

E.g. Warfarin, Novel-Oral Anti-coagulants (Rivaroxaban, Dabigatran and Apixaban)
An anticoagulant is a blood thinner that helps prevent the formation of new blood clots and keeps existing blood clots from getting larger
They work by interfering with the function of certain blood clotting factors
These are usually prescribed to patients with atrial fibrillation (AF) and some other heart and blood disorders

Medication for Cholesterol Control 

E.g. Simvastatin, Atorvastatin, Rosuvastatin, Ezetimibe, Fenofibrate, Gemfibrozil
Medications that lower your cholesterol level may help to lower your risk of developing heart disease and suffering another stroke

Lifestyle Modifications

Quit smoking
Limit alcohol consumption
Have a healthy and well-balanced diet
Exercise regularly
Maintain a healthy body weight
Take your medications as prescribed by your doctor
Attend medical appointments with your doctor as scheduled

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