Saturday, February 27, 2016

Strokes on the rise among younger adults. OT can help!

Issue: Strokes on the rise among younger adults. OT can help!

The majority of strokes are occurring in older adults over the age of 50, but the number of people under 50 having strokes is increasing. The article states that about 10% of all strokes occur in people between 18 and 50 years old. This article describes the experience of a 41-year-old man who suffered from a intracerebral hemorrhage.
Articles like this help to educate the public on what it is really like to have a stroke. The individual in the article states, “You don’t think of things you do until you cant do them. You basically have to start all over again. I mean, you retrain your brain to use your limbs. You retrain your brain to remember. You retrain everything. It’s pretty devastating.”

You can find the article and podcast here:

Service Delivery:
The service delivery to address this issue involves both the health care and educational systems. Educating the public on the risk factors that they can control would be a very important piece in reducing the number of strokes in young adults under 50. There are some risk factors that are uncontrollable such as age, gender, and ethnicity. However, the other factors can all be controlled. If we are able to educate the public on the importance of living a healthy lifestyle, we may be able to reduce the prevalence of strokes in younger adults under the age of 50.
            The health care system is also involved in the service delivery of the proposed policy because we would have to ensure that physicians and other health professionals would be willing to adopt these policies and actually assess for risk factors and educate their patients on how to reduce these risks. The health care system has the potential to change the lives of their patients! Providing free physicals to assess risk factors for stroke would be a great way to ensure that everyone is able to learn their risk for developing a stroke despite their financial situation.
The most common type of stroke occurring in adults under 50 is ischemic strokes. Ischemic strokes are caused by a blockage in the blood vessel. The article quotes a vascular neurologist who believes that the most likely underlying cause for the increasing incidence and prevalence in young adults under 50 is obesity. This also goes back to the healthcare system that parents should be educated by their children’s pediatricians on how to reduce risks for obesity. As childhood obesity has increased, these children grow up to be adults who if still obese, are at a great risk for stroke. As health professionals, we need to do what we can from the beginning to help prevent childhood obesity.

Policy:
There should be a policy made so that all individuals are required to get a physical at least once per year. This physical should screen for stroke risk factors such as high blood pressure, diabetes, obesity and lipid disorders. When a person has any of these risk factors, they should be educated on lifestyle factors that can be changed such as eating habits, physical activity, limiting or quitting smoking and drinking as well as medical risk factors that can be addresses such as high blood pressure, high cholesterol, diabetes, and poor circulation. To make this policy even better and more universal, the physicals should be free to all individuals. By offering free physicals, people will be more willing to get them and will not have to choose between a physical and something else they feel is more important to purchase. This policy could also incorporate an education component. If an individual is found to have any of these risk factors, they and their family should be educated on the signs of a stroke so that 9-1-1 can be called sooner. If this policy were put into place, I would hope that the number of strokes amongst young adults under the age of 50 would stop increasing and actually start to decline.

Data:
The data that would be needed to support this policy is the statistic that the number of young adults under 50 experiencing strokes is rising. In addition, the statistic that 80% of strokes can be prevented with lifestyle changes to reduce risk factors needs to be brought to the table. If a study was done in order to prove that education on prevention and signs of a stroke could help to decrease the amount of strokes and decrease the amount of time before 9-1-1 is called after witnessing a loved one’s stroke, this policy would be more supported. In order to educate the public on risk factors, there will need to be data to support the claims that these medical and lifestyle factors are indeed risk factors for having a stroke.  

Implications for OT:
Occupational therapy will be affected as we will begin to see more young adults suffering from strokes than ever before. Even though the majority of strokes occur in the older adult population, this will still have an impact on occupational therapy. Occupational therapists can work on advocating for the importance of education of the young adult population.
While some may think that because these individuals are young, they will be resilient and recovery quickly, this may not always be the case. Recovery will be difficult for anyone and these young adults are more likely to be raising children and have other responsibilities that are no longer possible to fulfill.  A stroke changes a person’s life completely. This drastic change in independence and function has the potential to lead to depression and other mental health issues.
As OTs, we have the power to make changes in peoples lives. Lifestyle redesign is “a treatment approach that has been shows to improve health and wellness by preventing and managing chronic conditions through building healthier lifestyles.” OTs can work with patients to redesign their lives so that they can acquire health-promoting habits and routines in their every day lives.
In addition, we can be training our clients and their families about FAST. FAST can help people to remember the warning signs of a stroke and recognize that their loved one is having a stroke and call 9-1-1 sooner. It has been shown that the faster an individual arrives to the hospital after a stroke the more likely they are to have a better recovery.
F= FACE. Ask the person to smile. Does one side of the face droop?
A= ARMS. Ask the person to raise both arms. Does one arm drift downward?
S= SPEECH. Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T=TIME. If you observe any of these signs, call 9-1-1 immediately.  Note the time of the first symptom.


Additional Resources
http://www.stroke.org/understand-stroke/recognizing-stroke/act-fast



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