Dr. Patricia Farrell on Medika Life

Stroke Patients Are Being Cast Aside by a Lack of Understanding and Bias

A stroke is often seen by too many as meaning permanent damage to someone's brain, and that's not the case, but the bias continues.

The word “stroke” often hits like a ton of bricks because too many believe it is the beginning of the end for someone’s cognitive and physical abilities; it couldn’t be farther from the truth. And when a stroke is used to deny anyone a future after appropriate rehab, it is more than shameful. If life is sacred, those with strokes must share that belief.

One of the most blatant examples of ignorance and bias has been shown in political campaigns where stroke seems to be a central issue — it shouldn’t be. The inappropriateness of a medical professional in this area is startling.

A stroke comes in varying degrees of brain involvement, some fatal and many neither life-threatening nor totally incapacitating. Medical breakthroughs and physical and cognitive rehab today, offering new hope for stroke patients, are breaking through the wall of ignorance and bias. Even stroke patients with sight loss are now receiving further treatments. One program helps patients to retain or potentially restore stroke-vision loss.

What about the cognitive impairments of a stroke? The results here all depend on the stroke type, the damage’s extent, and where it occurred. Many have ischemic strokes caused by blood clots; an illustration can be found here. One type of stroke, a TIAor transient ischemic attack, is a “warning stroke” that occurs when a blood clot blocks an artery for a short time. The only difference between a stroke and TIA is that with TIA, the blockage is transient (temporary).

Depending on the type of stroke, rehab can often aid the brain in accessing its extraordinary ability to utilize other areas to take over some actions. The treatments for a stroke are many and varied to address physical and cognitive difficulties. Currently, more than seven million persons in the US have had strokes, so the numbers are not minuscule. But one of the problems is that up to one-third of them don’t receive rehab. What might be the problem here?

One of the problems may be insurance coverage where services are denied because the insurance company doesn’t believe there is “medical necessity,” ask the doctor to get involved. If you believe you are being denied payment or access to a medical service that you are entitled to, you have the right to appeal the decision. If this should happen, appeal the decision or look for ways to take additional action to receive the needed services.

Disability consultants have told me that the usual rehab course is about one year, but insurance may only provide three months of coverage. If Social Security Disability benefits are received, and the consultant decides to limit benefits to three months, do not accept it. Appeal and provide yourself with a disability attorney.

What does Medicare pay for in terms of stroke rehab? Medicare reimbursement depends on the type of Medicare and co-insurance the individual has with Medicare.

The costs may vary, but one study found it can be expensive, especially if all of the stroke patient’s medical insurance isn’t sufficient. One-year costs after the start of medical specialist rehabilitation post-stroke from a societal perspective, were $70,601 and $27,473 for inpatients and outpatients, respectively. For both inpatients and outpatients, rehabilitation was the biggest contributor, yet to a larger extent in inpatients than in outpatients. Both the costs for staying in the rehabilitation facility and for all types of therapy were higher. These costs may not relate to the US since the study was conducted in Europe.

The many areas of cognitive rehab require specific interventions long enough to aid in remediation. Going back to work might be one of the things you can plan to do once recovery has begun. A few helpful hints are offered here to assist anyone recovering from a stroke.

Anyone who wants a high-profile example of a brain injury victim (and that is what a stroke can be considered) should follow former Congresswoman Gabby Gifford’s rehab after a gunshot head wound. The woman should inspire any stroke patient, whether they have had a major or minor stroke.

A stroke is not the end of everything, and one of the most potent factors working on a patient’s behalf is motivation to keep improving. The brain is a wonderful organ, so let it perform its wonders.

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Pat Farrell PhD
Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.


Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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