5. Rehabilitation and long term support

Stroke survivors across Europe are waiting too long to have their immediate rehabilitation needs assessed and therapies started. In general, the rehabilitation they get is not intense enough, is too short, and often fails to address on-going issues, such as depression. Very few people get follow up reviews. In the long term, support is too often non-existent. This section looks at what rehabilitation and long-term support is available for stroke survivors across Europe.

Many stroke patients have problems with mobility, fatigue, speech,  memory  and/ or emotions among others and need support from one or more therapy areas (such as physiotherapy, speech therapy, occupational  therapy  and/or  psychology). These problems affect their ability to complete daily activities at home and to participate in the community: in England, Wales and Northern Ireland, over a third (40%) of stroke survivors need help with daily activities when they are discharged from hospital[294]. Patients should be assessed for these problems by therapists while they are in hospital and a rehabilitation plan should be made.

Problems related to stroke can be long- lasting.  After  15  years,  two-thirds  (63%)  of survivors are living with disability, nearly two in five (39%) have depression and over a quarter (30%) have cognitive impairment[295]. Furthermore, stroke patients are much more likely than people who have not had a stroke to be living with another illness[296].

Health  and social  care services  need to understand and address gaps in rehabilitation and support, as inadequate rehabilitation can leave patients with disabilities that could have been avoided[297].

Stroke patients may find that health and social care services do not meet all their needs.  For  example,  in  one  UK  study, up to 59% of patients reported unmet clinical   needs[3].   Post-stroke   disability contributes significantly to long-term healthcare resource use, therefore effective rehabilitation will potentially save costs[7].