Health: Stroke Care

Baroness Pitkeathley Excerpts

Monday 30th January 2012 Lords Chamber

[Baroness Pitkeathley]

My Lords, I thank my noble friend not only for securing this debate but for the wide-ranging way in which she introduced it. Her personal experience as a carer enriches our debates, and it is on the care experience that I want to focus in the few moments available to me.

I want to bring to your Lordships’ House Olivia, who looked after her husband, Ronald, when he suffered a massive stroke. She said:

“He spent four months on a stroke ward where little was done to rehabilitate him; he was lucky if he got 10 minutes of physio a day and even less input from speech and occupational therapists”.

She felt that the care he was receiving was so poor that she would take him home, and she thought that she would be better off doing that. Within days of taking him home, she felt that his condition had improved, and Ronald also received support there from district nurses and a physiotherapist. Olivia had to fight to get information and support. She said:

“It took months to determine what help we might be entitled to. I was passed from department to department, we were subjected to assessment after assessment and review after review, answering the same questions over and over again, the various departments procrastinating over every decision”.

She is still convinced that she made the right decision to care for Ronald at home, but the lack of support for her meant that she had to give up paid work to care, and suffered then from stress and depression, providing round-the-clock care. The impact of both people losing their incomes forced them to sell their home and go into sheltered rented accommodation. Your Lordships may think that that is an extreme example but it is not. It is a common experience in some families.

One of the great difficulties about a sudden onset condition such as stroke is that carers have little time or opportunity to plan for caring responsibilities. Intensive support, or reablement as we often call it now, following hospital discharge, can make the difference between a more rapid recovery and the need for ongoing long-term care. Not only is it crucial to support the independence of the stroke sufferer but for family members, too. Many families can juggle short periods of intensive caring and ongoing lower levels of support with paid work. They are very willing to do that, and to juggle it with other family commitments. But the lack of rehabilitation services can extend the length and intensity of the caring responsiblities of families. Evidence from Carers UK shows that many families are at risk of longer-term penalities: falling out of work and risking isolation, ill health and financial hardship.

In addition to support with personal care and mobility, stroke survivors often experience communication difficulties and changes in behaviour. That, too, can lead to stress and strain in the caring relationship. When the Minister responds, I hope that he will acknowledge the importance of caring families and address specifically the latest developments to support the Olivias of this world, as well as the Ronalds, who are the sufferers, particularly in respect of the unacceptable variation in levels of support available to them.