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Post stroke care

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  1. #1

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    Jul 2014
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    Post stroke care

    Do you have any recommendation where/who I can contact for post stroke care/hospital/nursing home? Currently still bed bound at the moment. Only happened a month ago. Thanks


  2. #2

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    Asia Medical on 2524-6830, Aon China Building, Queens Road Central, have a specialist stroke unit.

    www.asiamedicalspecialists.hk


  3. #3

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    Feb 2009
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    Just let you know under normal circumstances, a well-trained, competitive acupuncture physician and Chinese medicine practitioner can make the patient walk again in a couple of months. I have seen many cases myself. Your case is particularly favorable as it occurred just a month's time.


  4. #4

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    Wishing you a speedy recovery. You can also contact Bamboo

    http://www.bamboos.com.hk/


  5. #5

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    Jul 2014
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    Thank you for all your reply. I'm still finding hard to find a good nursing home/rehab place in HK island. The doctors in the hospital really want to try to discharge as soon as possible. As soon as tracheotomy tube is taken out and stable. They're really making everyone stressed especially we don't speak Chinese. They're just doing their job i guess...


  6. #6

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    We have started acupuncture and massage therapist in the hospital too. Hospital also have physiotherapy coming every morning.. Neurosurgeon doesn't help much at the moment..only gave us update every week or so. Am I supposed to ask them to do more? Thanks


  7. #7

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    Feb 2006
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    I'm sorry to hear about ths stroke. Are they in a private or public hospital? If its a public hospital, they should be assessing the patient for transfer to a suitable rehab unit, and providing OT/PT/ST as needed.

    Try Maclehose Medical Rehabilitation Centre in Sandy Bay (Welcome to MMRC). It's where doctors themselves would go or send their family members. You can go as a full time residential patient or day patient. They also have a therapy pool - one of the few full such pools on HK Island - which might help given Australian research has shown water therapy to be very helpful in post-stroke recovery.

    For non-residential or onsite help, contact HKSA (formerly known as the HK Spastic Association). They are outstanding, and have long and extensive experience with neurological patients. They emphasize treatment as part of community living, and have had a good track record in going further towards restoring function than HKHA therapists, who are more focused on getting the patient well enough to be discharged, rather than able to function at as high an order as possible within their original environment. (SAHK). If the patient isn't mobile, you can get their therapists (OT, PT and ST are available, with OT/PT usually jointly assessing and treating stroke patients) to do outreach services to home/hospital, doctors permitting.

    I'm sure you know that the faster you can get occupational+speech therapy and physiotherapy started after the stroke, the better the prospects of a full recovery.

    I also know a very good former HKSA physiotherapist whose now in fully private practice, if you want just that, but I would definitely recommend getting a full assessment by the HKSA or Maclehose team across all functions before you just go for physiotherapy. (Unless, of course, this is a very minor stroke and the doctors have confirmed that speech therapy or occupational therapy isn't needed).

    Best of luck, this must be an anxious and stressful time. Hang in there, HK does have resources if you know where to find them.

    Kit16 and shri like this.

  8. #8

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    Thank you so much Z754103.

    Dad is in public hospital. The doctors there doesn't believe rehab is suitable as dad is not walking or fully conscious yet. So they've been referring us to nursing home for elderly only. However we believe that he's making a good progress - opening eyes longer, actively moving right arm and leg, responding well so we prefer putting him towards rehab centre/post stroke specialized nursing home than nursing home for elderly.

    I had been in contact with MMRC and mom will be visiting them tomorrow. Unfortunately I'm currently not in HK. So she's all alone there with no relatives. As they need a referral from the current doctor, we worry that either current doctor won't refer us or doctors at MMRC finds that dad's case is not suitable for them.

    Also for some reason mom believes that MMRC is a hospital. Is that true?

    When I asked the current doctors what has the physiotherapist been teaching dad, they couldn't answer as they're not a therapist. They didn't suggest that we should ask the therapist ourselves. Honestly we didn't even know there was a physiotherapist coming in every morning as it was always early in the morning before visiting times. Are doctors even in neurosurgery general ward in public hospital normally this unhelpful?

    So I've never heard of them talking about OT/ST. Everyone are still talking in Chinese instead of English to dad. Is this why he hasn't improve much in his speech? Should I request them?

    In the meantime I will contact HKSA as you suggested.

    Thank you again for taking time to reply.


  9. #9

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    Unhappy

    Quote Originally Posted by Kit16:
    Thank you so much Z754103.

    Dad is in public hospital. The doctors there doesn't believe rehab is suitable as dad is not walking or fully conscious yet. So they've been referring us to nursing home for elderly only. However we believe that he's making a good progress - opening eyes longer, actively moving right arm and leg, responding well so we prefer putting him towards rehab centre/post stroke specialized nursing home than nursing home for elderly.

    I had been in contact with MMRC and mom will be visiting them tomorrow. Unfortunately I'm currently not in HK. So she's all alone there with no relatives. As they need a referral from the current doctor, we worry that either current doctor won't refer us or doctors at MMRC finds that dad's case is not suitable for them.

    Also for some reason mom believes that MMRC is a hospital. Is that true?

    When I asked the current doctors what has the physiotherapist been teaching dad, they couldn't answer as they're not a therapist. They didn't suggest that we should ask the therapist ourselves. Honestly we didn't even know there was a physiotherapist coming in every morning as it was always early in the morning before visiting times. Are doctors even in neurosurgery general ward in public hospital normally this unhelpful?


    ***********************
    So I've never heard of them talking about OT/ST. Everyone are still talking in Chinese instead of English to dad. Is this why he hasn't improve much in his speech? Should I request them?

    -

    In the meantime I will contact HKSA as you suggested.

    Thank you again for taking time to reply.
    - Maclehose - it depends on what you mean by hospital. It provides residential rehabilitative care, and now comes under HK Hospital Authority, so from that point of view, you could say it is a hospital. (The 'living in' part might be what's causing the confusion.) However, it doesn't have many of the attributes I'd normally associate with a hospital - I'd say it is a rehabilitative centre. In contrast, HKHA has rehabilitation hospitals, or hospitals with rehab units (QMH patients sometimes get sent onto the Tung Wah Fung Yiu King Hospital or Grantham Hospital post-stroke).

    - Surgeons are notoriously bad with patients and have terrible bedside manners, the world over. Try making friends with the ward nurses and finding out from them. Also, leave a message with the nurses to say you'd like the doctor to call you, and they generally will when they have a bit of time to talk. As to doctor/PT co-ordination, in the British/US systems, doctors never are terribly sure what PTs do, and don't integrate PT/OTs very well into the overall care process. Australia's much better at this. Private sector doctors are just as bad - they know that PT/OT/ST helps, but can be pretty clueless about the process. Ask the nurse to leave a message for the PT to call you. If he's semi-conscious, they're likely to be giving him passive type PT, rather than teaching him a lot of stuff right now. They should also automatically have an ST assess him (he's not swallowing by himself yet, right?) as soon as he's able to swallow/chew. Check to see if they've put up any sign above his bed about his diet - you'll find it should be signed by an ST.

    If his primary/first language is English, do make sure they all know that. Otherwise it will add to his confusion, and make it hard for them to assess his consciousness level. Does he look Chinese? If he can be mistaken for a local Cantonese speaker, give everyone some 'explanation' to 'anchor' his language needs in their memory. e.g. he's actually from Malaysia and only speaks English, or he grew up in Canada and can only speak English. Ask if it can go into his medical notes.

    In general, for something serious like a stroke, he is best off in the public sector. Especially if you can afford to 'speed up' certain procedures like MRIs privately if needed. Having said that, after QMH suggested we did a private MRI (6 month waiting list otherwise) when her initial condition seemed stable, after my family elder took a turn for the worse, the geriatrics team arranged emergency CT and MRI immediately. So don't worry he won't get necessary care/procedures if there's an acute medical need.

    In terms of OT/PT/ST involvement, these things may be on autopilot. My family elder was assessed by STs at the speed of light after admission, and I only found out from seeing the big sign above her bed about needing soft diets that they'd got an ST to see her right away. Depending on his physical condition and alertness, they'll also pretty automatically have a hospital OT see him. If he's barely able to talk/move, with a low level of consciousness, then they'll probably wait a bit before the OT. If he's stuck in bed, he'll be seen by a PT automatically. e.g. all surgery patients who are immobilised, automatically have PT assessment and training to avoid DVT etc.

    If Maclehose won't admit him, find out why. Is it because he's still too ill and needs to spend time in a proper hospital first? Or are they just full and the waiting list too long for him to benefit. If the former, just follow doctor recommendations, and be alert to whether you should get him in there between getting out of hospital and going home. If the latter, ask if he can be admitted as a private patient or if they can recommend another rehab centre.

    Note that patients often can recover much better in their own home, so I'm not suggesting you move him from institution to institution for the sake of it. For example, if the doctors really believe he's well enough to be discharged fully, he may be best off going home, then going to Maclehose as a full day or half day patient (depending on his needs). Or, going to HKSA as day patient. I used to go to Maclehose as half-day patient 3 or 5 days a week, and you can get quite a lot done!

    Finally, before he goes home, arrange for an OT assessment of his abilities and his home environment, and get any living aids that would help keep him safe and active fitted. Ask HKSA for advice on this. (And let me know if you get nowhere).

    Sorry this reply jumps around, I've not got the hang of this great new site formatting yet and can't figure out how to embed my replies within yours properly.

    Good luck! It must be worrying not being on the spot. He will be getting decent care in a public hospital, on par with UK and US standards. (Not comparing average HK public hospitals with the Hammersmith or UCSF, but those are extreme outliers!) I'm not sure which hospital your father is being seen. Just in case he is under the care of QMH's Geriatrics Unit, please be reassured that is the top team, and he couldn't have better care anywhere . They saved the life of an dearly beloved 85 year old family member when other doctors were about to write her off as beyond medical help. In that case, the care they got her was on par with the top teaching hospitals in the West.
    Last edited by z754103; 07-08-2014 at 11:55 PM.
    rani, Kit16 and shri like this.

  10. #10

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    Jul 2014
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    Z754103

    Thank you so much for your reply. I apologise for the late response.

    PYNEH discharged my father last week as the rehab hospital they referred to (Cheshire home in Chung Hom Kok) has a bed available. So my dad was discharged the very next day.

    I asked one of the doctor if they can refer us to MMRC and he said no as it is a hospital policy not to refer to a hospital in the other district. I asked how are we ever going to cross district because my mother lives in the West district and the doctor say there's no way unless we go to private hospital in the West and maybe transfer to public in the west.

    Is this information even correct. I have no idea how hospital system works in Hong Kong. If this is true, it is so annoying and very inconvenient.

    In all honesty, I'm not even sure why the hospital drove my father to PYNEH when it is inch closer to QM.

    Don't get me wrong, I'm very grateful that PYNEH save my father's life. I'm just trying to find a way to transfer my father to the West so it is easier for my old and alone mother to visit him, that's all.

    Where he is at the moment, there's only a bus that will take my mom to the town to take taxi. If she miss that bus which only comes twice a day, she had to walk for 15 mins to town to get a taxi. If she has to do that twice a day everyday...it'll be so exhausting for her.

    Does anyone has any advice on how to transfer my father closer to home? We have applied to some private rehab/nursing home but even with private, there is a waiting list.

    Thank you


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