STROKE: Recognition, Management, and Prevention in Long-Term Care
Highlights of a Symposium
This supplement to Caring for the Ages was supported by an educational grant from Boehringer Ingelheim, and is jointly sponsored by the Elsevier Office of Continuing Medical Education and Caring for the Ages.
This supplement is based on proceedings of a continuing medical education symposium held on March 8, 2008, in Salt Lake City, Utah.
To view the supplement, click the image above. To take the CME test, download and print out the PDF file, and follow the test instructions on page 15.
Topics
• Introduction: Individualizing Stroke Management in the Long-Term Care Setting
• Recognizing the Signs and Symptoms of Acute Stroke
• Comprehensive Management of the Stroke Patient
• Secondary Prevention After Stroke or Transient Ischemic Attach
Faculty/Faculty Disclosure
William D. Smucker, MD, CMD Associate Director, Summa Heath System
Family Medicine Residency
Akron, Ohio Medical Director
Altenheim Nursing Home
Strongsville, Ohio Professor of Family Medicine
Northeastern Ohio Universities College of Medicine
Rootstown, Ohio Dr. Smucker has nothing to disclose.
Robert Reina, MS, MBA, Educational Reviewer, has nothing to disclose.
Target Audience
This activity is designed for long-term care (LTC) medical directors, assisted living facility directors, directors of nursing, nursing supervisors, pharmacists in long-term care facilities, consultant pharmacists, psychiatrists, primary care physicians, and other health care professionals who are involved in the treatment of patients susceptible to stroke.
Educational Needs
Each year, approximately 800,000 Americans experience a stroke; of those, 500,000 can be prevented (National Stroke Association). On average across the United States, someone suffers a stroke every 40 seconds, and someone dies from a stroke every 3 minutes. Stroke is also the leading cause of disability in the United States. A population-based 6-month follow-up study of people age 65 years and over who suffered a stroke showed that 50% had some paralysis on one side of the body (hemiparesis), 35% had symptoms of depression, 30% were unable to walk without some assistance, 26% were dependent in activities of daily living (ADLs), 19% had aphasia, and 26% resided in LTC facilities. Stroke puts a significant economic burden on individuals as well as on society as a whole. The direct and indirect costs of strokes in the United States in 2008 were estimated to total $65.5 billion.
LTC patients who have previously experienced stroke or who have risk factors for stroke pose unique management challenges. Such patients often have medical, neurological, and psychological co-morbid conditions and complex medication regimens. In the long-term setting, the multidisciplinary care team may be challenged by the difficult task of assessing the differentiating stroke from other causes of similar symptoms.
Learning Objectives
After reading this supplement, participants should be able to:
• Define stroke and recognize symptoms
• Identify barriers to recognition, assessment, and optimal management of stroke in the long-term care setting
• Assess the nature, causes, severity, and likely progression of stroke • Determine appropriate goals of care for individual stroke patients • Select and provide facility-wide systems geared to each individual patient
• Recognize and reduce stroke complications
• Identify steps to prevent secondary stroke.
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Elsevier Office of Continuing Medical Education (EOCME) and Caring for the Ages. The EOCME is accredited by the ACCME to provide continuing medical education (CME) for physicians.
The EOCME designates this educational activity for a maximum of 1.5 AMA PRA Category 1.0 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
