Outcomes for individuals with stroke have improved significantly due to the implementation of Acute Stroke System of Care. The community is better equipped to recognize stroke as a “brain attack,” and there is greater awareness of the importance of medical care within one hour of symptom onset. Likewise, EMS systems have been enhanced to transport individuals to regional stroke care centers that are equipped to administer fibrinolytics.
Thailand has observed global patterns of an enlarging elderly class: as fertility control is encouraged and medical advances are made, births shrink and people live longer.[5] The Thai government is noticing and concerned about this trend, but tends to let families care for their elderly members rather than create extraneous policies for them.[31] As of 2011, there are only 25 state-sponsored homes for the elderly, with no more than a few thousand members of each home.[31] Such programs are largely run by volunteers and are services tend to be limited, considering there is not always a guarantee care will be available. Private care is tough to follow, often based on assumptions. Because children are less likely to care for their parents, private caretakers are in demand.[31] Volunteer NGOs are available but in very limited quantities.[31]
Aiken Regional Medical Centers is dedicated to improving the quality of stroke care. We're proud to receive the Get With The Guidelines® Silver Plus Achievement Award for having reached an aggressive goal of treating patients with 85 percent or higher compliance to core standard levels of care as outlined by the American Heart Association/American Stroke Association® for one calendar year. In addition, we demonstrated 75 percent compliance to seven out of ten stroke quality measures during the 12-month period.
The patient recovered from the stroke with limited damage resulting in a limp and nerve damage in one hand, but he is able to walk 2-3 miles several times a week. He attributes his successful outcome to having received tPA through access to the teleneurology system. He is thankful to the emergency physician, Dr. Gregory Driskell, for the critical care he received. 

Considered to be one of the best stroke rehabilitation centers in America, the Rehabilitation Institute of Chicago, also known as RIC, takes care of more patients who have suffered from strokes than most other hospitals in the entire country. The medical staff includes specialists in physical medicine and rehabilitative techniques who are renowned for their expertise. Some of the finest speech language pathologists will guide your loved one in relearning how to speak or swallow if necessary. RIC also offers some innovative technologies that are hard to find at other stroke centers. The robot-assisted walking therapy is one of these cutting-edge technologies; it uses robotic devices that are attached to the patient, helping him move his legs in a natural manner. Physical therapy is complemented by patient training, education, and support groups to maximize the treatment’s effectiveness.


On both occasions I used their service, the caregivers either left minimal or no notes while visiting my elderly parents (no eating, sleeping or bathroom data). After the first visit, I contacted a supervisor at Around the Clock and asked specifically that the caregivers leave notes on eating, sleeping patterns, etc. Instead of improving, on the 2nd visit I only received notes from 1 of 3 caregivers...I paid for 16 hours of caregiving for people who may or may not have even showed up for all I know. Their medical staff is also hit and miss. On my father's post-hospital rehab, one of the 3 nurses missed appts at the house repeatedly...only making 1 of 5 scheduled appointments. After this, I contacted Around the Clock and asked them to send out a more reliable nurse. In the 5 weeks that have passed since, we have received 1 visit from a nurse...nobody makes their scheduled appointments. Is this the care you want for your elderly parents??
Medications delivered directly to the brain. Doctors may insert a long, thin tube (catheter) through an artery in your groin and thread it to your brain to deliver tPA directly into the area where the stroke is occurring. This is called intra-arterial thrombolysis. The time window for this treatment is somewhat longer than for intravenous tPA, but is still limited.
Mayo Clinic in Rochester, Minn., ranks No. 1 for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for neurology and neurosurgery.
Mayo Clinic in Rochester, Minn., ranks No. 1 for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for neurology and neurosurgery.
Finally, you should know about the end-of-life resources that are available to you in your home. Home hospice care is often covered by Medicare or other insurance; the cost is typically between $20-$50/hour. You'll have a team of workers that may include a care companion, social worker, nurse, and/or chaplain, and they'll help provide your loved one with comfort and pain management. You can find this type of support by searching hospice. You can also search in-home care and ask providers to tell you what hospice options they offer.
These documents have been provided to the American Heart Association by the below hospitals as examples of stroke best practices.  These documents are available only to give you an idea of how some hospitals might use discharge stroke best practices. By including this document on its Web site, the American Heart Association does not represent that these documents are complete, accurate or efficacious, or that it follows all of the American Heart Association guidelines for secondary and primary prevention of cardiovascular events or stroke. Hospitals should design their own stroke best practices based on their own procedures and professional experience.
U Care was developed in partnership with Lacuna Health, a subsidiary of Kindred Healthcare, to follow up with patients after they leave the hospital. Registered nurses with U Care reach out to patients by phone on a regular schedule to monitor the patients’ recovery progress, check their medications, ensure they have made appropriate follow-up appointments and answer any questions or health concerns that arise. The nurses have access to the patients’ health records and can escalate any concerns to hospital staff or physicians if a patient requires further clarification or intervention. The program pilot, which began in June, will follow 250 stroke patients for 45 days after discharge, whether they went home or to a rehab facility for recovery.
This app comes equipped with a calendar, to-do list, and notes built in, so you don’t have to jump between these separate apps on your device. It will connect the things you use most in life, like utilities, service providers, banks, and social networks, and then it will automatically tell you what you need to do. In that sense, it’s very similar to an actual personal assistant, who might be tasked with managing your schedule and keeping things running on time. 24me is available on Google Play and the iTunes app store.

“We are thrilled to support the University of Louisville Hospital – Comprehensive Stroke Center’s U Care program with our RN-led clinical AfterCare model. Patients and their caregivers need more resources and ongoing support when managing the transition from a hospitalization to another setting or home. We look forward to implementing this model and future programs to help UofL Hospital provide a differentiated patient experience for the communities it serves,” said Brian Holzer, M.D., M.B.A., C.E.O. of Lacuna Health.
Armistead Senior Care provides compassionate in-home care and services as people age in Vermont and New Hampshire.  Established in 1999 and locally owned, Armistead Senior Care supports the independence and quality of life of older adults, people with disabilities and anyone recuperating from an illness. We do this by providing an individualized plan of care, thoughtful caregiver/client matching, and superior care management.

This assistant is like Siri for Samsung. It has a cool feature that lets you identify landmarks and other visuals by taking a photo. You can also translate foreign languages using Bixby, or point your camera at something you want to buy and it will give you pricing options. It will recommend businesses and restaurants, or create reminders and manage your schedule. Bixby is available on all Samsung devices, like the Galaxy S8.


Data: Data collection is a vital component of the chain of survival. Data collection includes results from laboratory tests and both a physical and a neurological exam. A 12-lead electrocardiogram is recommended to rule out cardiac arrhythmias. In addition, a CT scan is an essential piece of the puzzle and is needed for an accurate diagnosis. A CT scan should ideally be performed within 25 minutes of arrival in the emergency room. Data collected is also needed to rule out conditions which may mimic a stroke, such as a brain tumor, drug overdose or hypoglycemia.

A local example of the life-saving stroke care making a difference was a man who came to Marshall North ER in June with weakness and impaired speech. Tests showed the patient to be a candidate for teleneurology and possible tPA – a clot busting medication. Through the teleneurology system – which links rural hospitals with a neurologist at Huntsville Hospital using a computer monitor – the medical team determined tPA should be administered. The patient received the drug and, after close monitoring, was transferred to Huntsville Hospital.


A less restrictive alternative to legal incapacity is the use of "advance directives," powers of attorney, trusts, living wills and healthcare directives. The person who has such documents in place should have prepared them with their attorney when that person had capacity. Then, if the time comes that the person lacks capacity to carry out the tasks laid out in the documents, the person they named (their agent) can step in to make decisions on their behalf. The agent has a duty to act as that person would have done so and to act in their best interest.

U Care is yet another innovation in quality stroke care by the staff at the UofL Hospital, the first hospital designated as a comprehensive stroke center in Kentucky by the Joint Commission. In addition, UofL Hospital once again has been awarded the top level of distinction by the American Heart Association/American Stroke Association with the Get With The Guidelines Target: Stroke Elite Plus, Gold Plus award. The award recognizes the hospital’s success in providing the most appropriate stroke treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke Quality measures to receive the Gold Plus Quality Achievement Award.


Disposition: Disposition is the last link in the chain of survival. This step in stroke care focuses on the continuing care of the stroke patient. It is recommended that patients be admitted to an intensive care unit or stroke unit within three hours of arrival in the ED. Continued monitoring of a stroke patient includes frequent assessment of neurological status and monitoring of glucose levels and vitals, as well as prevention of complications. Determining the cause of the stroke is also part of disposition.
All hospitals in the study participated in the GWTG program, and thus "it cannot be discerned whether GWTG-Stroke participation is necessary to meet high level process adherence," the authors noted. Residual measured and unmeasured confounding may have influenced the multivariable analyses, and it wasn't possible to ascertain whether length of time as a PSC-certified center affected care.
On average, someone suffers from a stroke every 40 seconds and someone dies from a stroke every 4 minutes. In all, 795,000 people suffer a new or recurrent stroke each year. The statistics are staggering, and make it clear why quick diagnosis and treatment is so important if you think you may be having a stroke. At MountainView Regional Medical Center, we know that a stroke can happen at any time. We’re ready all the time — 24 hours a day to provide vital, immediate attention.
Outcomes for individuals with stroke have improved significantly due to the implementation of Acute Stroke System of Care. The community is better equipped to recognize stroke as a “brain attack,” and there is greater awareness of the importance of medical care within one hour of symptom onset. Likewise, EMS systems have been enhanced to transport individuals to regional stroke care centers that are equipped to administer fibrinolytics.
Would home-cooked meals, help around the house and rides to the store make all the difference for you or your aging loved one? This most basic (and often most affordable) type of in-home care generally includes light housekeeping, companionship, meal preparation, and help with errands. You can hire help to come on a regular weekly schedule or only as needed. Expect to pay about $15-$40/hour for this type of service, depending where you live.
Maintaining the highest standards of clinical excellence is a central, ongoing objective at Stryker. To meet this goal, we are committed to continue to develop robust clinical data - transforming leading-edge research into real-world advances in medical knowledge and patient treatment. All with the ultimate goal of delivering Complete Stroke Care and helping achieve better outcomes.
This app is an easy-to-use voice-activated assistant that offers many of the same features listed in the apps above. Lyra offers the added feature of continuing the same conversation across multiple devices like smartphones, tablets, and computers by logging in to keep everything connected. Its creator claims you can speak to Lyra in any dialect, as it is “capable of understanding multiple languages, context, and intent.” Lyra is available on Google Play and the iTunes app store.  
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While there are certainly programs available for use by the elderly in Thailand, questions of equity have risen since their introduction.[32] The rich elderly in Thailand are much more likely to have access to care resources, while the poor elderly are more likely to actually use their acquired health care, as observed in a study by Bhumisuk Khananurak.[32] However, over 96% of the nation has health insurance with varying degrees of care available.[32]
However, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities, rather than the resident, may be providing the cost of care. If residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. The Adult Protective Services Agency, a component of the human service agency in most states, is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.[41]
A popular brand of personal care, Dove is owned by Unilever. It is considered as the home for real beauty. It is originated in the United Kingdom. Dove has been working towards making beauty a great source of confidence. The various products of Dove are manufactured in many countries like Argentina, Brazil, China, Canada, Germany, Indonesia, India, Ireland, Japan, Netherlands, Pakistan, Poland, South Africa, Thailand and the United States.
If you think you are having a stroke, call 911 so an ambulance can quickly get to the hospital. When talking to 911, an emergency medical service or the hospital, be sure to use the word “stroke” in order to possibly speed up a diagnosis. Every minute counts when treating a stroke, raising the number of brain cells that can be saved and chances for recovery.
To determine the most appropriate treatment for your stroke, your emergency team needs to evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your doctor may use several tests to determine your risk of stroke, including:
^ Donald R Hoover; Stephen Crystal; Rizie Kumar; Usha Sambamoorthi; Joel C Cantor (December 1, 2002). "Medical Expenditures during the Last Year of Life: Findings from the 1992–1996 Medicare Current Beneficiary Survey". Health Service Research. 37 (6): 1625–1642. doi:10.1111/1475-6773.01113. PMC 1464043. PMID 12546289. Last-year-of-life expenses constituted 22 percent of all medical, 26 percent of Medicare, 18 percent of all non-Medicare expenditures, and 25 percent of Medicaid expenditures.

We at NYU Langone’s Comprehensive Stroke Care Center are fortunate to have recently opened the Ronald O. Perelman Center for Emergency Service, which serves as the first line of urgent care for patients that are suspected of having a stroke. A stroke alert prompts a team of experts from our center to come to a patient’s bedside within minutes to confirm or rule out a stroke, allowing treatment and rehabilitation to begin as soon as possible.


Frankie Weekley suffered a stroke that could have left her severely debilitated. But prompt access to stroke telemedicine saved Frankie?s life and minimized the effect the stroke had on her health. Frankie Weekley of Titusville, Florida, says she has three heroes: her husband, Parrish Medical Center and Mayo Clinic. Frankie credits all three with saving [...]
Best Personal Care is a wonderful facility. I put my father at this facility 10 months ago. The staff at Best Personal Care communicated consistently and helped my father to become independent again. They made sure that he took all his meds and took him to his doctor appointments. They also were very helpful in making sure that he had continuous activities to help keep his mind occupied. I highly recommend Best Personal Care. Arnie and Anglelina are very caring people. My father has been to many other facilities that were not near as proactive with his care. Best Personal Care lives up to their name and made a big difference in helping my father to get better and be able to live independently again.
Microsoft calls Cortana a “digital agent.” It’s designed to learn from your commands to personalize your experience as you use it. You can type your queries, or talk to Cortana by saying “Hey Cortana!” It’s very similar to the Apple and Android options but is quickly gaining steam on Siri. Track packages, manager your calendar, or just chit chat with the virtual assistant. Cortana is available on Microsoft devices, including Windows phones and operating systems, as well as in apps on Google Play and the iTunes app store.
When a patient exhibits signs of a stroke, a first responder is immediately sent to the patient’s bedside, whether in the emergency room or on a nursing floor, to assess the patient. This begins a series of rapid activities, including lab work and CT imaging, to provide our emergency physicians and/or neurologist with the proper diagnostic information to determine which interventions are best based on each individual case. The physicians already on the case may bring other specialists, such as neurosurgeons or neuro-interventionalists, into the case depending on the course of treatment.

The overall goal of stroke care is to minimize brain injury and optimize the individual’s recovery. Preferential transport to stroke-capable centers has been shown to improve outcomes. Stroke centers are equipped with resources often not available at smaller community hospitals. The presence of specialists, including neurologists and stroke care specialists, multidisciplinary teams experienced in stroke care, advanced imaging modalities, and other therapeutic options make transport to stroke centers the most suitable option. The goal of the stroke team, emergency physician, or other experts should be to assess the individual with suspected stroke within ten minutes.

You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots.


Feeling overwhelmed by all of the personal care products available? With so many options to choose from, it is hard to know what’s best when selecting skin care, cosmetics and everyday necessities. Whether you are searching for anything from deodorant to toothpaste or shampoo to hair color, read hundreds of consumer reviews about different toiletries, personal hygiene and hair care products.
According to the United States Department of Health and Human Services the older population—persons 65 years or older—numbered 39.6 million in 2009.[11] They represented 12.9% of the U.S. population, about one in every eight Americans.[11] By 2030, there will be about 72.1 million older persons, more than twice their number in 2000.[11] People 65-plus years old represented 12.4% of the population in the year 2000, but that is expected to grow to be 19% of the population by 2030.[11] This will mean more demand for elderly care facilities in the coming years. There were more than 36,000 assisted living facilities in the United States in 2009, according to the Assisted Living Federation of America[12] in 2009. More than 1 million senior citizens are served by these assisted living facilities.[12]
"I almost can't express the joy knowing each and every one of you brings me daily. I am overwhelmed with love and gratitude by your acts of kindness and love, not only for my sweet papa, but for all the precious souls you treat with such dignity. You are all truly an answer to prayer .. And I will always hold everyone there in my heart ... Long after that sweet man leaves us. I love you!"
Data: Data collection is a vital component of the chain of survival. Data collection includes results from laboratory tests and both a physical and a neurological exam. A 12-lead electrocardiogram is recommended to rule out cardiac arrhythmias. In addition, a CT scan is an essential piece of the puzzle and is needed for an accurate diagnosis. A CT scan should ideally be performed within 25 minutes of arrival in the emergency room. Data collected is also needed to rule out conditions which may mimic a stroke, such as a brain tumor, drug overdose or hypoglycemia.
About This Box: Cora is a tampon subscription that’s giving periods a bigger purpose. This Certified B corporation donates to women’s health organizations around the world, fights for women’s empowerment, and even covers the sales tax (which usually falls on the customer) on their online orders in order to help make quality hygiene products as accessible as possible. If that’s not enough of a selling point, just look at their gorgeous packaging! In your first Cora order, you’ll get their “starter kit”—a vegan faux leather clutch built for tampons, a chic storage case, and a set of “stowaway” tampons that look more like lipsticks than period supplies. Check out our Cora Reviews to learn more.
Another top facility that you may want to consider is the University of Washington Stroke Center, which deals with diagnosis and post-stroke patient care. Certified by The Joint Commission as a primary stroke center, this facility is involved in innovative research of new medications as well as various procedures or surgeries that can help prevent or treat stroke. The medical services offered by the UW Medicine Stroke Center include emergency services, acute stroke teams, and neuroimaging, neurosurgical, and neuroradiology services. Health care professionals are continually upgrading their education so they can provide the best support and care. These medical services are available at any time of the day, ensuring that stroke victims are stabilized and can begin recovery as soon as possible after a stroke.
We believe that continuous improvement from onset through to post-treatment care is critically important to ensure stroke patients have access to the right therapy at the right time.1 Working together – through our Stroke Care Solution – we can improve patients’ access to advanced stroke therapy by addressing systemic issues. We’re partnering with healthcare professionals to pinpoint gaps in processes, establish root causes, and implement changes to create efficiencies and optimize coordinated care. Let’s collaborate to develop a tailored solution to help you achieve enhanced clinical and financial outcomes.
The American Heart Association/American Stroke Association strives to ensure that everyone who has heart disease or a stroke receives treatment at a hospital with the resources necessary to correctly make time-critical decisions. This recognition demonstrates Marshall Medical's high commitment to following the procedures outlined in a national program known as “Get With The Guidelines-Stroke," proven to improve patient outcomes. 
These documents have been provided to the American Heart Association by the below hospitals as examples of stroke best practices.  These documents are available only to give you an idea of how some hospitals might use discharge stroke best practices. By including this document on its Web site, the American Heart Association does not represent that these documents are complete, accurate or efficacious, or that it follows all of the American Heart Association guidelines for secondary and primary prevention of cardiovascular events or stroke. Hospitals should design their own stroke best practices based on their own procedures and professional experience.
Mayo Clinic provides easy access to its stroke rehabilitation services by working with numerous insurance companies, and in most cases, doesn’t require a referral from a physician. Once you’ve made an appointment, your loved one will be evaluated by doctors with extensive training in neurology, emergency medicine, rehabilitation, and other specialties. Doctors from the Mayo Clinic treat approximately 15,000 people who have suffered from stroke or similar conditions each year, so you can count on their expertise. For diagnostic purposes, Mayo Clinic uses advanced technology and imaging tests. One special type of diagnosis used at this facility is stroke telemedicine, or telestroke. Used only by doctors with advanced training and involving video cameras, the Internet, and advanced robotic equipment, telestroke is used to evaluate patients who have suffered from acute strokes.
That’s why it’s important to treat the underlying causes of stroke, including heart disease, high blood pressure, atrial fibrillation (fast, irregular heartbeat), high cholesterol, and diabetes. Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.
After a stroke, Allen Witcher required complex surgery, followed by months of physical therapy and rehabilitation. Thanks to that comprehensive treatment, Allen now relishes each new day he has to enjoy. Married for 54 years, Allen and Betsy Witcher like being active together. They particularly enjoy ballroom dancing and going for daily walks. But it [...]
About this box: The Stork Bag is an personal care box just for pregnant women.  You can expect to receive consumable items like stretch mark oils/creams and healthy pregnancy food samples, pregnancy books, beauty items & maternity products. They’ll ship you a new bag for each trimester, ensuring you have the products that you need at every stage of your pregnancy. Purchase individually or subscribe.
About This Box: Quip is an electric toothbrush and oral care company that focuses on helping you take better care of your teeth without gimmicks. They’re all about good design and routine in oral care, with care taken to educate you about proper brushing technique and their stylish, travel-friendly toothbrush that vibrates to let you know how long to brush. Check out our Quip Review to learn more.
This is another app that is very similar to an actual personal assistant. If you’re in need of someone to take notes or to summarize your meetings, this is the app for you. Tetra uses artificial intelligence to take notes and keep your team in sync. Your team members can place conference calls through the app, which will highlight important moments from the call and will send notes to all members upon call completion, allowing everyone to focus on the conversation instead of having to take personal notes. Tetra is available on the iTunes app store.  
Endovascular procedures. Endovascular procedures may be used to treat certain hemorrhagic strokes. The doctor inserts a long tube through a major artery in the leg or arm and then guides the tube to the site of the weak spot or break in a blood vessel. The tube is then used to install a device, such as a coil, to repair the damage or prevent bleeding.
We at NYU Langone’s Comprehensive Stroke Care Center are fortunate to have recently opened the Ronald O. Perelman Center for Emergency Service, which serves as the first line of urgent care for patients that are suspected of having a stroke. A stroke alert prompts a team of experts from our center to come to a patient’s bedside within minutes to confirm or rule out a stroke, allowing treatment and rehabilitation to begin as soon as possible.
The best post rehabilitation center I have seen in the country is center for Neuro Recovery. My father went there completely enfeeble and in a wheelchair when he started and left walking after nine months of strengthening and functional movement exercises. I have never seen such a state of the art facility and knowledge-based staff. If this was going to happen to another family member again, I know I would go back to this amazing facility.
When first started with ATC, it was great. They really was nice and offered variety of clients and places. They do pay mileage, but as my time working there I noticed that the business part really needed more structure. Like in the office and schedules. Payroll/payday was never accurate, mileage would be missing and schedule would not be available until last minute. ATC needs more structure and better office management along with communication skills.
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