“I’m sure patients are tired but environmental factors are very big factors about not being able to get any rest on top of having a stroke [3,39].” “…feeling tired well that’s post stroke fatigue [which] will hopefully be alleviated with time. [2:17]” This attribution may be indicative of the perceived focus of palliative care within an acute stroke context: usually end of life care for patients with a poor prognosis. “You’ve got the acutely ill patients, who’ve had

massive haemorrhage or a massive infarct and you can tell that they’ve sustained significant damage and that they’re not going to recover from their stroke. [2:5]” The physical consequences of stroke were associated with concerns about dependency and disability, Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical with half of the participants reporting worries about the effects of stroke on families, and one in four felt they were likely to need more help than their family could provide. Approximately 50% experienced some form of psychological

distress such as ‘anxiety’, ‘low mood’, ‘confusion’, ‘poor concentration’ and ‘loneliness’. The SPARC data indicated that one in every four stroke patients had some concerns about death or dying. Whilst staff indicated the importance of helping patients and families to ‘cope’ psychologically with stroke consequences, whether this selleck chemicals llc constituted palliative care was Inhibitors,research,lifescience,medical contested, with some participants preferring to use the term ‘supportive care’. A tentative distinction between supportive and palliative care that emerged focused on the degree to which patients were being actively treated. Palliative care was viewed as supportive

by some participants only when the overarching patient Inhibitors,research,lifescience,medical management strategy was active treatment such as rehabilitation. Palliative care was thought to relate Inhibitors,research,lifescience,medical mainly to the withdrawal of interventions. “…palliative is almost like stepping back. You’re alleviating any problems that they’ve got, like with pain, tiredness or discomfort but you’re not actively rehabilitating them. [2:24]” Capacity for palliative care Features of the stroke service model include rapid access to a specialist service and the commencement of early interventions such as thrombolysis and rehabilitation. Rejection of the historical therapeutic Drug_discovery nihilism around stroke has resulted in an increased patient acuity within an acute stroke service. “In the past, we’ve only brought people to the acute Stroke Unit for assessment when they have been awake enough for assessment or else deemed ready for assessment. So if we saw them on the MAUs and they were unconscious or really quite poorly and expected to die, then we wouldn’t bring them down. But now, because … we are a specialist unit … we have a better turnover, faster discharges and fewer bed-blockers … those patients come down to the Stroke Unit where the staff are geared up for assessing patients and rehabbing the patients, to a very active environment.