Communication disorders after stroke in Aboriginal Australians

Abstract

While similar life disruptions were found to those previously reported in the general stroke population, this study highlighted differences, which reflect the particular context of ACD for Aboriginal people and which need to be considered when planning future services. While implications are limited due to small numbers, the findings emphasise the importance of a holistic approach, and integration of communication treatments into community-led social activities. Implications for Rehabilitation Aboriginal Australians frequently experience a range of concurrent and complex co-morbidities and demanding social or family circumstances at the same time as coping with communication disorders post-stroke. A holistic approach to post stroke rehabilitation may be appropriate with services that accommodate communication disorders, delivered in collaboration with Aboriginal organisations, emphasising positive attitudes and reintegration into community as fully as possible. Communication and yarning are important for maintaining family and community connection and identity, and family and community context should be incorporated into all assessment and treatment activities.

Management of stroke in the Australian Indigenous population: from hospitals to communities

“…The importance of engagement with primary community care is reinforced as some patients had no GP identified on their electronic medical record with whom the discharge summary was to be sent for completion of requested investigations. Improved communication with primary caregivers will improve the rates of completion of outpatient investigations …”

“…Improved communication with primary caregivers will improve the rates of completion of outpatient investigations. 26 The significantly reduced participation in tertiary prevention following stroke in the indigenous population is likely to have a wide-ranging impact on the health system and the individual. 27 Length of stay following stroke is decreasing due to improvements in acute management.…”

Indigenous stroke care: differences, challenges and a need for change

“…Follow up after hospital discharge was found to be minimal and fragmented. Access to interpreters for bilingual/multilingual people from remote areas is particularly problematic, both while in hospital and after discharge . Access to tele‐stroke and tele‐rehabilitation services remains limited but is slowly expanding …”

“…Access to interpreters for bilingual/multilingual people from remote areas is particularly problematic, both while in hospital and after discharge. 17 Access to tele-stroke and tele-rehabilitation services remains limited but is slowly expanding. 18,19 Aboriginal Australian stroke survivors have expressed a desire for more practical information to assist with the adjustment to hospital processes, to understand stroke and its potential consequences and to access practical support following discharge from hospital.…”

“…18,19 Aboriginal Australian stroke survivors have expressed a desire for more practical information to assist with the adjustment to hospital processes, to understand stroke and its potential consequences and to access practical support following discharge from hospital. 17 They have also expressed a recommendation for hospital staff and health service providers in general to be provided with resources to assist them in better understanding Aboriginal cultures and ways to ensure culturally secure services. Such services exist where a person can practise their cultural norms and not be compromised in any way with regard to the services they receive as a result of that cultural norm.…”