By: Jane Genova
Stroke creates an emotional vortex. Everyone who cares about the stroke victim is reeling with feelings. Those include shock, fear, anger, uncertainty, panic, guilt, and powerlessness.
But soon enough those responsible for making decisions about caregiving will be overwhelmed with the cost of after-care. Usually some kind of rehabilitation begins right in the hospital about two days after the stroke. It could be as basic as moving parts of the body or more complex like regaining some speech. The choices caregivers make about after-care may be primarily determined by the cost of each kind of intervention, the setting, and the expertise of the provider. Too often, unfortunately, concerns about the “quality of care” have to be aligned with the practical matter of cost.
According to the latest 2014 figures from the American Heart Association, the 795,000 strokes which occur each year cost the United States $36.5 billion a year. That amount is so high because stroke survivors are the largest group of long-term disabled in the U.S. For about 23 percent of them, reports the National Stroke Association, that will be their second stroke. Those serial stroke victims might require an increasing amount of services. Those range from lifetime maintenance of all physical needs to extensive rehabilitation. That’s the expense story on the macro level.
On the level of the individual patient and caregivers the practical matter of costs quickly rears its head. The healthcare system usually provides helpful medical social workers. They outline the discharge options appropriate for the patient’s immediate needs. Those, of course, can lessen, stay the same or escalate during the post-hospitalization period.
However, any choices might be filtered through what the patient can pay. To determine that, caregivers have to evaluate the patients’ coverage from health insurance policies including Medicare. Then there is the income from an employer, Social Security including disability benefits, investments, assets and savings.
Depending on those cost constraints, caregivers have to sort through a growing array of modalities. Standard ones are:
- All care will be provided at home. That usually means caregivers have to curtail their own activities such as the number of hours they can spend earning their own living. How much will be the added costs of part-time aides depends on their skill level.
- Adult daycare, especially the kinds provided by charitable and government agencies, are relatively low cost. That permits caregivers to continue with their normal routine such as jobs.
- Inpatient and outpatient rehabilitation centers might be necessary. Insurance companies tend to reimburse expenses for stays in these facilities for those left severely disabled. However, it’s imperative to examine the terms and conditions referring to length of stay, co-pay, and exclusions.
- Assisted living and residential care facilities are less expensive than nursing homes. Because they usually don’t provide onsite medical care, they are appropriate for those who can function but require some aid with personal care.
- Nursing home might be a must for those unable to care for themselves. This can be expensive. Shopping around might turn up some which are affordable. Expect a long waiting list.
In the media, there are stories of miraculous recoveries from strokes. However, even in those situations, the road back was, well, expensive. Likely it also forced caregivers to make compromises about the quality of service because of expense.
The cost factor could end. The patient regains the ability to function independently. Or it could continue for the rest of that person’s life.
It is this brutal cost reality which motivates some caregivers to research stroke diagnosis and treatment. They begin to question if this medical catastrophe could have been prevented. That is, the possibility of medical malpractice occurs to them. Could the medical system have failed to pick up an impeding stroke? Time is brain. Was it treated immediately? Was the treatment correct? Could the second stroke have been prevented?
From this initial questioning might take shape the need to investigate if medical malpractice did indeed occur. If it did then the stroke victim should receive funds for the damage done. Those could take the form of both a compensatory and punitive award payment. Such an award from the justice system would allow the patient not to have to compromise on quality of care.