[mini-icon icon=”info-sign”] Originally appeared in the Southwestern Ontario Stroke Network 2013 Annual Report

robert_kingRobert King was not a man known for sitting still. At 62 he was planning his retirement after 37 years as a maintenance worker at Listowel Memorial Hospital, and keeping up several rental properties in the Listowel and Kincardine areas. Robert hadn’t missed a single day of work in his time with the hospital and attributed his good health to a health conscious, non-smoking lifestyle.

And perhaps that’s why what happened next was so frustrating.

On October 26, 2011, Robert was home for lunch and just ready to head back to work when he collapsed and couldn’t get back up. “I ended up crawling toward the front of the house and sort of falling down the steps before I called for one of our tenants living on the main level.” Robert knew he had had a stroke despite not having experienced any early warning signs.

Robert’s tenant, unable to enter the locked house, called 911. Local police broke in through a patio window and helped him to the ambulance which then transported him to Stratford General Hospital. Robert was rerouted by ambulance to London’s University Hospital when it was discovered that the CT scanner at Stratford Hospital was down. A CT scan indicated a brain bleed resulting in right side paralysis. Months before his retirement from a life of fulfilling work, Robert King faced perhaps the most difficult task of all – three months of rehabilitation to regain lost function and get his life back.

Robert was an inpatient at Stratford General Hospital for three months. His partner Donna, a social worker working in Guelph, made the trek from Listowel to Guelph to Stratford every day to visit him and be involved in his care. After a few weeks they had his care team’s permission to travel to Kincardine and spend time at their beloved home away from home each weekend. “Those weekends were good breaks,” comments Robert. The interprofessional care team at the hospital worked with Robert on his mobility, hand/arm use, speech, and other aspects of function that allowed him to return home capable of managing independently. The hospital staff was excellent say Robert and Donna, “they answered all our questions and kept us informed.” Stratford is a Designated Stroke Centre with stroke expertise and organized stroke care with a full interprofessional team. Louise Flanagan, Nurse Clinician with the Stroke Program, advocated for Robert to remain at Stratford for this expert care.

When Robert returned home, things were good, but he realized that he needed further support in order to return to his former life.

Louise recommended he continue rehabilitation at home with the support of a Community Stroke Rehabilitation Team (CSRT). Both Robert and Donna appreciate that the CSRT, consisting of a physiotherapist, speech language pathologist, occupational therapist and a rehabilitation therapist, took a very individual approach to care, starting with the question, “What do you want to accomplish?” This allowed them to customize their rehabilitation services to meet his personal goals. “The interventions at the hospital gave him his function back so he could be independent at home, but the CSRT helped him fine tune that function so that he could return to his previous activities,” adds Donna. Robert and Donna were unanimous in their praise of Stratford Hospital staff and the CSRT. “We can’t say enough positive words, every member of both teams was outstanding.” Robert says now that being stubborn, “isn’t all bad,” when it comes to rehabilitation. He was determined to always do to a little bit more than was suggested and pushed himself to do as much as he could.

Today he’s “95%” of where he was pre-stroke. The speed at which he accomplishes a variety of tasks is slower than it was previously, but he’s back to getting things done. More than a year and a half following his stroke, he is still regaining function – last week he realized he could easily turn pages in a book with his affected hand – and he is an enthusiastic proponent of stroke patients receiving long term rehabilitation so that they have the opportunity to keep improving.

“If it wasn’t for this team (in-hospital acute and rehabilitation teams and the CSRT), I wouldn’t have been able to be at home. I would have needed a lot of care. And I don’t want to forget to mention Donna, she was the most important support,” he concludes. “Robert worked very diligently through his rehab , he continues to pursue his rehab goals and I tell him often how proud I am of the effort he put forward,” adds Donna.

Robert’s story highlights the importance of good care by inter-professional expert teams across the continuum of care as well as the individual motivation and will to have a good outcome.