Post stroke recovery – financial help?!

Post stroke recovery – financial help?!

Strokes can have devastating effects on someone’s life in various ways; it can change your body, your personality, put huge pressure on relationships and there can be a financial impact.  You may need financial help. A stroke might prevent someone from returning back to work or for someone to require carer assistance which comes at a financial cost. At a time where the shock of your world having been turned upside down it’s hard to know who to ask for advice or help and what you’re entitled to.

In this article I will cover a few main benefits, however charities such as the Stroke Association have well advised volunteers who can help you identify what you might be able to apply for or you can contact your local social services for help.

Financial help – Housing benefits

If you are on a low income you may be eligible for financial help with paying all or part of your rent. Housing benefits will be gradually replaced by Universal Credit, so if you make a claim through Universal Credit,  any financial help you would receive will come through the Housing Element of Universal Credit. The amount of Housing Benefit you may receive also depends on your personal and financial circumstances.

What is covered?

  • If you rent a property or room from a private landlord, your maximum Housing Benefit will be calculated with the Local Housing Allowance rules.
  • If you live in council accommodation or other social housing, the most Housing Benefit you can normally get is the same as your ‘eligible’ rent

Eligible rent includes:

  • rent for the accommodation
  • Charges for some services, such as lifts, communal laundry facilities or play areas.

Even if it’s included in your rent, you won’t get any Housing Benefit for:

  • water charges
  • charges for heating, hot water, lighting, or cooking
  • payments for food or fuel in board and lodgings or hostels

 

How do I claim?

  • If you are not working then you can claim housing benefit with employment and support allowance, income support or Jobseekers Allowance, call Jobcentre Plus on 0800 055 6688.
  • If you are claiming pension credit then you can claim housing benefit with this. Call the Pension Service on 0800 991 234.
  • If you are not claiming any of the above than you can get a form for Housing Benefit and Council Tax Support from your local council.

Financial help – NHS Low Income Scheme

If you’re on a low income, this scheme could help you pay for all or some of your health costs. The amount you receive will depend on your household income and outgoings.  The help you are entitled to is also available to your partner.

You could get financial help towards:

  • NHS prescriptions
  • NHS dental treatment
  • sight tests, glasses and contact lenses
  • necessary costs of travel to receive NHS treatment

Who can apply: http://www.nhsbsa.nhs.uk/HealthCosts/1136.aspx

How to apply: http://www.nhsbsa.nhs.uk/HealthCosts/1128.aspx

 

Financial help – Personal Independence Payment (PIP)

What is it? If you need extra help because of an illness, disability or mental health condition you could get Personal Independence Payment (PIP)

To be eligible for a PIP, you must be:

  • be aged 16 to 64
  • need help with everyday tasks or getting around
  • have needed this help for 3 months and expect it to need it for another 9 months
  • usually be living in England, Wales or Scotland when you apply
  • have lived in England, Wales or Scotland for at least 2 years

There are exceptions to these rules if you’re terminally ill or in the armed forces

Click here for further details: https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/help-with-your-pip-claim/how-to-claim/

 

Financial help – Council Tax Reduction

Council Tax Support (or Reduction) is a local discount on your Council Tax bill.  Every council in England has a local scheme for reducing the Council Tax paid by people on low incomes.  The amount of help you’ll receive will depend on which part of the country you live in as each scheme is set locally.

How do I apply? Contact your local council for an application form.

These are just a handful of benefits or financial reductions you may be entitled to. Use the links below to help you investigate further.

Useful links

Benefit Calculator: https://www.gov.uk/benefits-calculators

Government UK: https://www.gov.uk/

Citizen’s advice: https://www.citizensadvice.org.uk/

Stroke Association: https://www.stroke.org.uk/

Written by Rachel Dines, Speech and Language Therapist

 

After a stroke – what does mental capacity mean?

After a stroke – what does mental capacity mean?

What is mental capacity? The severity of a stroke can be life changing, to the extent that the person you love can no longer have the ability to make decisions about their life and what’s best for them; this can be as simple as staying in a hospital to recover or larger decisions such as stopping treatment.

What is Mental Capacity?

Mental capacity means you have the ability to make your own decisions.  This means you are able to understand and think through information given to you and then you make your decision and choice based on this information.

All of us struggle to make certain decisions in life, especially those we haven’t had previous experience of. However struggling or being indecisive is not the same as not having the capacity.

The Mental Capacity Act 2005 is designed to protect individuals and support those who may lack the mental capacity to make decisions about their care, treatment, placement and any other decision they entail.

Important points:

  1. Someone’s lack of mental capacity can be temporary for example due to infection or initial brain injury. For others, lacking capacity can be permanent.
  2. The assessment of someone’s capacity is decision specific; therefore every decision which needs to be made requires a separate assessment. Just because someone cannot make a decision about their complex financial affairs does not mean they are unable to decide what they would like to eat or drink.

How does someone’s capacity get assessed?

Within the context of the healthcare service, someone’s capacity can be assessed by a doctor, a healthcare professional or a social worker.  If someone has a communication difficulty due to a brain injury then a speech and language therapist will advise and facilitate an assessment to ensure that the information is given to the individual in the most accessible way.  This can be through pictures, simple single words or simple yes/no questions. The assessment must be made as patient centred and accessible as a possible to ensure the person is given every opportunity to understand the information and the decision being made.

There are 4 stages to assessing someone’s capacity for each individual decision, and the individual must demonstrate that are able to carry out each stage.

  1. An individual must understand the information given to them.
  2. An individual must retain that information, there and then in the assessment
  3. An individual must be able to weigh up the information and what the choices are in relation to that decision
  4. An individual must be able to communicate their decision to the assessor. This can be in any form of communication.

 

What happens if someone hasn’t got capacity?

If someone hasn’t got the capacity to make the decision in question then a decision will be made in their ‘best interest’.  In order for the decision to be in someone’s best interest the individuals wants will be taken into consideration, along with the information from people who know them best and who would know the individuals wishes.   If the decision is medical, then the decision maker tends to be a doctor.

How to prepare for the future

Anyone can plan for the future and ensure their wishes are known or hand over the responsibility of making decisions to another person they trust.  This can be achieved in various ways:

Important things to remember:

  • Everyone is deemed to have the capacity until proven otherwise
  • Capacity is decision specific

Written by Rachel Dines, Speech and Language Therapist

 

 

 

Switching roles – the hidden impact of a communication difficulty on the partner of a person with a stroke.

Switching roles – the hidden impact of a communication difficulty on the partner of a person with a stroke.

Julie was always the mother, home-maker and the organiser. With 3 teenage children including a son with a developmental disability, she already led a very busy life. Julie was used to looking after her son Ryan, taking him to medical or therapy appointments and getting him to and from school in his wheelchair. That was until her husband, Simon, an adept and hard-working businessman, had a large stroke. After the stroke, Simon had a severe right-sided weakness and an acquired communication difficulty. He was 40 years old.

“The day Simon had the stroke, my world turned upside down. He was always the one who earned the money in the household and paid all the bills. I was always the one who looked after the kids, did the shopping, kept the house in order and made the meals for everyone. I was also the kids taxi service. But now I feel that I have to do everything, absolutely everything! We are so lucky that Simon had illness and disability insurance, but it was about 6 weeks before this started so we had to live on our savings for a while. I don’t know how I would have coped if it hadn’t been for the help and support of family and friends during those dark days”.

Switching roles with stroke – Carer in two senses

Julie, without realising it had extended her role as carer beyond her child to her husband as well. The emotional impact of this role change cannot be underestimated. The main emotional support she used to leaning on was not only gone, but now needed significant support himself. The changing dynamic from equal partner to carer changes the power dynamic in a relationship from emotional, financial, practical and sexual perspectives. This can place a partner like Julie under extreme stress and can, understandably, lead to anxiety and depression. Research indicates that carer stress is a significant burden in general in modern society leading to an increasing burden on mental health services.

Often the systems that are put in place to support the partners of people with disabilities to cope are critical to supporting the person with a stroke with the whole of their rehabilitation process. Overly stressed carers find it very difficult to support the person with a stroke to take achieve their independence. Some partners have more internal resources, experience and skills than others. For Julie, her experiences supporting her disabled son proved highly useful in supporting the rehabilitation of her partner, Simon. She often underestimated her role and found it difficult to see how amazingly resilient she was.  Each carer and each situation is different and the package of support required needs to be carefully considered in an individually sensitive way.

Time poor

Therapists often have expectations that family members will support therapeutic goals for the person with a stroke with daily practice of their goals. However, for Julie, who is so very time poor, unless the goals are embedded in everyday life there would be no chance of her supporting her husband to achieve them. The importance of an effective multidisciplinary team and particularly social work support to engage a range of social care services to enable her to manage her time effectively cannot be underestimated. Formal and informal respite care, to enable Julie to have guilt-free time for herself on occasion was also essential for her longer-term mental health and well-being.

Over time as Simon with the help of Physiotherapy and Occupational Therapy became more physically independent in his self-care and mobility, so the potential burden for Julie had begun to lift. However, despite this often carers can become locked into the safety and security of their coping systems. It can be that they do not see where or when they can step back a little and allow their partner to try to resume activities that their partner once used to do independently. This is most obvious for physical activities but can also be true for communication tasks such as answering the door or the phone, doing the family finances, or doing online ordering of groceries. For Julie, her dawning awareness of where she could encourage communication independence was a revelation.

“I’ve been doing the online banking to pay the bills ever since Simon had his stroke. Only the other day I noticed Simon looking over my shoulder at what I was doing, when I realised he wanted to try and do it himself but had totally lost confidence. I was in a hurry and thought to myself I don’t have time to do this with him now. But instead of just ignoring it, I asked him if he wanted to try to do the banking again, another day, with my support. He jumped at the opportunity. Afterwards I realised that if I supported him to do this for first few times by giving it some extra time, then potentially he could do it independently and this would free me up to do other things. It also would be great for his self-esteem. So, I was very pleased with myself for talking about it the way I did with him”.

A few years later, Julie and Simon were coping well. Simon continued to be motivated to do his rehabilitation and was doing more and more activities independently.

“I used to do the grocery shopping at the local supermarket but now Simon does all of our grocery shopping online. This has saved me about 4 hours a week and I am so pleased that I do not have to go through the checkout anymore with an overflowing shopping trolley! We’ve settled into a routine with it and it works really well .. Simon is now working to get his driver’s licence back and if that is ok then we will get his car adapted so he can get himself to his medical and therapy appointments independently.”

Power dynamic

Their life is moving forward in a smooth, albeit fundamentally different manner with the roles switching again but this time more positively with Simon doing more domestic tasks himself. The power dynamic in the relationship between the couple looks to continue to be on a much more even keel.

For more support and information try out our free stroke recovery speech and language course put together by our Iris Experts Team www.irisspeaks.com/stroke

By Kim Clarke, Speech and Language Therapist MRCSLT, MSPA, MASLTIP.

My Dad used to be a corporate high flyer but after a stroke he can’t speak anymore

My Dad used to be a corporate high flyer but after a stroke he can’t speak anymore

“Simone* (not her real name) posted this query on a social networking website. Then she went onto explain that her dad had high blood pressure and didn’t know it, one day he was well and working hard in his busy job in the city, next day he was in hospital after having a stroke on the way to work. He was due to do a big presentation to a large group of people and then felt faint in the taxi and managed to ask to be taken to hospital before he lost consciousness.

After that, it was as though he was completely silenced. He had a little bit of right-sided weakness but otherwise he was able to walk around and do most other things as normal. We had no idea of what it was until the doctor mentioned that he had had a stroke and had something called “Aphasia.” Some people say that these symptoms can resolve in about 24 to 48 hours but although Dad recovered a little bit of his speech after a few days, he was not back to normal!

The next few weeks were a blur with a short stay in hospital, investigations, lots of doctors, a pile of new medications and loads of information leaflets. Dad was discharged home pretty quickly before Christmas and he’s still on the waiting list for community speech therapy in his local NHS service. Although he looks well and is able to walk around as normal, he is struggling to say what he thinks and is starting to get really down about his talking. It’s not just his talking as well, his writing is affected – he just holds the pen but can’t seem to find the words to write down.

My mother, brother and I are at our wit’s end with not knowing what to do for him. There is no way that he can go back to his work right now because he used to be meeting with people, talking and presenting every single day. It’s been devastating to everyone in the family. Every single aspect of our life has been touched by this… Aphasia. What can we do to help him?”

 

Aphasia, or a language impairment that can occur after a stroke or brain injury and can be devastating because in today’s society, for the digital age and the work-place, communication is a critical skill. At any time, there are around 250,000 people in the UK who have aphasia and many of these people will be under retirement age1.

Hidden disabilities

Communication difficulties are often considered hidden disabilities because, they are not as visable as physical or sensory disabilities. Aphasia can affect all aspects of language function such as speaking, listening, reading, writing and even calculation skills. It can be devastating to relationships and self-image as so much of a person’s self-esteem, identity and personality is intimately intertwined with language skills.

The importance of a good social network and family support for someone with Aphasia cannot be underestimated. Emotional support is vital in helping the person with this devastating “silent” disability cope with the impact of the loss of aspects of, or all of their language skills in their life. This loss can impact on everyone in the family, particularly if the person with aphasia was the primary wage earner for the family as described above. Awareness of the impact of this loss on the person with aphasia’s (and their carer’s) mental health is also very important.

Fortunately, there is quite a lot that can be done to support someone with aphasia to improve their ability to communicate and support their mental health.

Services to access

The most important first step for this family to take is to try and get the support of a HCPC registered Speech and Language Therapist. A range of services exist, from the NHS to the private sector. Families should also be aware that they it is permitted to them to access private services whilst on a waiting list for their local NHS services. Help for finding services is available from the Royal College of Speech and Language Therapists and the Association of Speech and Language Therapists in Private practice. A Speech and Language therapist with specialism in stroke and aphasia can help shape their treatment goals into steps that can assist to maximise recovery, guide realistic expectations and help create a social environment that can support the person’s ability to communicate using all means available to them. The Speech and Language therapist can also provide emotional support and counselling related to communication which is invaluable for the person with aphasia and their loved ones. Support can also be provided by the Speech and Language therapist through liaison with the GP to arrange treatment for mental health problems that can arise related to the communication disability such as depression or anxiety.

Goal setting

Many aphasia clinical guidelines indicate that highly frequent practice of language skills (such as 45 minutes per day) in targeted activities are useful in regaining language function for those who can tolerate it. Whilst for many people with aphasia most of the spontaneous natural recovery occurs in the first 12 months, many guidelines have indicated that continued gains can be made in the longer-term particularly when the person with aphasia is motivated and able to participate in increased intensity of treatment. Preliminary goal setting should happen first to assist the therapist in choosing the right assessment tools to help the person with aphasia to achieve their realistic and meaningful treatment goals.

Treatment options for aphasia are often longer-term depending on the nature of the person’s needs, the severity of their communication issues and the availablity of people to support them. Treatment can include face-to-face as well as technology based treatments. Often a combination of the two are very beneficial in supporting the person with aphasia to achieve a more intensive treatment approach. Adult children of people with aphasia, who may be more technically savvy than their parents, are ideally placed to help their parents. From the set-up of their computer with the Speech and Language therapist recommended software and apps or just to support them in general to increase their familiarity with the technology.

Family and friends can also help to create a supportive environment to enable the person with aphasia to communicate successfully through:

  • using short clear sentences – give one piece of information at a time
  • don’t rush – allow time for the person to take in what you are saying
  • be patient – give the person with aphasia space to respond at their own pace
  • encourage the person to communicate in any way he/she can
  • encourage the person to let you know when they have not understood
  • clarify – and rephrase when necessary

 

In the longer-term however, it may not be possible for the person with aphasia to return to all of their previous function and roles depending on the nature and extent of their communication disability. However, with a supportive environment, their ability to create communication (through the use of gesture, technology, photos, writing, drawing, reading and speaking) can be amazing!

If you’re interested in finding out more check out our free tailored 10 part inbox speech and language therapy courses. Designed by our Iris Speaks Experts to help your family on their speech and language journey. Sign up here!

We’ve put together 9 tips for highflying stroke survivors and their families – a must see!
Click Here to Download PDF

1 The Stroke Association, 2008.

Written by Kim Clarke, Speech and Language Therapist

Finding help and support after a stroke

Finding help and support after a stroke

David, 67, was a retired mechanical engineer, who lived alone. He had his stroke in September 2016, and was seen for speech and language therapy for 7 months. His stroke left him with no speech, but he was able to understand what people said.

David and his speech and language therapist spent a long time working together on alternative ways of communicating. David took a shine to the use of his iPad as a way of communicating with others. He used the app ‘Predictable’ and also would use the internet and pictures to reduce the barrier of no speech.

David used to go to the football every Saturday to watch his beloved Chelsea, he didn’t feel confident enough to do this, as he would be seeing familiar faces, and having to communicate in such a different way. He did not feel ready to do this, even though this was a big part of his life he missed.

His speech therapist suggested his local stroke communication group, David went along and 9 months later goes every week, and reports back to the group how Chelsea played the previous Saturday. David attended the group and after 4 months of increasing his confidence and having positive interactions with his peers using his iPad and having their support, he returned back to watching football.

Getting back to a new normal post stroke

When all of the NHS therapy appointments have stopped and you’re trying to adjust back to some sort of normality, it can feel like your world has become very small. Having a communication difficulty following a stroke can make interacting with the world around you seem impossible. Feeling like this is not unusual and can cause you to question what your future will look like.

Adjusting to your new situation is difficult for yourself and the loved ones around you. This takes time and involves the courage to accept what has happened and to look forward. What you need to remember is you are not alone and you can go out, meet new people and enjoy the aspects of life you once used to.

Although you have had your friends and family around you, supporting you through your recovery, living with a communication difficulty is hard to understand unless you’ve been through it yourself.  This is why accessing local stroke groups in your area is a great way to seek support from someone who can relate to what you have been through and is a great way of building up your confidence to get back out doing what you enjoy.

What groups are there?

The two main organisations in the U.K that provide groups are ‘The Stroke Association’ and ‘Headway’ but there are also locally formed groups in your area. Depending on your local area will depend on what types of groups are available to you.

Stroke Association- www.stroke.org.uk

The Stroke Association is the UK’s leading stroke charity and is a vital resource for anyone who has had a stroke. The website offers support in understanding what a stroke is and the affects is causes along with a directory of groups. The stroke association offers different types of groups; long-term support, stroke clubs and communication groups. All of these groups allow someone to meet individuals who have also survived a stroke and for them to share their story. These groups give someone the time to build up their confidence in a safe environment and slowly integrate back into society at their own pace. The communication groups are a particularly a great supportive space for someone to adjust to any communication difficulties they are having and to practice any new communication strategies they have been given.

Headway- www.headway.org.uk

This is a UK wide brain injury charity and has branches and groups around the country. There website is another great resource with lots of information and guidance on living with a brain injury and what other support is out there to access. Headways services are open to anyone with a brain injury and depending on your local branch they can offer a range of services; support groups, help with returning to work, support with volunteering opportunities and even exercise groups. All of these services allow someone to return to some normality in their life but at the same time with support, knowledge and advice.

Importance of socialising to recovery

Trying to return to some normality after a stroke can be difficult, scary and daunting. Accessing groups as suggested above will allow someone to take that first step but with a little bit of support.

We’ve put together 12 things carers should know after a stroke in takeaway PDF for you

Click Here to Download

Good Luck!

If you’re interested in finding out more check out our free tailored 10 part inbox speech and language therapy courses. Designed by our Iris Speaks Experts to help your family on their speech and language journey. Sign up here!

Written by Rachel Dines, Adult Speech and Language Therapist