More therapists needed to help stroke patients fully recovery

There are not enough certified occupational therapists (OTs) on island to deal with people who suffer from strokes, while physiotherapists are also carrying a heavy burden because their numbers are also few.

Those disclosures were made by occupational therapist Melanie Buge and president of the Physiotherapy Association
Dr Gerry Warner at the Heart & Stroke Foundation of Barbados 35th anniversary public lecture and panel discussion at the Walled Garden Theatre of the Barbados Museum on Tuesday night, ahead of World Stroke Day celebrated on Thursday.

“There is one physiotherapist for the entire polyclinic system. At QEH [Queen Elizabeth Hospital] we have two physios in out-patient rehab and each of them sees 10 patients a day, so that is 50 visits per week that we are managing,” Dr Warner said.

“You are only able to feed 50 in at one time and stroke rehab is not quick. It is not a six-week treatment session.

“It is months that you are going to be with us. There is a fundamental . . . need  for a rehab plan.”The bigger challenge, however, is the lack of occupational therapists, not only in Barbados but the rest of the Caribbean.

The specialty is only taught extra-regionally and there are no occupational therapists in Antigua or St Vincent, while Jamaica only has six.

Buge, an occupational therapist at the QEH, said she was on the Stroke Unit for five years and for three of those years she was the only one. An additional OT was eventually hired in April this year.

“We do have two occupational therapists on the ward. However, we only cover the unit for 30 hours a week, which is not nearly enough to manage the patients that we see on a daily and weekly basis on the Stroke Unit,” she said, adding that in addition to the in-patient rehabilitation and the multi-disciplinary round that occurs every week, she also conducts home safety assessments for patients who are deemed to be severely disabled.

“We have no OTs in the public sector who manage patients in the polyclinics or the district hospital. The rehabilitation therapists are now in contact with the occupational therapists in order to facilitate that form of therapy in the community. They are 13 practising OTs on the island; four of us specialise in
physical dysfunction.

“We are getting a few graduates coming home as a result of COVID so the numbers are increasing between the end of the year and 2021, but still it is nothing in comparison to where we need to be. We have a lot of work to do and we are working really hard,” Buge added.

She said occupational therapy is often overlooked and the association was engaging the public to help people understand what OT is and the value it brings to the rehabilitation team.

Featured speaker Professor Anthony Rudd, Emeritus Professor of Stroke Medicine at King’s College, London, in delivering his lecture on Huge Strides in Stroke Management, said high-quality after-care for a stroke sufferer is critical.

“It is worth investing in the people necessary to provide that treatment, so you have to make sure you have the right number of doctors, nurses, therapists.

“It is important to ensure that longer term help and support is available for patients and their carers,” Rudd said.

Dr Natasha Sobers also echoed the sentiments about rehab. She said a medical student had examine the availability of the stroke rehabilitation and the challenges of accessibility.

“We have to think about those people who are living with the stroke and are not having clear access to the rehabilitation that they need to then become independent,” the doctor said. (IMC)