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Pilot project brings stroke treatment close to home

The Sunrise Health Region showed off some of the results of its Integrated Stroke Strategy pilot project with a tour of its Stroke Rehabilitation Unit in Yorkton on Monday.
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Client Esther Sawchin prepares a dessert for tour guests in the Jowsey House Stroke Rehabilitation Unit's therapy kitchen in Yorkton.

The Sunrise Health Region showed off some of the results of its Integrated Stroke Strategy pilot project with a tour of its Stroke Rehabilitation Unit in Yorkton on Monday.

The Integrated Stroke Strategy is an approach to stroke patient care that combines the efforts of rehabilitation therapists, nurses, and social workers, explained Lesley Stamatinos, the region's director of therapies.

"You might have a program that has a physical therapy service, a program that has a speech service, and one that has an occupational therapy service. What the strategy does is bring all the services together to assist the client with common goals of treatment and outcome."

Another critical aspect of the strategy is the placement of all of these services closer to home for those who need them. Previously, stroke victims had to travel to Regina or Saskatoon for their rehabilitation therapy.

The history of the Integrated Stroke Strategy in Yorkton began with a qualitative research study commissioned by the Heart and Stroke Foundation of Canada in 2004. Unlike previous studies, this one focused on the experiences of stroke survivors and their caregivers in rural Saskatchewan.

"What we found was that most people who had strokes outside the two major cities didn't even get referred for rehab," said Gwen Gordon, the foundation's director of stroke strategy. "And if they did get referred, they had very long waits."

The foundation, in partnership with Saskatchewan's health regions, submitted a proposal to the Ministry of Health for a pilot project based on an Integrated Stroke Strategy--something that has seen success in other provinces. Health Minister Don McMorris was receptive to the idea, and the Sunrise Health Region was deemed most suitable to host the project. The Health Foundation of East Central Saskatchewan raised additional funding for equipment.

The Integrated Stroke Strategy includes components of stroke prevention, emergency and acute care, rehabilitation, and recurrence prevention. On Monday, the rehabilitation component based in the Jowsey House wing of the Yorkton and District Nursing Home was in the spotlight.

As stroke rehabilitation is a long and difficult process, the Jowsey unit is carefully set up to resemble a home more than a hospital.

"The client is in their own room. They have their own bathroom to use, and they dress in the morning and then they come out to the central area to have their meals," explained Stamatinos. "It's an environment that facilitates self-care."

On Monday's tour, media and dignitaries including Minister McMorris saw the facility's clients in action as they worked their way back to independence. Traditional rehabilitation exercises and equipment are a large part of the process, but clients also practice their mobility in ways more relevant to their everyday lives: they have access to a kitchen, a Wii gaming system, and an outdoor garden.

"It's very important that [the therapy] is specific to what they want and what their interests are," said Stamatinos.

Since beginning operations in November of 2009, the rehabilitation unit has handled 14 patients who are now in various stages of inpatient and outpatient care. The majority of them have extremely positive things to say about the program, and several of their testimonials were read at the tour.

"My goal on entering the stroke rehab program was to live in my own home with minimal assistance,"

wrote Gladys, one of the unit's former clients. "Due to the therapists' hard work, patience, encouragement, and kind assistance of the Jowsey House staff, my goals have been accomplished. ... I spend hours on my own and I am able to stay alone at night."

The next stage of the program in the Sunrise Health Region will be the unveiling of the Stroke Prevention Clinic, which is intended to assist with early detection, counseling, and education about strokes. That component should be operational by the end of the year.

The expansion of the Integrated Stroke Strategy beyond the health region is a matter yet to be decided. If the final evaluation of the pilot project is as positive as anticipated, the Heart and Stroke Foundation intends to lobby for a rollout of a provincial stroke strategy and bring the benefits that Sunrise has enjoyed to other areas of Saskatchewan.

Health Minister Don McMorris' visit on Monday can only have helped with that goal.

"When you look at the successes that this project has shown us, it's hard to argue why we wouldn't expand it," he said, while noting that the decision would ultimately come down to a budget issue.