Beyond acute care: addressing the behaviours that can lead to second strokes

At 63, Peter Scott had an unexpected wake-up call that changed his life.

Now retired, Peter suffered a brain haemorrhage while on a work trip in Seattle, US, and shared his story with Aged Care Insite. 

While he was physically fit at the time, doctors believed that his stroke resulted from work-related stress and high blood pressure.

"After years of fast-paced, high-stress work in the IT industry, my body decided enough was enough," Peter said.

"I'm lucky that my colleague was next to me, who recognised the signs and took me to the hospital.

"It was a wake-up call for me. Despite living an active lifestyle throughout my childhood, it became evident my health had fallen second to my career and work goals."

Stroke is among the top leading causes of disability and reduced quality of life, with the medium age of having a first stroke being 75 years. 

Although a stroke can occur at any age, older people surviving one are at higher risk of mortality and poorer functional outcomes.

Research suggests that making healthy life choices and receiving appropriate support afterwards can help reduce these aspects. 

Peter, now aged 70, agrees that making healthy lifestyle choices is vital and prioritising your health over your career and life goals.

"You think you're in balance, but you might not be because you've been pushing yourself so regularly that it becomes normal," Peter said. 

"The plan of moving forward is much easier; it's generally changing your lifestyle. You need to be careful about your diet and exercise."

He was determined to make a full recovery and took a course in mediation to practise mindfulness. 

"Natural medication is probably the best treatment and being able to relax properly.

"I guess that's something I learned through the experience," Peter said.

Another recent study found that a stroke reduced a patient's life expectancy by five and a half years compared to the general population.

"This meant a stroke reduced a person's life expectancy by one-third," the authors of the University of Queensland report said. 

"We need to provide multidisciplinary care for these patients, which is known to reduce death and disability after a stroke."

Senior author Professor Billie Bonevski from Flinders University explored ways to offer easy and accessible support to stroke survivors after hospital care.

She created an interactive, tailored healthy lifestyle program that positively affected the participant's self-reported health and well-being.

"It was instigated by the realisation that many people who have a stroke receive the acute care initially in hospital, but then don't get a lot of ongoing care," Bonevski said. 

"There's a number of risk factors that are modifiable behavioural risk factors, such as smoking and nutrition, that we can target to lower people's risk of having that recurrent stroke.

"We found that the program improved the survivor's self-rated quality of life. In particular, things that are important for their day-to-day living."

Bonevski noticed in previous studies that people tended to return to their old behaviours after their hospital release.

People who, for example, used to smoke before their stroke picked up the habit again afterwards.

"The risk factors they had before the stroke often had the same risk factors after," Bonevski said.

"That means that after their stroke, they went back to smoking and drinking and their blood pressure went up again.”

The program tailors information based on their risk factors and provides ways how they can change their lifestyle.

Counselling and cognitive behaviour therapy provide practical strategies to change elements in their day-to-day activities to prevent a recurrent stroke. 

“For the future, we'd like to roll out the program nationally in the community so that any stroke survivors can use this,” Bonevski said.

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