New $1.4m programme to empower mild to moderate stroke survivors to take charge of own recovery

10/4/2024 10:00:00 PM | The Straits Times

The article is contributed/written by

Ms Reema Bhatti, a kindergarten teacher who suffered a stroke, is back at work at Al-Istiqamah Kindergarten six weeks after her recovery. ST PHOTO: AZMI ATHNI

SINGAPORE – Kindergarten teacher Reema Bhatti was getting her 30 charges from the Al-Istiqamah Mosque Kindergarten ready for an excursion in May when she started slurring and perspiring profusely.

Her colleagues noticed this and informed the kindergarten’s principal, who insisted she rush directly to the hospital. Fortunately, she made it in time.

Today, the 53-year-old is back at work after having spent six weeks recovering. Happy that she is safe, her colleagues now rally around her.

“They buzz around me to make sure I am okay,” said Madam Bhatti. “Some of them took over my duties of rushing around, changing the diapers of the three- and four-year-olds. My principal even monitors the number of times I drink water.”

Just such support is what a new initiative, called Reintegration for Stroke community Endeavour (Rise), aims to do for up to 1,000 patients recovering from mild to moderate stroke and their caregivers.

The initiative will “facilitate community reintegration and improve their overall well-being”, said Senior Minister of State for Health Janil Puthucheary, who was speaking at the launch of Rise at the 20th Singapore International Stroke Conference at the Academia on the Singapore General Hospital (SGH) campus on Oct 4.

Temasek Foundation will commit close to $1.4 million for the three-year project, and the programme is expected to be rolled out at both SGH and Tan Tock Seng Hospital in 2025.

“Rise will consolidate and enhance existing resources and partnerships in post-stroke care to provide comprehensive support throughout the rehabilitation process, focusing on three key areas,” Dr Janil said.

First, it will improve care coordination and support for stroke survivors after they leave the hospital by following up on screening for common stroke-related issues such as spasticity, incontinence and dementia. It will also provide patient-specific advice on medication compliance, healthy lifestyle changes and guided individualised care plans.

Second, Rise will implement a structured training programme for stroke caregivers.

Third, it will introduce the STroke Empowerment Programme, or Step, to help survivors take charge of their recovery by improving their function and quality of life.

Stroke is the fourth leading cause of death and the seventh leading cause of hospitalisation in Singapore, with one in four people likely to suffer from it in his or her lifetime.

The incidence of stroke has risen amid Singapore’s rapidly ageing population. While the number of stroke episodes increased by almost 58 per cent from 6,142 in 2011 to 9,680 in 2021, not everyone suffers massive strokes.

Neurologist Deidre Anne de Silva, an associate professor and the lead of Rise, said stroke is something that happens suddenly and can catch one unprepared.

“We envisage what life should be and what it may be in the next few years, but then this hits you suddenly, and your family or yourself may not be ready for it at all. People then have to adjust and that adjustment takes time,” she said.

“It takes a lot of different individuals – people who are caring for you physically, also people who may be helping you emotionally.”

According to Prof de Silva, who is also a senior consultant with the Department of Neurology at the National Neuroscience Institute, Rise complements the ongoing stroke care services that are already available, but it “really focuses on the transition of care from a hospital setting to the community, which is often a very difficult journey for stroke survivors”.

“(It focuses) on helping them control their risk factors and reduce the risk of subsequent strokes happening, as well as subsequent hospitalisation. It also helps them navigate the sometimes rather complex community that we have,” she said.

“(There are) many different resources, and one can get quite confused if you’re not familiar with it. So they will help them individually with their own specific needs.”

There will be a Stroke Liaison Officer serving as a single point of contact to follow up with an individualised care plan and coordinate with other community services for stroke survivors, and escalate cases to medical teams if needed.

“The plan is to have three Stroke Liaison Officers, and we are going to train laypersons. We want to have individuals, and they could even be people who have had a stroke before themselves, so they can interact with stroke survivors based on their own personal life experiences,” Prof de Silva said.

“We aim to target 1,000 stroke survivors and 1,000 caregivers as part of this pilot programme. We will be collecting the data to look (at), so that we can have evidence that, I am sure, is going to benefit individuals. And with that, we hope to scale it up to our wider community.”