It has been noted that when caregivers of stroke patients are taught caregiving methods, it leads to improved mood and quality of life of both patients and caregivers, even though it does not affect the mortality of the patients. The costs, however, are reduced. Haley and Han have previously reported a dearth of substantial research on the caregiver aspect of stroke patients and how to either train or support them in the most efficient way. However, just a year after they expressed this concern, reinforcement was made in the Royal College of Physicians Intercollegiate Guidelines for Stroke that stressed the need for support of caregivers through teaching or other forms. Bakas et al (2002) have shortlisted five important concerns and needs of caregivers. These are: emotions, information, behaviors, instrumental care, physical care, and individual responses to the process.
Along the process of teaching caregivers of stroke patients, nursing care must keep one important aspect of the same in mind i.e., even though the caregiver teaching can bring about immense social wellbeing and psychological changes in both patients and caregivers, it should not be expected to yield any remarkable impacts on physical outcomes of the patients.
The importance of teaching caregivers of stroke patients is also felt great because of the mind-boggling stroke statistics. According to the World Health Organization stroke disables around 5 million people permanently, and kills another 5 million worldwide each year. These statistics come out of a total of 15 million stroke victims each year throughout the world. In the United States alone stroke kills around 140,000 people each year, out of a total of 1 million people who suffer a stroke for the first or the second time. People aged more than 65 are the worst hit.
In Canada, 15,409 died of a stroke in the year 2000. The only silver lining in stroke incidence is that it is gradually coming down in the developed nations, primarily because of greater awareness campaigns that these countries run to reduce smoking and lower blood pressure; these are two important precursors to the occurrence of the first attack of a stroke. Such initiatives have also been undertaken in the United Kingdom where its incidence is reportedly declining. A British Medical Journal study has revealed that there was a consistent fall in stroke mortality and incidence until 2008 from 1999. Until the year 2004 per year incidence of stroke in UK was 110,000.
Stroke has devastating impacts because of the sphere that it involves. It impacts the patient, his family, and the quality of life of everybody related to the victim, which highlights its social impact too. It is a very difficult task to take care of the survivors – not only do they need professional care, the care has also to be provided on a long-term basis. Stroke victims lose community integration and social connectedness because of reduced self-image and self-esteem. Since around 80 percent of stroke survivors have to stay at home for post-hospitalization, the pressure shifts to the family members. Since family members cannot guarantee their presence at all times, replacement care costs a lot. Stroke patients at home have been reported to create chaotic dynamics in the families. Similarly, society has to bear direct or indirect costs related to stroke patients. Direct costs include services or goods related to rehabilitation, care, and treatment of stroke. Indirect costs include manpower or years lost due to disability or death from stroke respectively.
Nurses share the maximum burden of stroke patients when they are hospitalized. In each phase of care, they play an important role since they have to coordinate an effective mechanism in which they give the stroke patient all the nursing attention and at the same time teach caregivers how to shoulder responsibility at home. For nurses, stroke is a public health issue and any attempt at addressing it correctly would reduce their burden to some extent.