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Tuesday 26 September 2023

The financial impact of having a stroke

Managing Money After a Stroke

One way to alleviate some of the costs incurred after a stroke is to review your health insurance to ensure you are getting all the benefits you are entitled to. — Freepik

A big financial impact

The aftermath of a strokr can be expensive with medicines, assistive devices, home modifications, and caregiver costs, coupled with potential loss of income.

The financial impact of a stroke can be overwhelming and unpredictable.

The lifetime cost of ischaemic strokes – which comprise over 80% of strokes and are caused by blockage of blood vessels supplying part of the brain – were estimated at US$140,481 (RM659,698).

This includes the cost of inpatient care, rehabilitation and follow-up care.

A study that looked at the cost of post-stroke outpatient care in Malaysia in 2015, found that the average total cost incurred was US$547.10 (RM2,569.18).

Of this figure, 36.6% was spent on attendant care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and 8.5% on out-of-pocket expenses.

The main factor in the cost of post-stroke outpatient care was the severity of the stroke.

Increased costs was also associated with a haemorrhagic stroke – the other main type of stroke, which is caused by the bleeding, or haemorrhage, of a blood vessel in the brain.

Leading a safe and cost-effective life post-stroke requires a combination of self-care, medical management and lifestyle adjustments.

Here are some steps that can help:

> Follow medical advice

It’s important to follow your healthcare provider’s advice on medication, rehabilitation and lifestyle modifications.

This may include taking medication as prescribed, attending rehabilitation sessions, and making changes to your diet and exercise routine.

> Manage chronic health conditions

If you have other chronic health conditions such as high blood pressure or diabetes, it’s important to manage these conditions to reduce the risk of future strokes and other health complications.

> Make home modifications

Consider making modifications to your home to reduce the risk of falls and improve your safety.

This may include installing grab bars, non-slip mats and handrails.

> Use assistive devices

Assistive devices such as canes, walkers and wheelchairs, can help you maintain your mobility and independence.

> Adopt healthy habits

Adopting healthy habits such as eating a balanced diet, exercising regularly and getting enough sleep, can help you maintain your overall health and reduce the risk of future strokes.

> Stay socially active

Staying socially active and engaged can help reduce the risk of depression and improve your overall quality of life.

Consider joining a social group or doing volunteer work.

> Manage finances

Stroke can have a significant financial impact on the family, especially if the stroke patient is the sole breadwinner.

So it’s important to manage your finances carefully.

By following these steps and working closely with your healthcare team, you can lead a safe and cost-effective life post-stroke.

Managing the financial impact

As mentioned above, no doubt, one of the biggest challenges post-stroke would be the financial impact on the patient and their dependents.

Financial burdens following a stroke may be due to medical expenses and decreased income because of the inability to work, whether it is the patient themself or a family member who has to quit their job to become a full-time caregiver to the patient.

Addressing financial needs post-stroke can be challenging, but here are some strategies that can help:

> Review your insurance coverage

Examine your insurance coverage to make sure it includes all the necessary benefits and services, such as rehabilitation and home healthcare.

Consider speaking with an insurance specialist to ensure you are getting the most out of your coverage.

> Explore disability benefits

If you are unable to work because of stroke, you may be eligible for disability benefits.

Socso provides a range of benefits for employees, including medical treatment, rehabilitation and financial assistance.

There are also many NGOs (non-governmental organisations) that offer financial assistance to stroke patients and their families, including the National Stroke Association of Malaysia (Nasam), Stroke Care Malaysia, etc.

These organisations can help with medical bills, transportation costs and other expenses related to stroke care.

> Create a budget

You and your dependents should review your daily expenses and financial commitments to see what can be adjusted to compensate for the decrease in income and increase in stroke-related expenses.

A leaner budget might have to be created for the family to follow, to ensure that you don’t go into unsustainable debt, or even bankruptcy.

What’s good for yourself

It is also important, though challenging, to develop a sense of what is good for oneself after a stroke.

Here are some methods that can help:

> Listen to your body

Pay attention to your body and how it responds to different activities and situations.

Take note of what makes you feel better or worse. and adjust your routine accordingly.

> Set realistic goals

Set achievable goals that are tailored to your abilities and interests.

This can help you build confidence and a sense of accomplishment, which can improve your overall well-being.

> Prioritise self-care

Make self-care a priority, including getting enough rest, eating a healthy diet, and engaging in physical activity, as recommended by your healthcare providers.

> Seek support

Connect with others who have experienced stroke or other health challenges.

Consider joining a support group or seeking individual therapy to help you process your emotions and develop coping skills.

> Practice mindfulness

Mindfulness practices such as meditation, yoga or deep breathing, can help you become more aware of your thoughts and feelings, and develop a greater sense of inner calm and well-being.

> Experiment and adjust

Be willing to experiment with different approaches to self-care and self-discovery, and be open to adjusting your routine as needed.

By focusing on self-care, seeking support, and staying open to new experiences and perspectives, stroke patients can develop a greater sense of what is good for themselves and their overall well-being.

In a nutshell, it is not impossible for a person to regain a normal life after a stroke.

The real challenge lies in how stroke survivors can manage their post-stroke life and deal with the challenges from then on effectively.

Remember, there will always be light at the end of the tunnel for stroke survivors!

Dr Lee Tze Yan is a senior lecturer in molecular medicine at Perdana University. Matthew Teo Yong Chang is an occupational therapist specialising in stroke rehabilitation and senior lecturer at Manipal University College Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Life after a stroke, post-stroke care crucial

Tuesday 28 July 2015

Ageing together: it takes a nation, family; more children if you can afford to

THE Government cannot face the challenges of an ageing nation alone, Deputy Women, Family and Community Development Minister Datin Paduka Chew Mei Fun says.

The problem requires a joint effort involving the Government, local councils, developers, insurance companies, non-governmental organisations (NGOs) and individuals, she says.

“Everybody must be responsible and do their part,” she insists.

Giving an example, she says developers should plan townships for senior citizens to grow old within the community “like one big family”.

She says local councils also play a very important role in ensuring that the roads and buildings are accessible to the elderly.

To encourage collaborations between the NGOs, the Government gives incentives to corporations to run corporate social responsibility projects, she says.

She says individuals have to plan for old age by keeping healthy and active and saving for their future needs.

On plans to build more homes to accommodate the growing number of seniors, she says the ministry hopes to de-institutionalise homes because a family environment is always better.

However, legislation forcing grown children to care for their parents, is “not the way”, she stressed.

She says cultivating values like filial piety by stressing on the importance of family bonds through education, is preferable.

“We have nine (registered) old folks homes nationwide with a total of 1,590 residents.

“And, there are an additional two homes housing more than 200 bedridden residents, 70% of whom are above age 60.

“If we accept residents too easily, some will just send them to us because it’s convenient,” she says, adding that five activity centres for seniors will be built in addition to the existing 45 nationwide. The number will be increased steadily.

She says ‘caring complexes’ housing both seniors and orphans are in the pipeline.

“The idea is for kids to cheer up the seniors while learning from their elders,” she says.

She says better health services have led to Malaysians living longer with couples now having to care for their children, parents and grandparents.

Acknowledging that it’s a huge financial burden, she says the ministry is trying to educate young couples on how to better plan for their family.

Explaining that family planning isn’t just about birth control, she says it entails managing family finances.

“We’re not asking couples to give birth blindly but if you can afford to, you should have more children,” she says.

On June 14, Sunday Star front paged how urban parents can expect to pay as much as the combined price of a luxury car and a semi-detached house to raise a child up to degree level. The report followed a remark by Women, Family and Community Development Minister Datuk Seri Rohani Abdul Karim urging Malaysians to have more kids to address the projected shrinking population.

National Council of Senior Citizens Organisations Malaysia president Datuk Dr Soon Ting Kueh is “very disappointed” that the country’s seniors were left out of both the 10th and 11th Malaysia Plan, lamenting that the elderly are a neglected lot.

“There is no social security for the old,” he points out.

Calling for a national forum to be held fast, he cautions that the country may reach aged nation status even before 2030.

“Everyone will grow old. The only question is when.

“We must tackle these challenges together but the Government has to spearhead the solution with a detailed development plan.”

While supportive of the Government’s call for couples to have more kids, he feels that it won’t solve the problem.

Suggesting a private pension fund be set up, he says it will ease the financial burden on families caring for their old parents while giving the seniors a sense of independence.

Seniors who are poor and without family must be cared for by the Government, he insists.

“There aren’t enough government old folk homes nationwide,” he says.

“We need at least 90 but we don’t even have one per state.”

Those who can afford private nursing homes are also suffering, he says.

He estimates there are some 4,000 private centres nationwide but only slightly more than 200 are regulated.

“Some pay between RM500 and RM600 to live in very poor conditions where seniors are hosed down instead of getting a proper bath.

“These unlicensed homes are stinky and the living conditions very undignified,” he says.

He feels that country’s healthcare system also needs to be improved.

“The waiting time is too long and there are not many geriatric doctors.

“The seniors will be dead by the time they get treatment,” he says, only half-in-jest.

But, he stresses, the seniors themselves must grow old with dignity by keeping active.

Soon’s deputy, Susan Suah, says there’s a need for aged-friendly housing.

The interior designer is working to come up with building guidelines. Some problems in current housing include the lack of bathrooms on the ground floor, switches that are too high up and poor lighting, she says.

“We have rooms for maids but not for old parents?,”she says adding that aged-friendly homes must be made mandatory.

Universiti Sains Malaysia (School of Social Sciences) associate professor Dr Saidatulakmal Mohd notes that while some supermarkets and shopping centres have started becoming aged-friendly, none of the new housing developments are.It’s worse when residential houses are converted into nursing homes for the elderly as it has been proven to be non-conducive to their wellbeing.

“We don’t need to wait until Malaysia becomes an aged society. Many of the elderly are already being abandoned and abused, she says.

“While it’s easy to point to the Government for a solution, it’s important to note that welfare aid for seniors has risen over the years.”

To cover rising public healthcare costs, she anticipates higher taxes for the future generation.

But unlike their parents, youngsters today don’t expect their children to care for them in their old age.

“This is because they are facing financial hardship providing for their family while supporting their aged parents and don’t want their children to go through the same thing,” she explains.

She calls on the Ministry of Women, Family and Community to bring back the ‘elderly in the community’ initiative to promote active ageing.

To be a developed nation by 2020, we need active seniors who can contribute to the nation but this is only possible if aged-friendly infrastructure is ready and the elderly are financially supported.

“In the UK, I saw seniors shopping for groceries, paying their own bills and eating out - which is rare here.

“In Malaysia, seniors are seen as ‘abandoned’ if they do these things themselves.

“The perception needs to change.” - The Star/Asian News Network

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Not ready to age

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