No place for brain injury patients

CLARE brain injury patients have to travel outside the county for vital residential rehabilitation facilities because of a Health Service Executive (HSE) anomaly, it emerged this week.

The Clare Champion has learned that people suffering from brain damage cannot secure admission to a top-quality multi-disciplinary team in St Joseph’s Geriatric Hospital, Ennis, unless they are over the age of 65.
Clare patients under 65 years have to try to secure services at St Camillus’ Hospital in Limerick, private facilities that haven’t the necessary rehabilitation services or the National Rehabilitation Hospital, Dublin.
According to the HSE, health services in Clare are conducting a detailed review of this anomaly.
The crisis was highlighted at a HSE West Forum meeting in Galway on Tuesday by Councillor Tom McNamara, who asked the authority to outline the plans it has in place to provide residential rehabilitation for Clare brain injury patients under the age of 65.
Councillor McNamara told the meeting that patients cannot get admitted to St Joseph’s Hospital for rehabilitation unless they are over 65. The former psychiatric nurse said he is aware of a number of patients who have suffered from this anomaly since the start of this year.
He cited the case of one middle-aged Clare businessman, who was discharged home after a stroke, despite the fact he was not able to dress himself at the time. He said the man was eventually treated in the National Rehabilitation Unit in Dublin but could have been much closer to his family if intensive physiotherapy was available in St Joseph’s Hospital.
Praising the range of facilities in St Joseph’s, he stressed staff provide a “top-class” service, including speech therapy, occupational therapy and physiotherapy to brain injury patients over 65.
He claimed Clare patients have experienced extreme difficulty trying to secure admission to St Camillus’ as it caters for Limerick patients and it is felt Clare patients should be treated in their own county.
He also warned stroke patients face a higher risk of brain damage because of the lack of a 24-hour CAT scan service at the Mid-Western Regional Hospital, Ennis.
According to international best practice, anyone who suffers a stroke as a result of a clot needs to get an anti-coagulant in less than two or three hours. If a clot can’t be diagnosed quickly, Councillor McNamara warned they face a high risk of permanent brain damage.
Once a Clare stroke patient is treated at the Mid-Western Regional Hospital, Limerick, Councillor McNamara said the family is presented with a difficult battle trying to secure adequate services, as facilities such as private nursing homes and community hospitals haven’t the appropriate rehabilitation facilities.
“The home care packages are not available to provide physiotherapy and other treatments in a patient’s home. Getting physiotherapy once a week is not enough to facilitate recovery. Physiotherapy and other treatments are needed at least once a day. This issue needs to be resolved as it is affecting a lot of people,” he said.
Mid-West HSE area manager, Bernard Gloster confirmed health services in Clare are conducting a detailed review of the situation.
Mr Gloster assured Councillor McNamara every effort is being made to respond to people under the age of 65 who have acquired brain injury, which might be as a result of an organic condition or an accident, as is often the case.
“There is substantial evidence of a total health service response to people experiencing such difficulties, including the use of private facilities, the National Rehabilitation Hospital, Dublin, local outpatient services, home support services and in some cases funded nursing home placements prior to the introduction of the Nursing Home Subvention Scheme.
“I will be happy, while further detail is being analysed, to assist the councillor in any way if there is a particular case, which he wishes to bring to my attention,” he stated.
Regional operations manager, John Hennessy also pledged to look into the issues raised by Councillor McNamara.
According to Headway Ireland, between 7,000 and 9,000 people suffer from a stroke, up to 30,000 have an acquired brain injury, while between 9,000 and 11,000 suffer from a traumatic head injury annually in Ireland.
Headway counsellor, Michelle Murphy expressed concern about the lack of residential rehabilitation services for brain damage due to the lack of awareness concerning the impact of this serious physical disability on patients. She also highlighted the lack of appropriate treatment services for teenagers, particularly those who are 16, who often have to drop out from school after a serious head injury, due to the lack of treatment for emotional, psychological and behavioural issues.
“There is a huge lack of residential rehabilitation services for people under 65 who are suffering from a brain injury. It seems to come down to a lack of awareness of brain injury at government level and a lack of knowledge about the serious impact on these patients and their families. A much bigger concerted campaign is needed to secure major improvements in the treatment of brain injury,” she said.