Dispatch: The second step in the chain of survival is ‘dispatch’, which involves activating emergency medical services. In most cases, this involves calling 911. Medical dispatch should be thoroughly trained to identify a possible stroke patient so that the appropriate level of EMS services can be dispatched to the patient.  Simply stated, the faster EMS can be dispatched, the quicker lifesaving treatment can be delivered.
After adjusting for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% confidence intervals 2.86-3.47); 3.23 (2.93-3.56), and 1.72 (1.47-2.00) higher odds of adhering to stroke care guidelines, respectively, than hospitals that had neither recognition, wrote Gregg C. Fonarow, MD, of the University of California Los Angeles, and his co-authors in the Oct. 15 issue of the Journal of the American Heart Association.
continuous, uninterrupted - continuing in time or space without interruption; "a continuous rearrangement of electrons in the solar atoms results in the emission of light"- James Jeans; "a continuous bout of illness lasting six months"; "lived in continuous fear"; "a continuous row of warehouses"; "a continuous line has no gaps or breaks in it"; "moving midweek holidays to the nearest Monday or Friday allows uninterrupted work weeks"
The Institute for Rehabilitation and Research offers an elite center for stroke rehabilitation that combines medical and nursing care with counseling and support, not only for your loved one but also for you and your family. All patient rooms include modern equipment that is specifically designed to offer comfort and functionality. Your friend or family member can benefit from individual or group therapy sessions, physical and occupational therapy, speech therapy, and periodical evaluations from highly trained specialists. Patients can also take part in occupational therapy, a form of therapy that helps patients regain skills and functions necessary in getting them back to work. Each type of therapy is individualized to fit the needs of the patient. One important service offered by TIRR is an outpatient rehabilitation program that will help your loved one continue recovery after leaving the facility.
Delivery:  Delivery is the prompt transport of the patient to a hospital, preferably a stroke center. Emergency medical personnel should be trained in performing a rapid assessment of the patient’s condition. If a stroke is suspected, the patient should be transported to an appropriate receiving hospital as soon as possible. A medical history and baseline mental status should be documented. The time since onset of symptoms should also be noted and is referred to as ‘time zero’, or the last time the patient was seen to be normal. Emergency medical workers need to provide pre-arrival information to the receiving facility so that the ED can prepare for the arrival of a potential stroke patient.

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Traditionally, care for older adults has been the responsibility of family members and was provided within the extended family home.[6] Increasingly in modern societies, care is now being provided by state or charitable institutions.[6] The reasons for this change include decreasing family size, greater life expectancy, the geographical dispersion of families, and the tendency for women to be educated and work outside the home.[6] Although the changes have affected European and North American countries first, they are now increasingly affecting Asian countries as well.[7]
“We are currently negotiating funding with the HSE, to further develop the service so that it’s rapidly available to everybody,” says Thornton. “We began the service without any additional funding or new structures in place. There are charities such as the Irish Heart Foundation that are currently in the process of reviewing guidelines to publish a formal protocol for patients and doctors on how to approach and deal with a large-vessel stroke. But we need the HSE to formally recognise the importance of medical thrombectomy and to support urgent development of the service because it is essential that stroke patients in Ireland are getting the best standard of care possible.”
A distinction is generally made between medical and non-medical care, the latter not being provided by medical professionals and much less likely to be covered by insurance or public funds. In the US, 67% of the one million or so residents in assisted living facilities pay for care out of their own funds.[38] The rest get help from family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home. Assisted living facilities usually do not meet Medicare's requirements. However, Medicare pays for some skilled care if the elderly person meets the requirements for the Medicare home health benefit. [39]

The best post rehabilitation center I have seen in the country is center for Neuro Recovery. My father went there completely enfeeble and in a wheelchair when he started and left walking after nine months of strengthening and functional movement exercises. I have never seen such a state of the art facility and knowledge-based staff. If this was going to happen to another family member again, I know I would go back to this amazing facility.
Promoting independence in self-care can provide older adults with the capability to maintain independence longer and can leave them with a sense of achievement when they complete a task unaided. Older adults that require assistance with activities of daily living are at a greater risk of losing their independence with self-care tasks as dependent personal behaviours are often met with reinforcement from caregivers.[42] It is important for caregivers to ensure that measures are put into place to preserve and promote function rather than contribute to a decline in status in an older adult that has physical limitations. Caregivers need to be conscious of actions and behaviors that cause older adults to become dependent on them and need to allow older patients to maintain as much independence as possible. Providing information to the older patient on why it is important to perform self-care may allow them to see the benefit in performing self-care independently. If the older adult is able to complete self-care activities on their own, or even if they need supervision, encourage them in their efforts as maintaining independence can provide them with a sense of accomplishment and the ability to maintain independence longer.[43]
Mayo Clinic in Rochester, Minn., ranks No. 1 for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for neurology and neurosurgery.
^ Donald R Hoover; Stephen Crystal; Rizie Kumar; Usha Sambamoorthi; Joel C Cantor (December 1, 2002). "Medical Expenditures during the Last Year of Life: Findings from the 1992–1996 Medicare Current Beneficiary Survey". Health Service Research. 37 (6): 1625–1642. doi:10.1111/1475-6773.01113. PMC 1464043. PMID 12546289. Last-year-of-life expenses constituted 22 percent of all medical, 26 percent of Medicare, 18 percent of all non-Medicare expenditures, and 25 percent of Medicaid expenditures.

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While the apps listed above are all free, there are still others on the market that come at a cost. Despite the added fees, you may find you’d prefer more personal assistance via paid apps that utilize actual human beings to complete requested tasks, such as Magic, Fin, PleaseDo, Hello Alfred, and Trove. Take some time to do your research and determine which is best for you and your business. Depending on your needs, you may find that it’s just as economical to use an online sites and apps like Care.com to hire a personal assistant near you.
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Needs differ at different times in our lives. Sometimes all we need is a little extra help to be able to remain at home. An accident, surgery or an illness may cause us to require assistance with recovery. Whether your need is intermittent or continuous our team is available an hour a day to 24 hour care. Around The Clock Care wants to help you age in place in the comforts of your own home.
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