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]
Door: The fourth step in the chain of survival is ‘door’, which refers to the arrival of the patient at the emergency room (ED). Ideally, the stroke team should be in place at the receiving facility prior to the patient’s arrival to ensure prompt assessment and diagnosis. According to recommendations from the National Institute of Neurological Disorders and Stroke, an assessment should be completed by an ER physician within ten minutes of arriving in the ED.
“If a patient does experience the symptoms of a stroke, it is vital to receive appropriate clinical assessment and scanning in hospital early to confirm it is a blockage of a blood vessel. Patients are then referred to our interventional lab in Beaumont Hospital, the main route to thrombectomy. We will do an endovascular procedure, puncturing the artery and groin to pass a tube in the blood vessels up to the neck and head. Through the tube, we place a stent retriever, which pulls the blood clot out, restoring blood flow to the brain tissue.

Fast recognition and treatment can not only make the difference between life and death, but it can also decrease long-term disabilities. To develop a streamlined response to potential stroke patients, the American Heart Association developed the Stroke Chain of Survival. The chain involves eight links or steps to be taken by patients, family members, prehospital and emergency room personnel in caring for stroke patients.
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Data: Data collection is a vital component of the chain of survival. Data collection includes results from laboratory tests and both a physical and a neurological exam. A 12-lead electrocardiogram is recommended to rule out cardiac arrhythmias. In addition, a CT scan is an essential piece of the puzzle and is needed for an accurate diagnosis. A CT scan should ideally be performed within 25 minutes of arrival in the emergency room. Data collected is also needed to rule out conditions which may mimic a stroke, such as a brain tumor, drug overdose or hypoglycemia.
U Care is yet another innovation in quality stroke care by the staff at the UofL Hospital, the first hospital designated as a comprehensive stroke center in Kentucky by the Joint Commission. In addition, UofL Hospital once again has been awarded the top level of distinction by the American Heart Association/American Stroke Association with the Get With The Guidelines® Target:  Stroke Elite Plus, Gold Plus award. The award recognizes the hospital’s success in providing the most appropriate stroke treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke Quality measures to receive the Gold Plus Quality Achievement Award.
The quality of our care is a reflection of our Attendant Caregivers.  We closely evaluate and carefully select individuals who must successfully complete a criminal background check and multiple reference checks.
They are highly qualified individuals who are insured and who are provided with specialized training using the highly regarded American Red Cross Family Caregiving Program.  The strength of the American Red Cross training program lies not only in their expert content, but also in the way this content is delivered.
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