Page 52 - Policy-Communication-Report-Volume-67

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6 months

Palliative Care
End of Life Care
n E E E E En
10 – 20 % Severe impairment

Handicap
Intermediate Care
Long term Care
60 – 70 %
Disability/

Full recovery
10 – 20 % Mild limitation

Seamless care concept: Stroke IMC plus

Hospital based
Community based
øóß.
øóý./øóì.
øó.ÿê.
ñĎšðśü÷/Care giver
Ăÿö.
0-3 days
>6 months
6 months
Ļ Home healthcare
Ļ Home healthcare with Care giver
Ļ Care giver
Ļ Multidisciplinary rehabilitation
Ļ Multidisciplinary rehabilitation
Ļ Refer back to Community hospital
Ļ Community care:
Ļ Follow up for continuity of care
Ļ Multidisciplinary rehabilitation
Ļ Community care
Ļ Follow up for continuity of care
Ļ Specialist
Ļ Multidisciplinary rehabilitation
Ļ Hospital care: OPD
Ļ Hospital care: IPD & OPD
Ļ Hospital care: Stroke unit & IPD
Post stroke
Acute Stroke attack
Intermediate care

Stroke care process: Treatment flow