Clinical Rehabilitation

 

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Clinical Rehabilitation, Vol. 18, No. 8, 924-928 (2004)
DOI: 10.1191/0269215504cr807oa

The impact of discharge to a care home on longer term stroke outcomes

Lesley Leeds

Jolyon Meara

Peter Hobson

University Department of Geriatric Medicine (North Wales), Glan Clwyd Hospital, Rhyl, Wales, UK

Objective: To examine the impact of discharge to a care home on the longer term recovery after stroke.

Design: An uncontrolled naturalistic study of stroke survivors, matched for stroke severity, discharged from a stroke rehabilitation unit to either a care home (n=65) or to their own home (n=65). Stroke-related variables were assessed in both groups shortly before discharge and again at six months after discharge.

Setting: A stroke rehabilitation unit, care homes in the community and subjects' own homes.

Outcome measures: Functional activities of daily living (ADL), cognitive function, depression, health service utilization, health-related quality of life.

Results: Despite low levels of rehabilitation in both groups, at six months subjects discharged home had a better functional improvement in ADL (Barthel score 14.9 compared with 10.8) and health-related quality of life (HRQoL) (five-item EuroQol score 0.60 compared with 0.35).

Conclusions: Poorer outcome in subjects discharged to care homes may be remediable and could respond to better rehabilitative efforts and increased social support and encouragement for this group of stroke survivors.


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