Stroke rehabilitation in Stockholm. Basis for late intervention in patients living at home

Abstract

In order to identify the basis of late-therapy intervention in patients with stroke, we studied a population-based sample of 20 patients. The requests were that they should be living at home 1-3 years after being hospitalized, and that they had declared themselves in need of rehabilitation services. The assessment of abilities and activities of the patients was related to the model of human occupation developed by Kielhofner and co-workers. Most individuals reported a change in activity and interest patterns after stroke, and high motivation in current activities. The cognitive functions were within normal limits for all tested patients. However, the motor abilities and verbal performances were frequently affected and varied considerably. About 3/4 of the patients were not motivated to change their level of dependence in personal and instrumental ADL. Social and leisure activities outside the home were identified as the most promising goals for community-based rehabilitation programmes. Focusing on such activities, potential improvement in quality of life for this population could be achieved by individually-planned rehabilitation programmes using non-professional collaborators and patient organizations.