Community Care and Rehabilitation after Stroke in Japan

Abstract

The purpose of the research project was to determine, from a cross-cultural perspective, the care services and rehabilitation for elderly people with stroke living in the community in Japan. A written questionnaire and a semi-structured interview were used. The participants were a purposive sample of 21 elderly people and family/carer living in the metropolitan area of Tokyo, Japan. There were 11 men and 10 women with an average age of 70 years (range 42–86 years). The mean age at onset of stroke was 66.5 years (range 42–81 years) and the mean time since stroke was 3.2 years (range 3 months to 8 years). Varying levels of dependency were found, with an average Barthel Index score of 9.32 (range 0–18). Varying experiences of rehabilitation services were also reported: six people received physiotherapy only, six received physiotherapy and occupational therapy, and nine received no formal rehabilitation service either in hospital or in the community. Many participants were living in multi-generational households. Women had frequently given up jobs to care for their elderly relative, but were assisted in the caring role by community care workers (mainly nurses and home helpers). Environmental changes and disability equipment were evident in the homes. The project concluded that elderly people in Japan were supported by good community health care, although rehabilitation resources were limited. Cultural understanding as a key factor in rehabilitation processes is explored in the paper.