Elderly Stroke Survivors Research Articles

Sleep-wake rhythm and physical fitness in relation to activities of daily living in stroke survivors residing at home

To clarify the relationship between sleep-wake rhythm, physical fitness, and competence level of elderly stroke survivors living at home, thirty-seven stroke survivors living at home (65.4 ± 7.3 years) voluntarily participated in a cross-sectional study with an interview survey and measurement of physical fitness. All subjects lived in a community and received community home health care services. Sleep-wake rhythm and competence were evaluated by the questionnaire method. Physical fitness in relation to daily living activities was measured by both die time needed to walk 10 meters and that needed to stand up from bed rest position. There was a significant positive correlation between rising time and the 10 meter walking time. Regarding rising time and the competence score, there was a significant negative correlation. Stroke survivors who actively participated in community activities arose earlier than those who had a negative attitude toward participation in community activities. The sleep-wake rhydim, especially rising time, and the participation in community activities were related to the high competence level of stroke survivors living at home. Strengthening the synchronization of the sleep-wake rhythm and increasing the social network may serve as useful procedures to improve the competence of stroke survivors living at home.

Coping with Stroke: Perceptions of Elderly Who Have Experienced Stroke and Rehabilitation Interventions

This article reports the findings and implications of a study that explored the roles,values/beliefs, and behaviors of elderly stroke survivors in their recovery process. A qualitative design consisting of in-depth interviews with 39 elderly stroke survivors was used to identify trends and unique approaches to coping with stroke. The respondents in this study experienced significant changes in their pre-stroke lifestyles and abilities. Participants had important observations regarding ways in which they had learned to cope with stroke-related problems, and ways in which personal and professional caregivers had enhanced and obstructed this process.

Stroke Rehabilitation Units- Do Elderly Stroke Patients Benefit?

Despite increasing costs of stroke management in patients aged over 75 years, the advantages of stroke rehabilitation units over geriatric wards remain equivocal. A prospective controlled study was undertaken in 144 stroke survivors over 75 years. These patients were stratified into 3 groups according to prognosis 2 weeks after stroke. Patients were randomly allocated to a stroke rehabilitation unit (n = 71) or to mixed (acute and rehabilitation) geriatric wards (n = 73) and managed according to existing practices in either setting. Both groups were comparable in baseline characteristics. Patients on geriatric wards received more physiotherapy on average (18.4 ± 9.6 vs 15.2 ± 6.7h, p<0.05) but similar occupational therapy (10.4 ± 3.1 vs. 10.7 ± 2.4 h) compared with stroke rehabilitation unit patients. There was no difference in the proportion of time spent on different rehabilitation activities. Patients managed on geriatric wards showed higher mortality (p < 0.05), especially in those with poor prognosis. The median length of stay (84 vs. 36 days, p < 0.001) was also longer in patients managed on geriatric wards, especially in patients with intermediate or poor prognosis. Median discharge Barthel scores (14 vs. 13) and the percentage of patients going home (65 vs. 59%) were comparable in both settings. Functional outcome of stroke rehabilitation was comparable between the stroke unit and mixed geriatric wards. Stroke rehabilitation units have the advantage of reducing late mortality due to systemic complications and the length of hospital stay in elderly stroke survivors.

Stroke in Nottingham: provision of nursing care and possible implications for the future

Although the care of stroke patients accounts for a considerable proportion of Health Service resources, there have been few attempts to measure this burden directly. A survey was therefore performed in Nottingham (approximate population 700 000) during a two-week period to find out the total number and dependency levels of stroke patients receiving professional nursing care, whether in hospital, nursing homes or at home from the Community Nursing Service. Altogether 822 patients were surveyed, of whom 232 were in hospital (46 in general medical, 171 in geriatric wards and 15 on the stroke unit), 221 were in nursing homes and 369 at home with district nurse support. Of this total, 61 % were aged over 75 and 18% over 85; nearly half of the latter group being in nursing homes. Overall levels of dependency were greatest in nursing homes and the prevalence of severe disability was highest amongst the oldest patients. Two-thirds of all patients had had their strokes over six months before and 39% over two years before and 31 % had suffered more than one stroke. Thus, the main demand for nursing services is amongst the old and those with longstanding stroke disease. The rapid increase in the number of old people and changes in medical practice which reduce fatality in the early stages of stroke are both likely to increase the numbers of disabled elderly stroke survivors, and a large proportion of these may be cared for in private nursing homes. Simple cross-sectional studies of this kind should be repeated every few years so that these trends can be accurately plotted.

The Relationship Between Person-Environment Fit and Care-Giver Strain for Elderly Stroke Survivors

A qualitative, case-study methodology was used to explore care-giver characteristics that inhibited person-environment fit in households where a person over age 55 had recently suffered a stroke. R...