Individual occupational therapy needs at home after stroke: two case studies

Abstract

Introduction. Stroke is the third most common cause of death, with over 67,000 deaths each year, the significant impact of stroke is long term disability [2]. Stroke survivors are able to return home and continue many activities they did [3]. They experience many challenges: fear of having another stroke, loss of confidence, it’s major negative factors in regaining independence [4]. Rehabilitation can help prepare a person to go home, but cannot fully trained to live in the house [1]. Research aim. Examine the need of occupational therapy at home and reintegration into the community after stroke. Research methods and organization. The study was designed as a qualitative method, two most similar cases analyses. First, two similar participants were found in Kaunas Clinical hospital, Rehabilitation department, according to selection criterias: MMSE (21 and more) and Barthel index evaluation (35-45 score, by Lithuania order Nr. V-50 a person after stroke gets 40 days of rehabilitation), also ischemic stroke type. At the begining of rehabilitation program both was not able to eat, dress or walk, they had left side paresis. During rehabilitation respondents participated in four interviews and observed during occupational therapy intervention, after that it was continued at home, also four interviews (1 interview per 10 days), observations and goal aiming. Overall, the research was conducted for 80 days. Activities of daily living scale (ADL) was used to find the problems at home for persons after stroke and Goal Attainment Scaling to achieve goals with 2 older women. Both cases was independed before the stroke. After rehabilitation first case was able to walk with a stick and eat, but needed help while dressing and showering, case number 2 was able to walk again, dress upper body and eat. The findings suggest that the approach has the potential to successfully help clients with stroke achieve their everyday occupa[...].