Functioning in everyday life after stroke: a longitudinal study of elderly people receiving rehabilitation at home

Objective: There is a need to identify different rehabilitation needs over time among individuals with stroke in order to implement client-centred rehabilitation interventions after stroke. The objective of this research was to describe changes in some aspects of functioning and to explore the patterns of change in functioning in everyday life during the first year after stroke for elderly patients participating in rehabilitation at home. Design and subjects: Patients who fulfilled the inclusion criteria for a regular rehabilitation-at-home programme after stroke were considered for participation in this study. Twenty-seven elderly patients participated on four data collection occasions during the year immediately subsequent to a stroke. The mean age of the 27 participants was 78.8 years (SD = 5.9) and 67% of the participants were women. Methods: Data on certain aspects of functioning were collected and a person-oriented approach was used to describe the patterns in the change in functioning for individuals. Results: Four different patterns were identified: (a) moderate change in functioning (n = 4), (b) minor change in functioning (n = 11), (c) minor change despite major life event (n = 7), (d) disrupted change in functioning (n = 5). The study group improved significantly in most aspects of functioning, but still, most participants (n = 20) showed dissatisfaction with life as a whole 12 months after their stroke. Conclusion: This study identified different patterns of change in functioning in everyday life. This knowledge should serve to help guide rehabilitation professionals in their assessment of clients' needs during different phases after stroke.