Improving Stroke Caregiver Readiness for Transition From Inpatient Rehabilitation to Home

I wish our stroke medical professionals would solve the root cause rather than these aftereffects. Stop the neuronal cascade of death by these 5 causes in the first week. But then we have fucking failures of stroke associations that don't even have any idea what needs to be done. Gawd, the stupid, it burns.
http://gerontologist.oxfordjournals.org/content/early/2016/11/04/geront.gnw135.abstract

1. Barbara J. Lutz, PhD, RN, CRRN, FAHA, FAAN*,¹,²,
2. Mary Ellen Young, PhD³,
3. Kerry Rae Creasy, PhD, ARNP²,
4. Crystal Martz, MSN, RN,²,
5. Lydia Eisenbrandt, MA¹,
6. Jarrett N. Brunny, MPH³ and
7. Christa Cook, PhD, RN, MPH²

+ Author Affiliations

1. ¹ School of Nursing, University of North Carolina-Wilmington.
2. ² College of Nursing, University of Florida, Gainesville.
3. ³ College of Public Health and Health Professions, University of Florida, Gainesville.

1. ↵*Address correspondence to Barbara Lutz, PhD, RN, CRRN, FAHA, FAAN, School of Nursing, University of North Carolina-Wilmington, 601 S. College Rd., Wilmington, NC 28403-5960. E-mail: lutzb@uncw.edu

• Received April 14, 2016.
• Accepted July 21, 2016.

Abstract

Purpose: As the population ages, older adults are more often living with functional limitations from chronic illnesses, such as stroke, and require assistance. Because stroke occurs suddenly, many stroke family caregivers in the United States are unprepared to assume caregiving responsibilities post-discharge. Research is limited on how family members become ready to assume the caregiving role. In this study, we developed a theoretical model for improving stroke caregiver readiness and identifying gaps in caregiver preparation.

Design and Methods: We interviewed 40 stroke family caregivers caring for 33 stroke survivors during inpatient rehabilitation and within 6 months post-discharge for this grounded theory study. Data were analyzed using dimensional analysis and constant comparative techniques.

Results: Caregivers identified critical areas where they felt unprepared to assume the caregiving role after discharge from inpatient rehabilitation. Steps to improve preparation include (a) conducting a risk assessment of the patient and caregiver; (b) identifying and prioritizing gaps between the patient’s needs and caregiver’s commitment and capacity; and (c) developing a plan for improving caregiver readiness.

Implications: The model presented provides a family-centered approach for identifying needs and facilitating caregiver preparation. Given recent focus on improving care coordination, care transitions, and patient-centered care to help improve patient safety and reduce readmissions in this population, this research provides a new approach to enhance these outcomes among stroke survivors with family caregivers.