The role of the social network during inpatient rehabilitation: A qualitative study exploring the views of older stroke survivors and their informal caregivers

This is a secondary problem. Solve the primary problem of 100% recovery and you don't have to do research on this.

 The role of the social network during inpatient rehabilitation: A qualitative study exploring the views of older stroke survivors and their informal caregivers

 Maria W.G. Nijhuis-van der Sanden Rob van der SandeEsther MJ Steultjens Received 13 Sep 2020, Accepted 29 Dec 2020, Published online: 11 Jan 2021 Download citation 

ABSTRACT 

Acknowledgements Background 

After discharge, stroke survivors and their informal caregivers need support from their social networks to resume their most valued activities. Rehabilitation professionals could help them establish a strong support system. Explore how older stroke survivors and their primary informal caregivers expect to resume their valued activities after discharge, and discover their ideas about involving, informing and educating their family members, friends and important others during inpatient rehabilitation so that, once home, they will have adequate support. 

Methods 

We conducted semi-structured interviews with stroke survivors from three geriatric rehabilitation centres and their primary informal caregivers, used the pictures of daily activities to elicit their perspectives, and applied a descriptive and interpretive design to data analysis. 

Results 

Many participants had no concrete idea about how to resume their activities after discharge but nevertheless were optimistic they would. They expected help to be available and saw no need for professionals to involve their network during inpatient rehabilitation. However, once they had insight into the challenges to expect after discharge, they often appreciated the idea of professionals contacting their network. To better understand the challenges after discharge, it was helpful if professionals provided concrete, honest information about the stroke’s consequences for daily life. Actually doing daily activities also helped gain better insights. 

Conclusions 

To enhance insight in the need of social support after discharge, we suggest that rehabilitation professionals are honest about what to expect(So you are using the tyranny of low expectations you bad people, you.) and let stroke survivors explore their valued activities in a realistic context more often. KEYWORDS: Stroke,informal caregiving,valued activities,meaningful activities,social network,social support latest articles 

Introduction 

Stroke is associated with serious perceptual, cognitive and motor impairments.² As a consequence of these impairments, many stroke survivors have difficulty resuming previously valued activities, such as their social, family or leisure activities. For some, the struggle of renegotiating these activities persists for many years after the onset of stroke. ^3–7 However, the loss of activities not only applies to stroke survivors, but also to their primary informal caregivers.⁸ Because of their extensive caregiving task, these caregivers generally have no time and energy for their own activities, such as their social activities. ^8–11 In the long run, both stroke survivors and informal caregivers tend to become more homebound and have fewer social relationships,which easily results in social isolation. ¹⁷ Research shows that loss of valued activities and social isolation are related to depression and reduced wellbeing in both stroke survivors ¹⁹ and informal caregivers.^20–22 Since engagement in valued activities and social relationships are predictors of better (mental) health and wellbeing,^23–27 it seems important that rehabilitation professionals help stroke survivors and primary caregivers resume their valued activities and inform them about the importance of maintaining social relationships. ⁸ Additionally, because an understanding and supportive social network is a prerequisite for activity resumption, ^{8 10 28 31–34} several authors suggest that rehabilitation professionals should invite family members, friends and acquaintances to play an active role during inpatient rehabilitation. ^{28 29 35–37} Professionals should inform and educate these social network members about how to support stroke survivors’ and caregivers’ activity resumption so that adequate support will be available once the stroke survivor returns home. Involving and educating social network members seems especially important in case of older stroke survivors because they generally suffer from more initial impairments and more severe strokes, ³⁹ resulting in a less favourable functional status and fewer possibilities to return to previously valued activities. ^{3 40 41} However, before developing ways to work with the broader network in inpatient settings, it is important to know whether older stroke survivors and their informal caregivers are open to the idea of involving their social networks during rehabilitation and, if so, what their preferences are. Therefore, this study aims to clarify the views of these stroke survivors and their primary caregivers with regard to: (a) their activity resumption after discharge, (b) the role their broader social networks could play in this respect, and (c) how their social networks could be involved during the institutional rehabilitation phase to equip them for the expected role.