Client and carer experience of transition home from inpatient stroke rehabilitation

Abstract

Purpose: The purpose of this qualitative study was to enhance our understanding of the transition experience for clients with stroke and their carers during discharge and the first month at home. Method: Semi-structured interviews were conducted with five clients with stroke and their carers (n = 5) at 1 month after discharge from stroke rehabilitation. Questioning in the interviews explored preparation for and the experience of the transition. Inductive thematic analysis was completed with the client and carer interviews and the resultant themes were compared. Basic demographic data were collected to allow description of the participants. Results: Five clients and five carers were interviewed 1 month after discharge to home. The analysis of the client interviews yielded three themes including: rehabilitation was okay, it’s a struggle, and supports and assistance. The carer interviews also yielded three themes including: the purpose of rehabilitation, life is different now, and looking to the future. Conclusions: The clients and the carers all spoke of the positive aspects of rehabilitation but raised concerns about the limited ability to undertake daily tasks regularly and develop personalised routines in preparation for discharge. The daily routines at home were disrupted with clients taking longer to complete daily activities and carers juggling caring responsibilities with their own lifestyle. Overall, the results suggest that there is a need for stroke rehabilitation services to better prepare the clients and carers for transition to home.

Implications for Rehabilitation

• Stroke rehabilitation should offer more opportunities for clients to participate regularly in meaningful activities in the hospital environment.

• It is beneficial to consider transition from the perspectives of the client and carer as a working unit.

• Alternate models of service delivery that increase outreach to the home environment may be beneficial.

Keywords::

• Cerebrovascular accident
• qualitative analysis
• transition

Acknowledgements

We would like to thank the staff and patients of the rehabilitation unit in this study who have supported this, and ongoing research projects, focussing on improving transition home.

Declaration of Interest: This study was supported by a Queensland Health – Health Practitioner Research Scheme Funding Grant.