The impact of discharge to a care home on longer term stroke outcomes

To examine the impact of discharge to a care home on the longer term recovery after stroke.

An uncontrolled naturalistic study of stroke survivors, matched for stroke severity, discharged from a stroke rehabilitation unit to either a care home (n = 65) or to their own home (n = 65). Stroke-related variables were assessed in both groups shortly before discharge and again at six months after discharge.

A stroke rehabilitation unit, care homes in the community and subjects' own homes.

Functional activities of daily living (ADL), cognitive function, depression, health service utilization, health-related quality of life.

Despite low levels of rehabilitation in both groups, at six months subjects discharged home had a better functional improvement in ADL (Barthel score 14.9 compared with 10.8) and health-related quality of life (HRQoL) (five-item EuroQol score 0.60 compared with 0.35).

Poorer outcome in subjects discharged to care homes may be remediable and could respond to better rehabilitative efforts and increased social support and encouragement for this group of stroke survivors.