Causes of Dependence in Personal Care Three Years after StrokeA Study in the Home Environment

Many activities of daily living (ADL) assessment instruments are available for judging the ability to perform personal care in, among others, persons suffering a stroke. However, ADL assessment instruments do not normally treat the underlying causes of failure to perform an activity.Seventeen persons with stroke were videotaped when performing personal care in their home environments about three years after the incident. The underlying causes of their failure in personal care are described in intrapersonal, interpersonal, and environmental dimensions. Interpersonal obstacles proved to be the main reasons why the persons in this study did not perform personal care.The self-reports of a 24-hour activity pattern showing the relationship between use of time for performance of personal care, sleep and rest, and other activities are presented.For the participants in this study, the Klein-Bell ADL Scale, an assessment instrument comprising 170 observation points, was judged to be valid and reliable, but some modifications are proposed.