Stroke patients in long-term care--the relatives' conception of functional capacity and appropriate care

The closest relatives of 29 permanently institutionalized stroke patients were interviewed about their relationship to the patient before and after stroke, the functional ability of the patient before and after stroke, and their opinion of an appropriate care setting for the patient. The patients had all been independent before stroke, but were now dependent on help with most primary activities of daily living. Twelve patients had severe communicative difficulties. Most relatives could not suggest a realistic alternative to nursing home care, due to the patients' severe disabilities and extensive need for care. One patient was, however, later discharged to a sheltered living facility in accordance with her relative's wishes. One-third of the relatives expressed need for more information and support and wanted to take part in a support group. The nursing staff need high competency in providing good care for the patients and offering psychological support to the relatives, and should include the relatives in the overall treatment plan.