Strokes provide numerous challenges to not only the sufferer of the stroke, but also to that individual’s caregiver. Because of the suddenness of strokes, many family caregivers are unprepared to provide caregiving responsibilities once a stroke sufferer is released from inpatient care. In order to help these caregivers, researchers identified the gaps in preparation for such situations and developed a model for improving the readiness of stroke caregivers.
Gaps in preparation reported by caregivers ranged from not having necessary equipment (bed pads, urinals, etc.) to lacking the knowledge to adequately care for a stroke sufferer. Perhaps more importantly, caregivers often had little understanding of what they needed and where their preparation was lacking. Moreover, they reported feeling “abandoned and alone with no one to turn to post-discharge.”
Based on interviews with caregivers, the researchers suggested a three-step process for preparing for their new roles. The first step is conducting a risk assessment, by looking at both the patient’s needs (such as physical and cognitive status) and the caregiver’s readiness (their commitment and capacity). This should be done as early as possible during the patient’s inpatient stay. Next, identify gaps between the patient’s needs and the caregiver’s readiness, and prioritize which gaps need the most attention. Once this is done, a systematic plan can be made to best address the gaps identified. This planning needs to involve both identifying and activating available resources that can help fill a gap. Bureaucratically, this might include applying for government support or obtaining power of attorney. Physically, this would involve assessing needed changes in the home. Educationally, most caregivers may need training on meeting the patient’s day-to-day needs, as well as training for taking on a case management role for the patient. Additionally, plans should address the needs of the caregiver—finding ways to prepare for life changes and providing resources to assist with the impact of the stroke on their lives (for example, family counseling).
Planning holds great promise for both reducing caregiver burden and improving patient outcomes in such unexpected, life-changing circumstances.
Lutz BJ, Young ME, Creasy KR, et al. Improving stroke caregiver readiness for transition from inpatient rehabilitation to home. The Gerontologist. (2016). DOI:10.1093/geront/gnw135