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Modifying homes for stroke survivors helps them remain independent

Modifying homes for stroke survivors helps them remain independent

Modifying homes for stroke survivors helps them remain independent

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Stroke survivors often struggle to live independently and 1 in 8 die within a year. Equipping homes with safety equipment can help more people live alone, new research shows.

FRIDAY, June 21, 2024 (HealthDay News) — Everyday tasks like showering or navigating the stairs can be risky business for people who have had a stroke.

But grab bars, shower seats, ramps and other safety interventions allow many to live independently and reduce the risk of premature death, new research confirms.

One in eight stroke survivors die within a year of leaving the hospital.

“The transition period is a critical time for stroke survivors returning home after weeks of inpatient rehabilitation,” said lead study author Susan Stark, professor of occupational therapy, neurology and social work at the University of Washington School of Medicine in St. Louis. “The home environment looks different and is more challenging than a facility with accommodations.”

Her team tested a program in St. Louis in which occupational therapists visit the homes of stroke survivors.

Visiting therapists look for barriers, such as low toilets or stairs without handrails, then make improvements that address individual patient needs. It also teaches stroke survivors how to solve problems, such as finding affordable transportation.

Stroke patients with minor physical and mental impairments usually go to outpatient rehab after leaving the hospital. Those with severe injuries usually go to a skilled nursing facility for ongoing care and therapy.

Stark’s study focused on the 25 percent of patients in the middle—those with moderate mental and physical impairment. These patients usually go to a rehab center to prepare themselves for life.

But their lives at home won’t be the same, the researchers noted.

A simple task like pulling a shirt from the laundry basket tests the muscles weakened by a stroke. Compromised balance makes using the toilet a challenge, and climbing stairs can seem like an obstacle course.

Such challenges are a barrier to reengaging with friends and neighbors and a recipe for depression, the researchers pointed out.

“People become even more depressed when they don’t re-engage in their community,” Stark said in a university news release.

To learn more, her team studied how 183 stroke patients aged 50 or older made the transition from rehab to living at home.

Participants were randomly divided into two groups: one received home modifications and self-management training. The other received stroke prevention training.

Appreciation: Removing obstacles and teaching patients to solve problems saves lives.

During the study, recently published in the Archives of Physical Medicine and Rehabilitation, 10 people who received only stroke prevention training died; none in the intervention group did. Those who received home modifications and self-management training were also less likely to end up in a skilled nursing facility.

Throughout the study, Donna Jones, who suffered a stroke in 2021, received modifications that gave her the confidence to live independently, regaining balance and learning new skills. She described it as life-changing.

“My modified bathroom gives me hope that my life is moving in the right direction,” she said. “The practical tools and services I received are the foundation of my new journey. I have a new life. It’s very different and I love it.”

Three months after his stroke, Jones received his doctorate in ethical leadership and employee development. Nine months later, his right leg was amputated.

None of them stopped her. Jones remains active in her community and enjoys event planning and travel.

“I am grateful for the study that provided the foundation to approach my future with a positive outlook,” she said.

Stark said the intervention needs to be tested more widely and the costs and savings associated with home modifications need to be defined to win over insurers. There is no system to cover the cost.

“The biggest barrier to implementing this program is getting insurance to reimburse the cost of home modifications,” she said. “If $500 in home modifications keeps people out of the hospital or a skilled nursing facility, that seems like a no-brainer to me.”

More information

Learn about the signs of stroke at the Stroke Awareness Foundation.

SOURCE: Washington University in St. Louis, press release, June 19, 2024

What does this mean for you?

Training and home modifications for stroke patients can help them live independently.

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