In Indian context early discharge to home care following stroke is a common scenario. The reason for such discharges are generally to avoid hospital based secondary infections, or financial status/ family compulsion around the patient. I would like to know is there any evidence/ research finding to support extending in-hospital rehabilitation in view of better motor/functional outcomes.
Dear Allexander,
I am able to under the relevance of the post you have made, to the question I have asked.
I don´t have the evidence, but the experience that early home care can work better, if the carers are instructed not to care too much. If a post - stroke patient is challenged by his normal surroundings, and still has duties around the house, participates, I am reasonably sure that he will have better outcomes. Over the years I´ve often encountered literature that supports this, but alas I don´t have it handy :-(
I think I would use participation in the MESH
Thank you for the comment Geert Jeuring. I do agree that home environment (or) environment where he/she usually functions (or) environment which provokes the functions will be more beneficial than a structured environment like hospital. However in developing countries like India, where home environment is challenging for stroke survivors. Occasionally the patient will be discharged due to other reasons like hospital related infections. But the patient will not have potential to get rehabilitated in home, or resources will not be sufficient at home. I am looking for support to have a cutoff motor score when patient can be discharged to home.
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