Clients' perceptions of discharge housing decisions after stroke rehabilitation.
OBJECTIVE
The purpose of this research was to examine the perceptions of older persons with stroke concerning the discharge housing decisions made during their rehabilitation program. The research explored clients' locus of control, their perceptions of the role of the rehabilitation team and their family in the decision, and their perceptions of their activities of daily living skills.


METHODS
Sixty-two subjects with stroke completed four measures: (a) the Functional Independence Measure (FIM), (b) a housing information questionnaire, (c) a semistructured interview, and (d) the Bialer Locus of Control Scale. Rehabilitation team members also completed the FIM and housing information questionnaire for each subject. These instruments were used to collect data relating to clients' perceptions of their functional status, discharge from the hospital, housing options available, and locus of control.


RESULTS
Despite the team or family opinions on discharge housing, subjects saw housing decisions as primarily their own. The majority of subjects were reluctant to consider alternatives to returning home, even though they have self-care deficits and frequently reported that the presence of a spouse and family members were important to support their return home. Subjects generally seemed unaware of the influence of team and family opinions and the impact of their functional status on their discharge housing. Subjects' locus of control seemed unrelated to satisfaction with the discharge decision process.


CONCLUSIONS
Clients who have had a stroke could use assistance to determine housing that is appropriate for their living skills. Discussions with clinicians concerning accommodation options may lead to a smoother transition from the hospital to longer term housing for clients after stroke.
Unsworth
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Boston School of Occupational Therapy, Tufts University, Medford, Massachusetts 02155, USA.
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D003657:Decision Making; D005260:Female; D006798:Housing; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010358:Patient Participation; D012944:Social Support; D014739:Victoria