[Stroke patients in need of long-term nursing home care. Who are they? What are their problems? Which care do they receive?].
OBJECTIVE
Many patients who suffer from an acute stroke, will need long-term nursing home care. We are poorly informed about the demographic and clinical characteristics and about the care problems and received care of these patients. This study aims to provide a first description of these characteristics in this group of patients.


METHODS
Data on demographic and health-related characteristics, social participation and received care were collected with the Minimum Data Set of the Resident Assessment Instrument, from january 2004-march 2007, in patients who needed long-term nursing home care. Data were collected in eight nursing homes at admission and six months after admission.


RESULTS
Many patients were functionally impaired, suffered from depressive symptoms and pain, and were cognitively impaired. In addition, decisional capacity was frequently diminished. The majority of patients were residing at somatic wards, even when severe cognitive impairment was present, such as dementia. Several forms of restraints were frequently used, also at somatic wards. About 40% of the patients, mostly residing at somatic wards, received paramedical treatment. Social engagement was low and was correlated with functional impairment.


CONCLUSIONS
Stroke patients who need long-term nursing home care suffer from problems in several domains. The high prevalence of cognitive impairment in stroke patients residing at somatic wards, combined with the ample use of restraints on these wards, raises questions about the appropriateness of the currently delivered care to these patients, considering the problems they have.
Smalbrugge
M
M
Afdeling verpleeghuisgeneskunde/EMGO, VU medisch centrum, Amsterdam. m.smalbrugge@vumc.nl
Achterberg
W P
WP
Dik
M G
MG
Hertogh
C M P M
CM
Frijters
D H
DH
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008134:Long-Term Care / Q000523:psychology / Q000592:standards; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009735:Nursing Homes / Q000592:standards; D011787:Quality of Health Care; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D020521:Stroke / Q000150:complications* / Q000523:psychology*; D000071939:Stroke Rehabilitation