Filling up the hours: how do stroke patients on a rehabilitation nursing home spend the day?

Abstract

Objective: To describe the time use of stroke patients on rehabilitation units of a nursing home focusing on the time spent on therapeutic activities, non-therapeutic activities, interactions and the location wherein these took place.

Design: A descriptive study.

Setting: Rehabilitation units of a nursing home.

Subjects: Seventeen chronic stroke patients, including 9 men, 8 women, with a mean age of 77 years (SD +/- 7.6 years).

Main measures: Daily activities of patients were measured using Behavioural Mapping, including therapeutic activities, non-therapeutic activities, interactions and their location. Functional status was measured with the Barthel Index.

Results: Of the patients 15 (88%) were partly/fully paralysed, with a mean Barthel Index score of 9.4 (SD +/- 4.3). The patients spent 20% of the day on therapeutic activities, whereas 80% of the day was spent on non-therapeutic activities; 9% on therapeutic activities with the nurse. For 60% of the day patients were alone and not interacting with others.

Conclusions: Stroke patients spend only short periods of time during the day on therapeutic activities. For the largest part of the day, the patient is alone and passive. A challenge for nurses is how to activate patients and engage them in purposeful task-oriented training in daily activities.