HOME-CARE - A REALISTIC ALTERNATIVE FOR BED-BLOCKING STROKE VICTIMS IN ACUTE HOSPITAL-WARDS - THE CONCEPTIONS OF CAREGIVERS IN 6 DISCIPLINES CONCERNED

Up to half of the stroke patients admitted to acute hospital wards bec ome bed-blockers. Investigations have been carried out in an effort to identify factors related to this problem. Very little is known about options which may lead to an alleviation of this problem. We investiga ted to what extent, in the opinions of professional representatives of six disciplines, home care can contribute to a solution. Sixty-nine s troke patients who were actually blocking beds in an acute hospital wa rd were described and examined on paper by a multidisciplinary panel. These patients were all moderately to severely disabled and needed a h igh degree of help in activities of daily life (ADL) and household act ivities. Estimations of the number of patients who were judged to be s uitable for home care varied, although there was a fair degree of agre ement between panel members concerning those patients who could and th ose who certainly could not return to their homes. Concerning one-thir d of the patients, the opinions of the caregivers diverged. Factors re lating to the judgement of each panel member are identified. A method for selecting patients to be substituted to lower levels of care is su ggested and discussed.