Swedish study - Strokes and ADL's - Report No: 213

The costs and benefits of 'Aids to Daily Living' and housing adaptations for older people in the first year following a stroke.

Gunilla Gosman-Hedström
The Institution of Occupational Health and Physiotherapy
University of Gothenburg.

SUMMARY

Strokes are one of the most common public health ailments among older people in Sweden and are often the cause of continuing handicaps. The daily consequences of the illness are apparent for both the individual and their relatives. To have access to 'aids for daily living' and to have the physical environment suitably adapted is of critical importance in enabling a person to remain as independent as possible whilst continuing with their daily life. What aids are prescribed for stroke patients? In what daily activities and how often are the aids used?

The objective of this project was to look at the use, costs and benefits for various aids and of housing adaptations for older people in the first year after a stroke. The rationale for the project was based on a more extensive study which was carried out as a joint investigation between the Sahlgrenska University Hospital and the Institution of Occupational Health and Physiotherapy, University of Gothenburg. In the earlier study it had been established that the cost for the aids constituted approximately 2% of the total cost of the care and rehabilitation during the first year after a stroke.

At the first year assessment, a total of 143 out of the 173 persons investigated had used one or more aids during their daily activities. The frequency of use was great. Of the 569 prescribed aids, 492 (86%) were used. The main reason that an aid was not used was that the person concerned considered that they no longer had need of such an aid and preferred to manage without the aid where possible.

The majority of the people needed aids for hygiene and mobility requirements. The most common hygiene aid was a bath board and every third person used one. The most common mobility aid was a walking stick, followed by a 4-wheeled walker and a manually-operated wheel chair. The most frequently used manual wheel chair was of a traditional type, but only a third was of an "active" type wheel chair. For most of the users the use of the aid meant increased mobility, dexterity and independence as well as increased safety whilst managing the activity. The total cost for all the prescribed aids was SKr 805,500.

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