Rehabilitating the Stroke Patient through Patient — Family Groups

Abstract

The intermediate service of the West Haven Veterans Administration Hospital is designed as a rehabilitative setting for medical patients who have completed the phase of diagnosis and early treatment. In our nursing and social work with recuperating stroke patients and their families on this service, we noticed that although many patients were engaged in a program of physical, occupational, and speech therapy, they and their family members were frequently having great difficulty with the emotional acceptance of the patients’ disabilities. This was clear from the patients’ depressive affect and inability to express their feelings about their illness, with the concurrent inability of families to exchange reactions with the patients about the stroke and the ways in which this was going to affect their family life. For example, patients were often very frightened that any disability would mean that they could not function at home again. Family members sometimes shared this fear, and families and patients could not communicate their concerns. Because of this poor communication, there often was a strained relationship between patient and family, and realistic discharge plans could not be made. In addition, the patients did not use the appropriate community supports that would have allowed the most effective community adjustment, i.e., rehabilitation centers, visiting nurse associations, and vocational retraining centers.