The Nurse's Role in Enhancing Quality of Life Post-Stroke

Abstract

Stroke remains a leading cause of disability, with over 795,000 individuals in the United States experiencing a stroke annually. Extensive research has focused on post-stroke management, particularly during the long rehabilitation process after the acute phase. However, research gaps exist for the "oldest old," or those aged 85 and older, who face unique challenges in treatment and the provision of social and emotional support. This article aims to provide primary care providers with current guidelines for post-stroke treatment tailored to elderly populations, emphasizing the importance of early rehabilitation and addressing the multifaceted needs of elderly stroke clients. The Critical Period after Stroke Study (CPASS) found that interventions targeting upper extremity motor rehabilitation conducted between 2 and 3 months post-stroke led to significantly greater recovery of motor function compared to controls. These findings underscore the significance of initiating therapy during critical windows and extending rehabilitation efforts into chronic stages post-stroke. The primary objective of post-stroke therapy is to transition the client into acute, sub-acute, or home/outpatient therapy as soon as they are medically stable, with significant psychosocial support essential for both the stroke survivor and their support system. Stroke disproportionately affects women, with risk factors and outcomes differing between men and women. Elderly women often live alone, lacking substantial social support, which increases their likelihood of requiring institutionalized or community care. The management of stroke in elderly clients should encompass a multifaceted approach, including dietary modifications, physical exercise or rehabilitation, adherence to prescribed medications, and evaluation for depression, behavioral changes, and cognitive impairments. Primary care settings and advanced practice registered nurses play a critical role in ensuring continuity of care for stroke survivors, supporting their reintegration into the community, promoting self-management, and preventing secondary strokes.