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

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.