School of Medicine

Modifying homes for stroke survivors saves lives, extends independence

Researchers at Washington University School of Medicine in St. Louis have found that safety interventions — such as walkers, grab bars, ramps and other home modifications — allow many stroke survivors to keep living independently in their homes and may reduce their risk of death. (Photo: Getty Images)

Every 40 seconds, someone in the United States suffers a stroke, in which blood flow to the brain is blocked. For the survivors, the ensuing brain damage can lead to lifelong disabilities, making mundane tasks, such as using the toilet and taking a shower, risky ventures.

One in eight of those who experience a stroke die within a year of hospital discharge. But a clinical trial led by researchers at Washington University School of Medicine in St. Louis has found that modifications to stroke survivors’ homes — such as grab bars, shower seats, ramps and other safety interventions — reduce the risk of death within a year or so of leaving the hospital and allow many to keep living independently in their homes.

“The transition period is a critical time for stroke survivors who go home after weeks in inpatient rehabilitation,” said senior author Susan Stark, PhD, a professor of occupational therapy, of neurology and of social work. “The home environment looks different and is more challenging than a facility outfitted with accommodations. We have found that occupational therapy can make impactful contributions by creating safe spaces that enable stroke survivors to remain independent and in their own homes.”

The study is available online in Archives of Physical Medicine and Rehabilitation.

The research team tested a novel program in St. Louis in which occupational therapists visited stroke survivors’ homes to identify environmental barriers — such as stairs without handrails, low toilets and dark walkways — and implement accommodations to address their specific needs. The therapists also provided self-management training that involved building problem-solving skills, such as how to connect with accessible transportation.

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