The role of accommodations in poststroke disability management

J Gerontol B Psychol Sci Soc Sci. 2014 Nov;69 Suppl 1(Suppl 1):S26-34. doi: 10.1093/geronb/gbu117.


Objective: To explore use of assistive devices and personal assistance and unmet need for assistance among older stroke survivors and identify potentially modifiable factors to optimize self-care and mobility activities in this population.

Method: Using the 2011 National Health and Aging Trends Study, we compared demographic characteristics, accommodation-enabling factors and need-related factors for self-reported stroke survivors (N = 892) and stroke-free controls (N = 6,709). For individual self-care and mobility activities, we examined type of accommodation (no devices/no help, devices/no help, devices/help, help/no devices) and unmet need by stroke status. For the sample of stroke survivors, we then estimated (a) multinomial logistic regression models predicting type of accommodation and (b) logistic regression models predicting unmet need.

Results: Stroke survivors used more assistive devices and received more personal assistance and had greater unmet need than stroke-free controls. In adjusted models, physical and cognitive capacity measures were most important in predicting accommodations and accommodations most important in predicting unmet need.

Discussion: Although accommodations are commonly used by older adult stroke survivors, unmet need is also substantial. Future research should focus on finding ways to improve poststroke functional capacity and cognitive capacity and enhance adoption of assistive devices with the aim of reducing unmet need.

Keywords: Assistive devices; Disability; Personal assistance; Stroke survivors..

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Disabled Persons / rehabilitation*
  • Disabled Persons / statistics & numerical data
  • Female
  • Health Status
  • Humans
  • Independent Living / statistics & numerical data*
  • Male
  • Mobility Limitation*
  • Needs Assessment
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Self-Help Devices / statistics & numerical data*
  • Stroke / epidemiology
  • Stroke Rehabilitation*
  • Survivors / statistics & numerical data
  • United States / epidemiology