Activities of daily living and rehabilitation needs for older adults with a stroke: A comparison of home care and nursing home care

Aim: To compare the changes in benefit levels of activities of daily living (ADLs), rehabilitation, and long-term care services (LTCS) in older adults with a stroke in different modalities of LTCS, which include home care and nursing home care. Methods: This study analyzed national data regarding LTCS from 2008 to 2009 in South Korea. The data about 7668 older adults with a stroke were extracted from a pool of 182,535 total beneficiaries. In order to control for the baseline differences between older adults who received home care and those who received nursing home care, propensity score matching (PSM) was carried out and there were 1099 matched pairs of participants (n = 2198). After the PSM, the changes in ADLs and rehabilitation between the two groups were analyzed by using a paired t-test and the changes in LTCS benefit levels were compared by using the χ²-test. Results: The ADLs and rehabilitation needs of the older adults who received home care improved, while the older adults who received nursing home care experienced deterioration. After 1 year, the LTCS benefit levels were significantly different between the home care and the nursing home care groups. Conclusion: All of the ADLs, rehabilitation needs, and LTCS benefit levels for 1 year had improved in the home care patients, while they worsened in those who received nursing home care. This finding provides evidence to direct the policy of LTCS and offers information to guide older adults with a stroke and their family when deciding between the modalities of LTCS.