Health and handicap profile of patients with cerebrovascular diseases in an inpatient rehabilitation center

In order to get more precise information on the staffing and structural capacities needed in the care and rehabilitative treatment of patients with cerebrovascular diseases (CVD), the profiles of illness and disability were studied retrospectively on the basis of the medical histories of CVD patients who had been treated at a neurological rehabilitation centre in 1987 and had mostly come from the facility's assigned catchment area. Due to insufficient documentation of certain profile data in the patients histories, the same data were recorded in a complementary study for all patients in this target population admitted in the first half of 1988. The classification of patients into nursing care categories, already practiced in everyday clinical routines, turned out a valid global estimate for the total nursing, medical and therapeutic efforts required in the individual patient. A high correlation exists between the nursing care category assigned and the numbers of necessary care interventions as well as functional disorders requiring rehabilitative attention. The nursing care interventions needed concentrate on certain situations during the day, which has to be taken into account in staff planning. Given the multitude of impairments and disabilities seen, comprehensive management in a neurological rehabilitation unit presupposes a team of diverse diagnostic and therapeutic specialists, which, apart from medical specialists and nursing staff, should at least comprise physio- and Occupational Therapists, neuro-linguistic or logopedic specialists, as well as psychologists. In view of the high incidence of accompanying internal diseases, a stroke rehabilitation unit must have access to an internal medical service at least on a consultancy basis, and available on an extended time scale.