Occupational therapy predischarge home visits for patients with a stroke: what is national practice?

Background: Little is known about day-to-day procedures in conducting predischarge home visits in occupational therapy. The aim of this study was to identify current practice in relation to people with stroke. Method: A questionnaire was designed and piloted; 184 were posted to stroke units in England. Results: Responses were analysed from 85 stroke units from 10 regions. The main reason for conducting visits was to 'assess or practise activities of daily living in the home environment' (93%), closely followed by to 'identify or address safety issues' (92%). Wide variations exist in time spent on the actual visit (range 10-135 minutes), with a mean time of 63 minutes (SD 20.36), and a mean time of 61 minutes (SD 33.13) for writing a report. Visits were generally conducted by an occupational therapist, with an occupational therapy/physiotherapy assistant. The majority (95%) of therapists reported having a home visit bag and the most common item included was incontinence pads (83%). Conclusion: This research has provided valuable information on, and highlights the variation in, day-to-day predischarge home assessment visits for patients after stroke. The next step must be to use this knowledge to evaluate patient selection and to examine the costs and effectiveness of such visits.