Development of a Culturally Adaptable Intermediate Care Model For Older Adult Stroke Survivors

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Introduction Intermediate care is vital for maximizing post-stroke functional recovery and maintaining a continuum of rehabilitation. However, robust evidence validating the development or practical deployment of home-based intermediate care models for older adults in Nigeria is currently absent. Objective(s) To develop and validate a home-based intermediate care model for improved functional outcomes and quality of life in older adult stroke survivors. Methods This study employed a two-round Delphi consensus process involving stakeholders in stroke care, including clinicians from geriatrics, neurology, nursing, physiotherapy, and medical social work, to develop and validate a home-based intermediate care model for family caregivers of stroke survivors. The model was developed through a multi-stage process. First, a systematic review was conducted to identify existing intermediate care models and their gaps. Subsequently, a qualitative study explored stakeholders’ perspectives on the home-based care needs of older adult stroke survivors. Findings from the systematic review and qualitative study were integrated to develop a preliminary intermediate care model, which was subsequently refined and validated through the Delphi consensus process. Results The development and validation of the intermediate care model resulted in 10 domains of caregiving. These include stroke knowledge, seizure management, medication management, mobility and fall prevention, vital signs, service referral, reminiscence therapy, speech therapy, nutrition, and financial education. Discussion This model provides a structured framework to facilitate the transition of hospital to home care for older adult stroke survivors.