Four Stroke Recovery Models to Help Customize Treatment Plans

Stroke recovery is a long process that begins during inpatient care. It is critical that practitioners and researchers understand the recovery process from the perspectives of stroke survivors and their family members who will be providing post-discharge care. Several conceptual models are designed to help us better understand the recovery process, allowing us to tailor treatment plans to the needs of both stroke survivors and their caregivers.

1. The ICF

The ICF (International Classification of Functioning, Disability, and Health) is a conceptual model that the World Health Organization developed in 2002 to merge the medical and social models of disability.1 While not specific to stroke, this model was designed for “measuring health and disability at both individual and population levels.”2 It can be used as a framework for research and practice with recovering stroke patients. The model includes classifications for Body Function and Structures, Activities, Participation, and Environmental and Personal Factors.

2. “Timing it Right”

Dr. Jill Cameron’s “Timing it Right” framework outlines the phases of stroke recovery from the stroke event through stabilization, preparation, implementation, and adaptation.3 It can be used to identify the stroke survivor’s and caregiver’s needs across the stroke care continuum, from admission to community re-integration.

3. Mauk Model of Post-Stroke Recovery

Dr. Kris Mauk’s Model of Post-Stroke Recovery focuses on understanding how stroke survivors integrate the effects of stroke in their self-identify.4 The model includes 6 phases of recovery:

  1. Agonizing
  2. Fantasizing
  3. Realizing
  4. Blending
  5. Framing
  6. Owning

The model helps providers understand how stroke affects a patient’s sense of self, depending on their phase of recovery. Providers can then tailor treatment plans to match the patient’s emotional recovery from stroke.

4. Stroke Crisis Trajectory

The Stroke Crisis Trajectory shows how stroke survivors and their family caregivers move through the continuum of care, from the stroke event through acute care to inpatient rehabilitation.5 The model highlights two crisis points for caregivers and stroke survivors:

  1. The stroke event occurs.
  2. The caregiver realizes they may not be adequately prepared for the caregiving responsibilities at home.

The trajectory helps providers and researchers create discharge plans or interventions that are tailored to meet the needs of both stroke survivors and family caregivers.

Why Do These Models Matter?

The stroke recovery models contribute additional information for providers and researchers to better understand the stroke recovery trajectory. They are valuable resources to providers, aiding in the creation of custom treatment and discharge plans or interventions. Both stroke survivors and family caregivers benefit from the recovery models as they allow providers to address the needs of both groups throughout each stage of the recovery process.

References
  1. World Health Organization (2002). ICF: International classification of functioning, disability, and health. World Health Organization. Retrieved from: http://www.who.int/classifications/icf/en/
  2. World Health Organization. http://www.who.int/classifications/icf/en/
  3. Cameron, J.I. & Gignac, M.A.M. (2008). ‘‘Timing It Right’’: A conceptual framework for addressing the support needs of family caregivers to stroke survivors from the hospital to the home. Patient Education & Counseling, 70, 305-314.
  4. Mauk, K.L., Lemley, C., Pierce, J., & Schmidt, N.A. (2011). The Mauk Model for poststroke recovery: Assessing the phases. Rehabilitation Nursing, 36(6), 241-247.
  5. Lutz, B.J., Young, M.E., Cox, K., Martz,, C., & Creasy, K.R. (2011). The crisis of stroke: Experience of patients and their family caregivers. Topics in Stroke Rehabilitation, 18(6), 786-797.