<p>In the wake of a cerebro-vascular accident, survivor and caregiver are often apprehensive about being on their own at home; this is particularly so for those living in low socioeconomic circumstances in the rural areas of Namibia. The situation is aggravated by the fact that there is no structured system of home visits by health workers that could assist caregivers in their daily tasks. Phenomenological interviews were therefore conducted to explore how these caregivers cope with providing home care to the survivors of such accidents. The findings that emerged were categorised into four themes, namely, survivors were unable to provide self-care and were dependent on others for help, the altered role function and performance of survivors, negative emotions because of altered self-esteem, and disrupted social interaction. These experiences together illustrate that some survivors are unable to take care of themselves at all and depend completely on their caregivers for help.</p>
A cerebro-vascular accident entails the sudden death of brain cells resulting from a problem with the blood supply. The patient is consequently left with varying degrees of disability, and usually requires the assistance of a caregiver. This article describes the development of a home-based health care programme intended to facilitate optimal functioning, which formed the final phase of a qualitative study that explored and described the experiences of survivors of cerebrovascular accidents and their caregivers. The development of this programme was based on the four themes that emerged from the original study and which were conceptualised by applying Dickoff, James and Wiedenbach's (1968) practice theory. These four themes were restructured as four dynamics, namely, reframing knowledge and skills regarding self-care, modifying the daily routine, assisting with the adjustment to altered social relationships, and reframing negative emotions. The programme was implemented over four days and an evaluation was done after two months. The feedback revealed that the survivors and their caregivers had benefitted with regard to the skills and knowledge gained from the educational programme.
A cerebro-vascular accident is a devastating experience and those who survive the initial incident often suffer from a variety of physical disabilities. These disabilities frequently result in an adult becoming incapable of, or being limited in, the provision of ongoing effective self-care. In anticipation of improving such situations the researcher developed a supportive-educative programme to be conducted in a home-based setting. This programme formed part of the main study and was implemented over four days. The researcher considered these educative sessions to be an ideal approach for implementing the programme, because adjusting, stabilising and coping can only be facilitated and put into practice through interactive participation. Eight survivors of cerebro-vascular accidents and their caregivers, all of whom had participated in the main study, were selected for the training sessions. During these sessions, the purpose, objectives and content of the programme were presented and discussed. Following the sessions, the participants were encouraged to apply what they had learnt from the training. After two months the researcher and the participants came together to conduct an evaluation of the programme.
Providing care for the survivors of a cerebro-vascular accident in home settings is an increasingly common practice. Accordingly, a conceptual framework was developed with the aim of establishing guidelines for the implementation of a support programme to enable survivors and their caregivers to function optimally at home. The framework involves the attributes of the agent (lecturer as a facilitator), the recipients (survivors and caregivers), the context (the home setting), the procedures for enabling optimal functioning and, finally, the terminus, which is defined at optimal functioning for both the survivors and their caregivers.
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