This project seeks to build on previous research by investigating the social and cultural factors that impinge on the long-term life reorganization of individuals age 5O and over who have sustained chronic impairments resulting from one type of illness-stroke.
The specific aim of the proposed anthropological research is to examine the processes by which individuals reorganize their lives during the period of 4 to 16 months post-stroke. Four processual issues emerged for stroke patients that remain unresolved in the first year following the stroke: 1) Older persons and their families are ill equipped to cope with the long- term problems in daily living imposed by stroke-caused impairments; 2) Many stroke victims make an active effort to return to former patterns of living regardless of functional impairments; 3) Patients express a need to integrate the profound disruptions the stroke has caused into the self-image, so that a continuous sense of self emerges; 4) there is divergence between health provider and patient goals once the stroke patient's condition has stabilized. patient needs regarding life reorganization are not within the scope of providers' interventions. To investigate these issues in the proposed project, we have two goals: 1) to focus on the factors involved in the transition from the delivery of home care services to the termination of those services. Data collection in the proposed study will begin shortly before home care services terminate; 2) to investigate variables that influence the amount of informal, community-based support received in the one-year period following the discharge of the patient from home care services. We will be concerned with how such variables determine the life reorganization process for the patient. 100 stroke patients and their families will be followed. Interviews and participant observation are the data collection strategies. Data analysis will include qualitative content analysis and descriptive statistical procedures, especially path analysis and multiple regression. Findings will help both researchers and providers understand a) the relationship between aging and chronicity, b) the process of life reorganization in old age, and c) the impact of the growing incidence of chronic disease on biomedical knowledge and practice.
| Becker, G; Kaufman, S R (1995) Managing an uncertain illness trajectory in old age: patients' and physicians' views of stroke. Med Anthropol Q 9:165-87 |
| Becker, G (1993) Continuity after a stroke: implications of life-course disruption in old age. Gerontologist 33:148-58 |
| Kaufman, S R; Becker, G (1991) Content and boundaries of medicine in long-term care: physicians talk about stroke. Gerontologist 31:238-45 |
| Becker, G; Kaufman, S (1988) Old age, rehabilitation, and research: a review of the issues. Gerontologist 28:459-68 |
| Kaufman, S; Becker, G (1986) Stroke: health care on the periphery. Soc Sci Med 22:983-9 |
