NeuroDash

The stroke case library

chronic — tier 3

Caregiver Training at Four Months

Patient74F, chronic phase
LesionMCA territory, moderate
SeverityNIHSS 7
Days since onset120
Before the strokeIndependent, keen cook, ran the household
Also on the chartAtrial fibrillation; Osteoarthritis of both knees
PrecautionsCaregiver back strain during assisted tasks; Anticoagulated — avoid high-risk practice setups

Test yourself

How should you structure the caregiver’s role in the home programme?

The teaching

Caregiver-mediated exercise improves outcomes when carers are trained and supported (Vloothuis 2016) Over-helping breeds dependence and learned non-use — support without smothering Assign the affected arm real daily jobs, and let the carer cue rather than do

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The full sequence

This page carries the case’s first decision. The full sequence — every decision, the five-domain examination, and the debrief that grades you — is in the drill, and the library is included with membership.

Sources on this page: Vloothuis 2016, Cochrane Database of Systematic Reviews, caregiver-mediated exercises after stroke. Winstein 2016, Stroke, guideline for adult stroke rehabilitation and recovery