Going home early is a treatment — early supported discharge
| Patient | 69F, subacute phase |
|---|---|
| Lesion | MCA territory, moderate |
| Severity | NIHSS 8 |
| Days since onset | 12 |
| Before the strokeIndependent in all activities; the household cook | |
| Also on the chartControlled hypertension; Hypothyroidism | |
| PrecautionsHome assessment before discharge — front steps, bathroom layout, bed height; Antihypertensive timing on active mornings | |
Test yourself
She is medically stable at day twelve with support at home. What does the evidence favour?
The teaching
Early supported discharge reduces long-term dependence for suitable patients (Langhorne 2005) ESD is a coordinated team continuing rehabilitation at home — not a leaflet and a six-week wait Trained caregivers are co-therapists; untrained exclusion wastes daily practice (Vloothuis 2016)
Read next
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: Langhorne 2005, Cochrane Database of Systematic Reviews, early supported discharge services for stroke patients. Winstein 2016, Stroke, guideline for adult stroke rehabilitation and recovery · Vloothuis 2016, Cochrane Database of Systematic Reviews, caregiver-mediated exercises after stroke. Winstein 2016, Stroke, guideline for adult stroke rehabilitation and recovery