The Leeds Family Placement Scheme: an evaluation of its use as a rehabilitation resource

Abstract

The Leeds Family Placement Scheme (FPS) was designed to provide short term support for vulnerable stroke patients on discharge from hospital. Suitable patients were discharged into the care of 'substitute families': lay carers recruited from the community and trained by staff of a rehabilitation unit. Patients received care from their substitute family for an average of eight weeks during which time specific targets were met and a phased return home organized. Placements were supervised, guided and monitored by a key worker: an occupational therapist with counselling skills. All patients taking part in the FPS showed improvement during placement. Comparison of a group of 10 placed patients and a control group of 61 unplaced patients, all with recent stroke, showed a statistically significant increase between three and twelve month poststroke Barthel scores in placed patients (mean scores 73.0 and 87.0 respectively). No overall improvement was observed in the control group (mean scores 74.4 and 75.7 respectively). The decline in social and home-based activities following stroke was comparable in the two groups. While recognizing the limitations of this small study, it is suggested that the use of trained lay carers and a key worker can maximize the benefits gained by intensive hospital rehabilitation.