Linda is an 83-year-old woman who was admitted to the rehabilitation hospital following a right cerebral vascular accident (CVA) with left weakness. Upon admission, Linda was identified as a fall risk and requires assistance in both ADLs and IADLs. At this time, Linda walks independently with a “toe drag” on the left, and is walking throughout the facility using a standard walker. Increased muscle tightness was noted throughout the left upper extremity.

On initial assessment, Linda could feed and groom herself, given setup. She needs minimum assistance in transfers and moderate assistance in bathing. She uses her right hand for most tasks, and will use the left arm as a gross assist in some activities. Her left shoulder and elbow are weak, with muscles scoring in the “fair” grade of strength.

Linda has an impaired awareness of light touch on her left body side and she has left visual inattention. Linda is interested in participating more in dressing and cooking tasks, but requires prompting to stay on task and to follow a schedule for task completion.

Goals Linda set for herself in rehabilitation include: “walk like I used to,” “use left hand when I need to,” and “pain control.” Linda’s husband Bob has visited her daily while she was hospitalized, but has not wanted her discharged to home because he did not feel competent to care for her. Both Bob and Linda will need a lot of support as she transitions back to living in her home.

Linda lives with her husband Bob in a one-story home that has two steps (with no handrail) to enter the house. At home she now has a walker, a lift chair, a shower chair, and grab bars in the bathroom. Linda is unable to dress herself, requiring Bob to assist with both upper-body and lower-body dressing. Linda has home health therapy support and is highly motivated to improve. Because her ADL activities and her therapy activities take most of her day, both she and Bob have had little ability to socialize or maintain their relationships in the community.

Look at the discussion of home modification that can help support healthy aging. Some of these could be beneficial to Linda and Bob. List some that you think would be good ideas, and why you chose them.