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Post-stroke rehabilitation with neglect — SCE Geriatric Medicine MCQ

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ModerateStroke carePost-stroke rehabilitation with neglectSCE Geriatric Medicine

An 86-year-old man is transferred to a community hospital after stroke. He can sit unsupported, has left neglect, dysphagia requiring modified texture diet and Barthel score 7/20. His daughter asks for a fixed discharge date, but the MDT notes improving transfers and endurance over the past week. What is the most appropriate management?

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Correct answer: D — Set patient-centred rehabilitation goals with regular MDT review before deciding final discharge needs

Stroke rehabilitation should be goal-based, multidisciplinary and responsive to observed progress, with discharge planning updated as function changes. A low Barthel score early in rehabilitation does not mandate permanent placement. Neglect affects rehabilitation needs but does not mean therapy is futile. The teaching point is that discharge planning and rehabilitation should proceed together rather than sequentially.

Reference: National Clinical Guideline for Stroke 2023; NICE NG236