AA

Key Points

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  • In many cases, discharge from hospital is delayed for SCI patients due to lack of accessible housing, which leads to unnecessary increase of cost of care.
  • ILCs with MRP relationships serve more clients than those without, and the most frequently serviced individuals are those with SCI who attend for peer counseling, skills training and discharge planning.
  • Living with a spouse and/or children, living alone, or living with unrelated persons are more desirable arrangements than living with parents and spouse/children together, living with distant family (i.e. grandparents), or living with parents and siblings.
  • Marital status, transportation barriers, education level, medical supervision requirements, economic disincentives, services received, and severity of disability are predictors of independent living.
  • Choice and control are important when planning living situations and setting goals with clients with SCI because they are directly related to residential and life satisfaction.
  • Individuals with SCI have lower perceived life satisfaction, locus of control, and satisfaction with certain aspects of housing than a normative sample.
  • Accommodation options for a person with a disability are limited. The preferred accommodation is a private house or apartment.
  • Living with someone prior to SCI, having insurance or private funding for equipment, and being young decreases the risk of being discharged to an extended care facility following SCI rehabilitation.
  • Individuals with SCI have a need for assistance with fire safety to increase their perception of home safety.
  • Individuals with SCI move multiple times after injury. In most cases, they start living with their parents and/or in an institution before moving into their own homes.
  • Most informal caregivers are female spouses of individuals with SCI who require assistance in fulfilling and maintaining services.
  • There is substantial burden to family caregivers who report feeling overwhelmed, decreased psychological well-being and decreased satisfaction with life.
  • There is general satisfaction with informal attendant services.
  • The most significant predictors of personal care assistance use are motor function, days spent in rehabilitation, and length of stay in a nursing home.
  • Personal attendant turnover is positively correlated with higher injury level and increased need for assistance in exercise and transfers.
  • Directing one’s care, establishing roles and boundaries for PCA, and improving training may facilitate consumer independence.
  • Goal-directed occupational therapy can achieve gains in role performance and improvements in life satisfaction.
  • Counselling on proper technique and hygiene for at least one session might reduce the risk of UTI to below threshold for individuals at risk for UTIs.
  • Re-hospitalization might be reduced after participation in an educational intervention involving a workshop, a collaborative home visit, and access to follow-up.
  • Skills development educational workshops for attendants and consumers can increase knowledge about spinal cord injury, wellness, and communication.
  • Directing, training, and financing one’s personal attendant care may lead to financial savings, better health outcomes, and increased life satisfaction.