Rehabilitation needs of older adults with cognitive impairment following ischemic stroke: a qualitative study.

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Original abstract

<h4>Aim</h4>To explore the self-reported experiences of older adults with post-stroke cognitive impairment following ischemic stroke and their needs for cognitive and functional recovery, rehabilitation information, psychological support, daily-life assistance, and healthcare services. The study aimed to generate evidence for improving rehabilitation support and patient outcomes.<h4>Methods</h4>A qualitative descriptive study was conducted using semi-structured interviews. From May to July 2025, older adults with ischemic stroke and post-stroke cognitive impairment were recruited from the Departments of Neurology and Rehabilitation of a tertiary hospital in Jiangsu Province, China. The interviews explored participants' understanding of cognitive impairment and rehabilitation, psychological responses, difficulties encountered in daily life and treatment, experiences of seeking help, expectations of healthcare support, and hopes for future recovery.<h4>Results</h4>A total of 12 participants were interviewed and included in the final analysis. Data saturation was achieved during data collection. The participants had a mean age of 72.3 ± 5.6 years; 10 were male and 2 were female. Three themes were identified. The first theme was shared and supported rehabilitation goals, referring to needs recognized by both patients and healthcare professionals. The second theme was patient-identified needs beyond current support, describing needs expressed by patients but not routinely addressed. The third theme was undisclosed concerns and potential health risks, encompassing distressing concerns that participants hesitated or were unable to express openly.<h4>Conclusion</h4>Older adults with post-stroke cognitive impairment have multidimensional rehabilitation needs that may not always be expressed spontaneously or clearly. Rehabilitation should therefore adopt a patient-centred, holistic, and cognitively appropriate approach that integrates cognitive and physical recovery, symptom management, health education, emotional support, family involvement, social participation, and identity adjustment. Coordinated support across hospital, community, home, and family settings is essential to ensure continuity of care and promote long-term independence and well-being.

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