Stroke Training and Awareness Resources (STARs)


Clinical applications

Irene and Judith together in the Sunrise nursing home

Irene is an 84-year old lady who is a resident of the Sunrise Nursing Home. Judith is 82 years old and is in the room next to Irene. Both ladies had a stroke in the same week one year ago, which resulted in them experiencing left weakness and neglect. Their left arms developed spasticity. A core part of managing this was daily stretches by the therapy and nursing staff to make sure they had the opportunity for their arms and legs to be moved through their full range of motion. Despite the best efforts of the stroke acute and rehabilitation units, neither lady achieved adequate independence to return home and, after eight months, found places in Sunrise.

Sunrise Nursing Home is a modern and well-run nursing home. The staff are trained well and the environment is clean and well-maintained. However, its popularity has led to it operating consistently at nearly full capacity. The staff are always busy and they are limited to providing this additional care routine for the residents.

Irene’s two sons, their wives and various grown-up grandchildren visit her regularly. They were taught by the therapists in the hospital how to stretch Irene’s arm, hand and leg and they do this whenever they visit. In contrast, Judith’s family live 400 miles away and they can only visit occasionally and were never taught how to stretch Judith’s arm and leg. The Sunrise staff do not have the time to provide the stretching that Judith needs.

Although, Irene’s left elbow and hand can become tight, she is able to straighten them by using her right hand and she remains comfortable. Sadly, Judith’s elbow and fingers can no longer be fully stretched out as her muscles have permanently shortened due to the lack of stretching. She has developed muscle contractures. The staff of Sunrise must keep swabs in her left hand as the tightness is now causing her fingernails to dig into the palm of her hand.

The story of Irene and Judith emphasises how important it is for people to have the opportunity for their limbs to be moved through their full range of motion on a daily basis.

Page last reviewed: 04 May 2020