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Table 2 Jenny’s needs and experiences in rehabilitation

From: The case of value-based healthcare for people living with complex long-term conditions

Jennya is a 79-year-old woman who had a stroke four days ago. She lives alone and until now had been quite independent. Since the stroke, however, she has faced problems moving her right arm and hand. She can manage to get dressed, although it takes a long time, and she has to wear more casual clothes than she is used to because it is difficult to manage buttons and other closures on dressier or more formal clothing. She can eat with her left hand but needs help to cut the food. She has just arrived at the rehabilitation unit and has high expectations for her stay. She is very motivated and determined to return to her previous level of independence. After only a few days, Jenny is discharged and returns home, where she continues rehabilitation sessions with her primary-care stroke team. They visit her once a week, and after six weeks the rehabilitation ends. Jenny has improved her arm and hand function, and the stroke team considers the rehabilitation very successful, but Jenny has not returned to her previous level of independence. For example, though she had long taken great pleasure in cooking, Jenny now needs home-help service to deliver food boxes for her to heat in the microwave oven. Jenny is very disappointed and had hoped for a much more intensive rehabilitation.

  1. aJenny is a pseudonym