An investigation of management care pathways and health inequalities amongst older people with stroke and atrial fibrillation in care homes: A mixed-methods project

There are more than 1.2 million stroke survivors in the UK and stroke is a leading cause of disability and mortality in the UK. After discharge from hospital, stroke survivors are likely to have complex physical, cognitive and psychological care needs. Over 1 million people in the UK are living with atrial fibrillation (AF), the most common sustained heart arrythmia which increases the risk of stroke five-fold. Early detection of AF is critical to implement integrated management pathways including the use of oral anticoagulants to reduce risk of stroke.

The incidence of stroke increases with age, but it is unclear how many older people in UK care homes are living with stroke and what their co-morbidities, level of frailty and complex care needs are. People with stroke who are transferred from hospital to care homes should receive assessment and treatment from stroke rehabilitation and social care services to the same standards they would receive in their own home. It is unclear if people living in care homes are receiving the same standard of care post-stroke they would receive at home and if determinants of health inequalities impact their care. Furthermore, methods to reduce risk of stroke such as risk prediction models for AF and stroke have not been examined for people in care homes.

Older people living in care homes are often excluded from research, and there is a need to identify approaches to optimise care pathways and treatment to improve health and quality of life for these individuals. This includes research into the care and treatment people receive in care homes following a stroke. People living in care homes post-stroke have higher levels of disability compared to people living in the community post-stroke. Yet, relatively little research has been conducted with people following a stroke living in care homes.

Application is by CV and covering letter. The covering letter must detail your interest in the studentship, related experience and training and suitability for the position. Applications are to be sent to Professor Gregory Lip, [Email Address Removed].