Learning Objective #1: Describe the familiar modifications that may occur after cerebrovascular accident in elderly people

Learning Objective #2: Realize the needs of acting with the family, guaranteeing the maintenance of elderly people in its context

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After being hit by Cerebrovascular Accident (CVA), elderly persons demand greater attention from their families in view of the difficulties resulting from the disease. This study aims to: identify the level of dependence and independence for daily activities among elderly victims of CVA; characterize and evaluate the elderly and their respective families, as well as identify family changes that occurred after the CVA. We used the Daily Activity and Daily Instrumental Activity Scale to identify the elderly's level of dependence and independence; the Calgary Family Evaluation Model to characterize and evaluate the families and the adapted Critical Incident Technique to identify the changes that occurred after the disease. The sample consisted of 11 families of elderly victims of CVA, assisted at a hospital institution in the interior of São Paulo, Brazil, in 2002, totaling 34 participants. Data were collected at the elderly's homes by means of semi-structured interviews, which were realized in the second semester of 2003. With respect to the elderly persons, 90.9% suffered ischemic CVA, while 9.1% were victims of haemorrhagic CVA; 63.6% were male and 36.4% female; average age was 73.4 years; 72.7% were married and 27.3% widowed; 45.4% depended on another person for most everyday activities. The family structure consisted of 4.3 members on the average; monthly revenues varied from one and a half to nine minimum wages; and the catholic religion was predominant. The analysis disclosed 8 categories of family changes, totaling 360 changes, which were organized into 77 subcategories, 29.2% of which were positive and 70.8% negative. The study revealed the need to work with the family in order to guarantee that the elderly persons are maintained within the family and social context, to help improving or maintaining the family's functioning and to face the chronic disease.