1401 - Functional Recovery and Housing Instability in a 74-Year-Old Stroke Survivor Relocating for Rehabilitation

A 74-year-old man with hypertension and a history of right-sided ischemic stroke with residual left-sided weakness and visual deficits.

Case Description:

The patient presented with acute stroke outside the tPA window and underwent successful mechanical thrombectomy. He was discharged on secondary prevention with aspirin and a statin. Despite these measures, he experienced persistent left-sided weakness and visual impairment, limiting his independence. Originally residing in a rural area, he relocated to a major city to access appropriate rehabilitation and follow-up care. This transition led to loss of stable housing, and he is now unhoused for the first time in his life, despite maintaining an apartment in his rural hometown. He was referred to a medical respite center for ongoing care and support.

Discussions:

This case highlights the complex interplay between medical outcomes and social determinants of health in stroke recovery. While advances such as mechanical thrombectomy improve survival and functional outcomes, patients may still face profound disability requiring specialized follow-up. Access to rehabilitation is often limited in rural areas, forcing relocation to urban centers. For this patient, the need for accessible care directly contributed to new-onset homelessness, underscoring the vulnerability of older adults with chronic illness. Clinicians should consider housing instability as a potential complication of stroke recovery, particularly when patients must leave established support systems to obtain treatment.

Conclusions: Stroke recovery requires not only medical management but also attention to social determinants such as housing and access to rehabilitation, as these can critically affect long-term outcomes.