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Arriving Home After a Stroke

Caregivers, once you get home from the hospital with your loved one who has experienced a stroke, you may have many questions. Rehabilitation and home care nurses, social workers, therapists, and physicians are great resources of information. There are many options for stroke survivors and their family members to learn more about stroke.Therapy

How fast will my loved one recover?

Recovery from a stroke is a lifelong process. Many survivors start out with going to rehabilitation. Here, the therapists work with you loved one to gain strength, perform activities of daily living, and restore speech to the highest possible level. According to the National Stroke Association:

  • 10 percent of stroke survivors recover almost completely
  • 25 percent recover with minor impairments
  • 40 percent experience moderate to severe impairments requiring special care
  • 10 percent require care in a nursing home or other long-term care facility
  • 15 percent die shortly after the stroke.

Why should my loved one go to therapy?             

This is an opportunity for the stroke survivor to gain strength and independence. Not every stroke survivor has the same needs. Rehabilitation is specifically designed to meet the needs of your loved one.

Physicians can send Occupational and Physical Therapists to your home. Therapy requires time and resources. Check with your insurance company for the programs that are covered. This will help you choose what is right for you.

What types of therapy are available?

Physical TherapyPhysical therapy: This therapy helps patients relearn how to regain function. It is often referred to as PT. It helps with skills such as walking and moving arms and legs with ease. This also helps the stroke survivor to feel more independent.

Occupational therapy: This therapy is also referred to as OT. An occupational therapist helps re-teach the stroke survivor to dress, feed, and use the bathroom independently.

Speech Therapy: The stroke survivor will also undergo speech therapy if needed. The speech therapist will help the stroke survivor re-learn to speak and communicate.

Vision Therapy: Often times, stroke survivors have visual problems after a stroke. In order for the survivor to regain vision, their brain and the eyes have to work together. The stroke survivor should have a complete eye exam after the stroke. This exam will uncover any stroke-related vision problems. Ophthalmologists or optometrists can diagnose any problems and come up with treatment to help with the vision problem.

What do I need to do to prepare my home?

Since function and mobility can be difficult for a person recovering from a stroke, some modifications may be needed around the home. To ensure safety for the stroke survivor, Physical and Occupational Therapists may be able to evaluate your home prior to your loved one getting home to set up optimal operation in your house. Check with your insurance company to see if this service is available to you.

Make a list as you go along of things around the house that work well for you, and things that are a problem for you. This can help you come up with ways to fix the problem. Here are some suggestions:

  • All throw rugs should be picked up from floor to reduce chance of tripping.
  • A shower chair may be used during bathing.
  • Shower chairs may be rented or purchased form medical equipment or your local drug store.
  • A bathroom and sleep area may need to be on one level or floor for ease of use.
  • Beds may be placed in other rooms for sleeping on the first floor.
  • Move furniture to get a walker or wheelchair in certain places.
  • Adjust lighting in the house to assist in clear visibility.
  • Keep telephone within reach.
  • Wear non-stick shoes around the home to prevent slip and falls.
  • Install handrails in bathroom and stair wells.
  • Move or reorganize clothing and personal items so they are within reach.

Please visit this web site for more information. http://www.stroke.org/site/PageServer?pagename=surv_ed

For more tips visit http://www.stroke.org/site/DocServer/NSAFactSheet_ManagingLifeatHome.pdf?docID=994

What your loved one may encounter…

  • Problems with talking – Difficulty communicating can be seen in stroke survivors. The damage that the brain sustains from a stroke can affect the ability to speak and find words. Occupational therapy can help reestablish ability to talk and communicate, to the highest level possible.
  • Diet and weight change– Stroke patients may gain weight from an inability to move around like they used to. A diet low in salt, fat, cholesterol may help with maintaining their current weight, and might help to prevent another stroke. Talk with your healthcare provider or physician about making diet changes.
  • Memory–This can be displayed in memory loss, confusion, mood swings, or difficulty in making decisions. There are strategies to deal with this decrease in function. Talk with your family physician about these changes.
  • Depression – Depression is very common in survivors. This is due to the change in their lifestyle and not being able to do things that they enjoy. If you find that your loved one is experiencing feelings of sadness talk to your physician immediately for help.
  • Mobility–Many survivors experience inability to move one of their arms or legs. They also may have problems with balance due to the decreased functioning of their arm or leg.
    • The stroke survivor may need assistance with a walker, cane, or wheelchair if they need one.
    • They also may need help with having someone at their side to walk until they get more stable and used to walking after the stroke.
  • Pain–Stroke survivors can experience many different types of pain after stroke. Talk to your family physician on ways to manage pain.
    • Medication may be required to manage the pain.
    • PT may also increase the flexibility and strengthen your loved one’s muscles and decrease his/her pain level.
  • Pseudobulbar Affect (PBA) – This medical condition may cause sudden outbursts of crying, laughing, or other emotional displays. This is uncontrollable and may disrupt your life or the stroke survivor’s life. If the stroke survivor cries easily, laugh at inappropriate times, or has sudden emotional outbursts, talk to your physician about helping control these outbursts. More information can be found on strategies to manage these outbursts at:
  • Seizures – Seizures may occur after a stroke. If your loved one experiences a seizure after a stroke, the stroke survivor should get to the emergency room as soon as possible to rule out another stroke and take proper interventions to prevent a future stroke: CALL 911 FOR ALL MEDICAL EMERGENCIES.

Additional Information:

The following are some web sites to provide you with more information about arriving home after a stroke:

Adapting the Home after a Stroke

Living at Home after Stroke

Recovery after Stroke: Managing Life at Home

Returning Home After a Stroke

 

References:

Cash, J.C., & Glass, C.A. (2011). Family practice guideline (2nd ed.). New York, NY: Springer.

McPhee, S.J., & Papadakis, M.A. (2012). Current medical diagnosis & treatment. New York, NY: McGraw-Hill.

National Stroke Association. (2012). Strokes. Retrieved from www.stroke.org.

U.S. National Library of Medicine. (2012). Stroke. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001740/

Developed in 2012 by Jennifer Ash RN, BSN at the University of Toledo for the Caring~Web©.

Last Updated: 6/17/14