Stroke Survivors Coming Home

The likely constraints for stroke survivors include paralysis of a limb or one side of the body, loss of speech, vision problems, difficulties with thinking and memory, difficulty swallowing, loss of bladder control and problems with balance. Physical rehabilitation focuses on getting the patient mobile and improving coordination, strength and endurance.

Up to 80 percent of patients are unable to walk independently right after a stroke, but due to a combination of physical rehabilitation and natural recovery that number later drops to less than 20 percent. A stroke patient might need to use a living aid such as walker or cane in the early stages and gradually progress to more independent walking.

Adapting the home after stroke

Going home to the old home or a new one is also a big adjustment. When a stroke survivor returns home, the home environment itself can also impact a person’s recovery.

While the home environment includes physical features such as the housing materials, structures, and special equipment, it also includes the social and cultural environment such as the people who live there, as well as the customs and preferences of individuals.

It is important that it supports continuing recovery and safety for the patient. Basic education is essential to stroke survivors and their families about potential problems with the physical aspects of the home.

Preparing a living place

A stroke survivor needs a living place that supports continuing recovery.

Before a patient goes home, a physical or occupational therapist usually visits his or her home to check for potential hazards and suggest changes to make getting around the house easy and safe. This helps identify problems that need to be discussed or corrected before the patient returns. They may suggest changes to make it safer.

Changes might include changing rooms around so that a stroke survivor can stay on one floor, moving scatter rugs or small pieces of furniture that could cause falls, and putting grab bars and seats in tubs and showers.

Home modification ideas

Home modification for stroke victims is often necessary to prevent falls and enable them to have a better quality of life possible with their new disability, in which the living environment is intentionally changed to increase safety, ease of use and the capability of the stroke survivors to help themselves.

• Bathroom:
  • The bathroom is the most dangerous part of the house for anyone with physical disabilities. Some home modifications and devices are can be installed for patient protection.
  • Non-slip flooring and scrub brushes are easy to purchase and install. Moisture resistant non-slip adhesive tape can be applied to the bathroom floor, including in the shower.
  • Important safety devices like tub benches and toilet chairs are available from medical supply stores and home health services by prescription, and may be covered by your insurance.
  • It is important to discuss bathroom safety with the stroke care team before moving to any new home environment.
• Bedroom:
  • To increase independence in the bedroom, a stroke survivor may need to reorganize clothing and personal items so that they are easily accessible.
  • It is also important to consider the room from a nighttime perspective such as adequate lighting, clear pathways, and access to a toilet are essential in order to avoid accidents in the dark.
  • A chair may also make it easier for dressing.
• Dining room:
  • Using utensils, sitting up to the table, and swallowing are often difficult following a stroke. In addition to help from health professionals such as a speech therapist and a nutritionist, specialized utensils and dishes are available that may make dining less frustrating and more enjoyable.
  • "Stable tables" may be a useful device. These are a tray with a soft-filled underside that can mold to the surface on which it is placed (most often the patient's upper thighs).
  • If an arm is affected by the stroke, chairs with arms provide a place to rest the affected limb.
  • Whatever the obstacle, patience plays a key role in improving the dining experience.
• Kitchen:
  • In order to prevent accidents, it is important to consider every aspect of the kitchen that a stroke survivor could come into contact with on a daily basis.
  • With some thoughtful planning, a stroke survivor may be able to feel safe enough to prepare his own food or at least be able to do things in the kitchen with some help.
  • It may involve some major construction changes; or simple organizational ideas that may make kitchen activities more feasible.
  • There are plenty of kitchen implements that have been designed for older people with limited mobility and strength. These can be used. Examples include a wide handled vegetable peeler, grater. However, care needs to be taken with sharp implements as most stroke patients are on anti-coagulents and a cut can take a long time to stop bleeding.
• Doorways and staircase:
  • Ensure that doorways are wide enough for a wheelchair or walker.
  • If necessary, remove doors or doorframes to widen the space.
  • You may also need to install threshold ramps.
  • Handrails on both sides of a staircase are important for safety and the confudence if the stroke survivor.
  • It is important that lighting is bright enough, especially over stairways or other potentially hazardous areas.
• General ideas:
  • Keep a telephone in each room, along with emergency numbers printed in large, bold type. Also, make sure phones are placed at a level a stroke survivor can easily reach.
  • To increase safety, you need to be sure that help is within reach if needed.

There are also a variety of living aids that can make life easier.