Post-Stroke: Extra Care Needed For Recovery

The road to recovery after a stroke can be long and challenging, and it's essential that patients receive the necessary care and support to optimize their healing journey. Post-stroke care is a critical component of the recovery process, aiming to help patients regain their physical, mental, and emotional health and adjust to any lifestyle changes that may be necessary. The quality of post-stroke care can significantly impact a patient's overall well-being and their ability to return to their daily activities and routines. In this discussion, we will delve into the various aspects of obtaining extra care for post-stroke patients, exploring the available resources, support systems, and strategies to enhance their recovery and overall quality of life.

Understand the effects of a stroke

Understanding the Effects of a Stroke

The effects of a stroke vary from person to person, depending on the type, severity, location, and number of strokes, as well as the area of the brain affected and the extent of the damage to the brain tissue. The brain is an extremely complex organ, controlling both motor and sensory functions throughout the body. When a stroke occurs, if blood flow is unable to reach a particular region of the brain, that part of the body will be affected and may lose normal function.

The brain has three main areas: the cerebrum (left and right sides), the cerebellum (back of the brain), and the brainstem (base of the brain). The effects of a stroke depend on which of these areas is affected. For example, a stroke in the cerebrum may result in paralysis, sensory loss, vision problems, cognitive impairment, and behavioural changes. A stroke in the cerebellum can lead to issues with coordination and balance, while a stroke in the brainstem can cause severe problems with vital functions such as breathing and heart function.

The first three months after a stroke are critical for recovery, with the most rapid recovery usually occurring in the first three to four months. During this time, patients may experience spontaneous recovery, where a lost skill or ability suddenly returns as the brain finds new ways to perform tasks. However, setbacks can also occur, such as pneumonia, a heart attack, or a second stroke, which can significantly impact the recovery process.

It is important to be aware of the potential physical, cognitive, and emotional effects of a stroke, as well as the possibility of post-stroke depression, which can affect up to 50% of survivors. Understanding these effects can help caregivers provide the necessary support and seek appropriate medical and therapeutic interventions to aid in the recovery process.

Prepare your home for the patient's return

Understand the effects of the stroke

Before preparing your home for a stroke patient's return, it is important to understand the potential effects that stroke survivors may experience. A stroke occurs when the blood supply to or within the brain is interrupted, resulting in a lack of oxygen and essential nutrients being delivered, which causes damage to the affected areas of the brain. Depending on the areas of the brain that were damaged, survivors may experience a range of physical, cognitive, emotional, and behavioural changes. These effects can vary in severity, with some survivors experiencing mild effects and others requiring around-the-clock care.

Consult with professionals

Doctors and nurses are essential components of a stroke survivor's medical team, but it is also important to consult with their physical, occupational, and speech therapists, who have a detailed understanding of the survivor's abilities and limitations. Occupational therapists, in particular, can advise on the types of assistance and adaptive equipment that may be needed at home. Social workers and case managers are also key members of the stroke recovery team and can provide critical information on insurance coverage, setting up home health or outpatient rehabilitation, and obtaining necessary medical equipment.

Make home modifications

Modifying your home can improve the stroke survivor's ability to navigate and reduce the risk of falling. Common home modifications include:

• Installing grab bars and non-slip mats
• Reducing clutter and removing floor mats and cords from walkways
• Removing or securing rugs with double-sided tape
• Replacing worn or torn surfaces
• Rearranging furniture to allow adequate space
• Ensuring doors can swing open at least 90 degrees
• Widening passageways to accommodate wheelchairs or walkers
• Clearing paths to essential rooms, such as the kitchen, bedroom, and bathroom
• Installing railings on both sides of stairs

Practice caregiving

Practicing caregiving in a safe environment, such as through a caregiver training session with an occupational therapist, can help prepare for the stroke survivor's return home. This may include practising assisting with basic daily activities such as dressing, bathing, and showering. Some rehabilitation facilities also offer home visits, where a therapist travels to the survivor's home to ensure the environment is set up appropriately and to address any concerns regarding the return home.

Promote recovery

Family members and caregivers play a vital role in encouraging and supporting the stroke survivor's recovery. This includes allowing survivors to actively participate in their daily activities as much as possible, providing emotional support, and encouraging a positive outlook on the recovery process. It is also important to continue practising rehabilitative exercises at home to stimulate neuroplasticity and promote recovery.

Provide emotional support

Providing emotional support to a post-stroke patient is crucial as the mental health of the patient is just as important as their physical health. Emotional support can help the patient come to terms with what has happened to them and deal with the emotional impact of the stroke. Here are some ways to provide emotional support:

• Counselling: Offer counselling sessions with professional counsellors to help the patient explore issues such as loss and adjustment, understanding guilt and anger, and building confidence and self-esteem. Counselling can also be extended to the patient's family and caregivers, as they too may be affected by the emotional impact of the stroke.
• Peer Support: Facilitate peer support sessions led by trained volunteers and emotional support coordinators. These sessions can provide an opportunity for the patient to connect with others who have gone through similar experiences, fostering a sense of community and support.
• Address Emotional Distress: Stroke survivors often experience emotional distress, including anxiety, panic, guilt, sadness, and symptoms of post-traumatic stress. It is important to help them manage these emotions and provide strategies to cope, such as mindfulness, problem-solving, gratitude, and self-care.
• Manage Uncertainty: The recovery process after a stroke can be uncertain, and patients may worry about their future health and the possibility of recurrent strokes. Help the patient focus on the present and provide clear communication about their treatment and progress to reduce uncertainty.
• Supportive Team: Encourage the patient to build a supportive team of family, friends, and medical staff. Having a strong support system can make a significant difference in their recovery journey.
• Access to Resources: Provide information about community resources, such as stroke survivor support groups and caregiver support groups, that can offer additional emotional support and a sense of community.
• Monitor Behaviour Changes: Keep an eye out for any changes in the patient's behaviour and emotions. If they are having difficulty controlling their emotions or exhibiting signs of depression, consult a healthcare provider to develop an appropriate plan of action.

Help with daily tasks

Daily tasks that were once simple may become challenging after a stroke. Here are some ways to help post-stroke patients with their daily activities:

• Understand the patient's needs and abilities: Identify the areas where the patient requires assistance, such as bathing, dressing, preparing meals, or performing basic hygiene routines. Understanding their specific needs will help you provide targeted support.
• Encourage independence: While providing assistance, it is essential to promote the patient's independence as much as possible. For example, if they can perform certain tasks with minimal assistance, encourage them to do so and provide supervision or assistance only when necessary. This helps boost their confidence and sense of control.
• Modify the home environment: Make changes to the patient's living space to accommodate their new needs. This may include installing grab bars in the bathroom, placing frequently used items within easy reach, or rearranging furniture to create wider pathways for easier mobility.
• Offer assistance with mobility: If the patient has difficulty walking or moving around, offer your support by providing a steady arm or using mobility aids such as a walker or wheelchair. Ensure their walking paths are clear and free from obstacles to prevent falls.
• Help with personal care: Assist the patient with personal hygiene tasks such as bathing, grooming, and dressing. Be respectful and patient, allowing them to perform as much of the task as they can independently. Provide guidance and adaptations as needed, such as adaptive equipment or clothing with easy-to-use fasteners.
• Support with meal preparation: Offer to help with meal planning, grocery shopping, and preparing meals that align with the patient's nutritional needs and any dietary restrictions advised by their healthcare team. Encourage a healthy diet to aid in their recovery and lower the risk of another stroke.

Monitor their health

Monitoring the health of a stroke patient is crucial, and it can be done in several ways. Firstly, it is important to be aware of the patient's medications and their side effects. Additionally, caregivers should monitor changes in the patient's attitude and behaviour, as post-stroke depression is common, affecting 30-50% of survivors. This can significantly hinder their recovery and rehabilitation, so a plan of action should be developed with a healthcare provider if this occurs.

Secondly, it is important to monitor the patient for physical symptoms such as dizziness, imbalance, difficulty walking or moving, and inability to complete daily activities. These symptoms can indicate the need for physical or occupational therapy. Falls are also common after a stroke, and if they occur more than twice in six months, or result in severe pain, bruising, or bleeding, a visit to the emergency room or a consultation with a physician is necessary.

Thirdly, vital signs such as heart rate, blood pressure, body temperature, and oxygen saturation should be continuously or intermittently monitored, as per the patient's care plan. This can help detect adverse changes or complications that require acute medical treatment.

Finally, regular visits to the healthcare provider are essential to monitor the patient's overall health and prevent another stroke. This includes evaluating their diet, exercise routine, and medication adherence.

Frequently asked questions