How to Care for a Stroke Patient at Home
If you are caring for a stroke patient at home, you may have a lot of questions about whether your loved one will recover and what his or her needs will be in the months and years ahead. You may also ask about how you will manage your new role.
Despite the challenges of caregiving, many people report that they appreciate life more and feel positive about being able to help.
As a caregiver, it can be all too easy to make your loved one the focus of your life but it’s vital to ask for help. You can’t do it alone. Here are some suggestions that can help you balance the needs of the stroke patient with your own health and happiness.
Coming Home after a Stroke
There are some issues should be considered before arriving home:
Consider safety and access
Get an occupational therapist assessment to determine if you need to do anything to make the home safer. In Toronto, the LHIN or hospital will dispatch an occupational therapist to do a house call and assess the home. If this doesn’t happen, Guardian Home Care works with OTs and can supply a thorough assessment, complete with written recommendations and links to find equipment. You may need to move the bedroom to another floor to avoid stairs, install a stairlift, remove rugs to prevent falls, or install grab bars and seats in the bathroom and shower.
Get ready for behavior or mood changes
The losses from stroke, whether temporary or permanent, can be devastating to the survivor. There are a lot of possible changes in behavior or mood swings.
Stroke survivors are at risk for depression — from 30% to 50% are affected, and if you start to see signs of depression ask your doctor immediately for help. The loss of what life looked like before the stroke, and the possible long rehabilitation ahead, can be overwhelming for everyone involved. Ask for help from a social worker from the hospital or rehab facility where your loved one was discharged to support you in this. If you are bringing in hired help, let them know how everyone is feeling and incorporate some companionship and redirecting activities into the care plan to help.
Be aware of the risk factors for a second stroke
Always remember that your loved one who had a stroke is at a higher risk for a second stroke, so it’s important to help minimize that risk. When caring for a stroke patient at home, be sure your loved one takes medications as prescribed and keeps doctor appointments. Again, this is something that can be easily delegated to a hired caregiver, it’s what they are trained for, and can alleviate some of the “enforcement” required from family caregivers.
Encourage daily rehabilitation exercise at home
If you are reading this while your loved one is in a rehabilitation facility, book time to observe and take part in a couple of therapy sessions before your loved one comes home. This way, you can see what the rehabilitation sessions look like and how the exercises are performed safely. Ask the rehab therapist any questions about what is happening and how to perform the exercises so you feel comfortable at home. Also ask for photocopies of the exercise plan and anything else that will be helpful for when you are on your own.
After returning home, your loved one may not be motivated to exercise or continue to rehabilitate, especially under the authority of a family member or spouse. You may need to bring in outside help to continue exercising and regaining strength and ability. At-home physiotherapists are plenty in Toronto and a PSW or at-home nurse can get acquainted with the exercises and encourage them daily or twice daily, whatever is recommended. This way, the family caregiver is removed from chasing down their loved one to exercise.
Keeping up with exercises and rehab at-home is of utmost importance. It is key to maintaining, and further improving, the post-stroke ability regained in the hospital. Maintaining ability and enhancing it allows for both the patient and caregiver to lead better lives.
Day programs in Toronto specific to stroke survivors
The Toronto Central neighbourhood House holds a Stroke Survivors Club: Recreation and dialogue for stroke survivors. It’s a day program hosted at 349 Ontario Street in Toronto, and a social/recreational/respite program for stroke survivors and their caregivers, placing an emphasis on providing an intellectually stimulating environment for stroke survivors. While they recognize that suffering a stroke is a major trauma to the individual and his or her family, they focus on possibility.
The Afterstroke program from March of Dimes provides an incredible resource of help and community. After calling their Afterstroke Warmline at 1-888-540-6666 you will be connected with an Afterstroke coordinator who will help you on your road to recovery.
Stroke patient at home: Assess patient needs as well as your ability to meet them
The stroke survivor may need the following:
- Personal care such as bathing and dressing (depending on what type of stroke experienced)
- Coordination of health care needs including medications and doctor and rehab appointments
- Supervision, is your loved one able to stay home alone, even for short periods?
- Exercise and physio (as discussed above)
Remember that you can’t do everything (or at least, not in the long term). Try to be realistic with yourself about what you can take on and what you may need help with. If personal care is needed, we would be happy to discuss an approach that would fit your needs and budget. If you feel you can afford to bring in outside help, a personal support worker would look after the bathing, grooming, dressing, exercising, and medication reminders, so that you can have support with making an at-home caregiving situation work in the long term and avoid burn-out or frustration.
Further Caring: Learn and assess
There can be a lot to learn, so take advantage of every opportunity to learn about stroke and your loved one’s condition and prognosis. Talk with the health care team at the hospital or rehab facility about what the stroke recovery and rehabilitation process looks like, and ask them for any information they have. Also ask them if you can call or visit them in the future for follow-up enquiries.
Join support groups or programs that are offered by the hospital – these can be the best source for of information and support, because you are connecting with people who are in your situation.
The Canadian Heart and Stroke Foundation has organised two very active peer support groups:
1. one for the community of survivors, and
2. the other for caregivers of stroke survivors.
Stroke Care Plan Essential: Taking Care of Yourself
The more you care for yourself, the better you can care for your loved one. Exhausting yourself won’t allow you to provide the loving help you want to give. It’s not selfish to take time for your needs — it’s essential, and beneficial, for both of you.
Time and time again we receive calls from family caregivers who will not give themselves permission to bring in help. Family members who are not providing care do not realize the committment and strain of caregiving, and therefore will only rarely suggest or encourage you to get help!
Every caregiver needs respite, and waiting until you get permission from someone else to get it may be difficult. Other people do not know the responsibilities that you have and the situation you are in. You need to take care of yourself as well as your loved one.
Remember that you have a right to your own time and activities.
Plan time apart and recharge your batteries by having respite care that allows you to participate in your own activities.
Focus on your physical health
Learn healthy ways to manage stress and relax. Eating a healthy diet, exercising regularly, and getting enough sleep will help you keep up your strength.
Focus on your emotional health
Allow yourself to feel frustrated, angry, and sad, and share it with someone other than your loved one. These feelings are normal, and in order to not dwell on them, you need to express them. This is where friends and support groups can play an important role.
Studies show that caregivers are also at risk for depression, especially if the survivor has dementia. Depression responds well to treatment, so talk with your doctor if you think you may be depressed.
We can help you to get an assessment for government funded home care. As a senior home care company in Toronto, we work with the LHIN to supplement care so that stroke survivors can get the care they need.