Planning in home care, recovery and rehabilitation for a stroke patient

The journey to recovery from a stroke is a combination of hard work, faith, and hope. A stroke doesn’t just occur to an individual, it impacts families, friends, and loved ones. Once your loved one leaves the hospital, the reality of the situation typically sinks in during the first few days at home.

For the affected person, strokes injure the brain and results in a range of impairments and difficulties across their body. Recovery often takes time – it takes frequent and persistent rehab both in the hospital and at home. And the journey is usually more complicated if the stroke affected person also has co-morbid conditions like Dyslipidemia, Diabetes, Alzheimer’s, Dementia, Depression, Bladder or Bowel dysfunctions. Typically, only 40% of stroke survivors are successful in achieving rehab goals.

For family members, caring for a stroke patient at home comes with a lot of challenges. The physical aspect of caring can be very demanding. In addition, coping with the emotional stress that comes from the changes in your loved one’s personality, moods and behavior is even more challenging.

We have had the opportunity to work with stroke patients from leading hospital providers in the DDW, for example, UT Southwestern Medical Center’s Stroke Rehabilitation program and Post Acute Medical Health. We support their journey to recovery through experienced reliable in-home care.


With our experience having served many stroke patients, there are 5 key things to keep in mind as you plan for a loved one’s stroke recovery journey at home:

1. Safety

This cannot be stressed enough. The last thing you want as a family member is to inadvertently end up compromising safety for your loved one and having them back in rehab even more frustrated! In our view, it is better to be safe than sorry and over plan this aspect. With today’s medical equipment availability (e.g sit to stand lifts, hoyer lifts, shower boards, grab bars, wheel chairs), there is a lot we can together do to ensure your loved one’s safety in the bed, in the bathroom, in the shower, and in your home.

 

2. Prepare yourself for your loved one’s mood and personality changes

The losses caused from a stroke are both physically and emotionally huge to the survivor. There are a lot of pent up feelings including anger, resentment, feeling victimized that crop up after a stroke. As Dr Selenick, a prominent expert on stroke rehab and neurorehabilitation says in his book “Try not to tell your loved one that you know how they feel, because you don’t really know. Offer love, patience, and support, but expect resent, anger and stubbornness”. Accepting life changes after stroke is important in navigating the recovery path.

3. Balance the “tripod of care” — in home care provider, Doctor and Rehab facility

Your integrated care team of doctor, rehab, and in home care provider work like the three legs of a tripod, in balance and synergy, to help your loved one achieve a good trajectory for post stroke life, and minimize the likelihood of a subsequent stroke or readmission.

3a. In home care

Managing a stroke patient in the home setting of care is significant and can be strenuous and often demands 24/7 attention! Having experienced and reliable caregivers from a high quality home care company can definitely help ease the workload. A knowledgeable caregiver can support activities of daily loving (showering, changing, toileting, physician and mental exercises, safe transfer in and out of wheelchairs, overnight care), and key aspects of post stroke care (e.g. rehab exercises at home, diet changes, medication and dosage changes, and close coordination with physical therapists, occupational/speech therapists, and doctors’s office).

 3b. Rehab

The rehab activities and exercises at home and hospital as recommended by physical therapist, speech and occupational therapists are absolutely critical for longer term recovery. Don’t make the mistake of assuming you are both back home, so one can slow down – one should not lose momentum especially right after coming home. Rehab program will help assist with mobility, build strength, develop cognitive and behavioral strategies to help compensate for deficits, enhance skills needed for daily activities, improve balance and restore physical function

 3c. Doctor’s office, blood tests and diet adherence

Because strokes are caused by a reduction in blood flow to the brain, doctors usually prescribe anticoagulants and adjust dosage based on blood flow. Regular blood testing is therefore critical to reaching optimal, safe and accurate dosage for a stroke patient and this will lead to frequent visits and interactions with the Doctor’s office and regular blood tests. On the diet front, usually there are 2 important things: Firstly, limiting the intake of fat, cholesterol and sodium is critical to a healthy recovery post stroke especially for clients that are co-morbid with Diabetes or Dyslipidemia. Secondly, maintaining a regular meal schedule, even when not hungry is very important.

 

4. Pace yourself. This is a marathon

Recovery from a stroke cannot be rushed. The brain is gradually rebuilding damaged synapses. A recovery from a stroke feels closer to a long-distance marathon than a short-term sprint. The body is recovering as well and activities that were routine (e.g., walking, moving hands) present new physical challenges. Being patient with your loved one, yourself and your professional caregivers is critical to assure measurable and small steps in recovery. The idea is to continually achieve small, measurable and consistent improvements every day without feeling rushed to a deadline.

After every few weeks, take a half hour to systematically track and evaluate progress on your loved one’s stroke recovery journey. Tracking clinical metrics like improvement in ambulation (e.g. after 7 days, can Bob slowly stand up on his own and walk 5 steps with a slow, steady gait?), improvement in bed transfers, 60 day hospitalization if any, are important. Additionally, tracking more subjective and “softer” metrics like your loved one’s level of frustration, outbursts, mood changes, hours slept are equally important. Your integrated care team needs to all be equally aware of progress on these metrics so the recovery journey can be appropriately adjusted if a need is detected for more or less interventions.

 

5. Self care

Remember to care for yourself as you care for your loved one. For families dealing with the challenges of caring for a loved one with stroke can be emotionally draining. Do remember to take time out for yourself to recoup emotionally and physically from these challenges.

Do you live in Dallas Fort Worth area? 

Care Mountain provides award-winning in-home care for people recovering from stroke, especially those that have other co-morbid conditions like diabetes, dyslipidemia, or Alzheimer’s. We are a high quality home health care provider with 16 years of experience providing personalized care for 3,000+ DFW families. 
Give us a call to discuss your needs. 

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