One minute you and your spouse are enjoying life. You both had a fun-filled day with your grandchildren. They really loved the zoo; the zebra and giraffes were the young one’s favorites.
These are memories to be cherished.
At dinner, you notice your spouse isn’t eating and has a blank stare. You ask what is wrong. They try to speak, but their speech is slurred. You realize these actions could be the first signs of a stroke.
You call 911. The ambulance arrives and transports your spouse to the hospital. Your spouse has suffered a stroke. Your lives are forever changed.
Strokes, also called cardiovascular accidents, are common. According to the CDC, every 40 seconds, someone in the United States has a stroke. Strokes are a leading cause of serious long-term disability.
Since you knew the early signs of stroke, you knew early intervention was key to survival and recovery.
After an extended stay in the hospital and rehabilitation facility, your loved one is ready to come home. The hospital case manager has scheduled home health and physical therapy to come in and assess and instruct you and others helping in the care of your spouse with post-stroke instructions.
Many emotions and questions are running through your mind.
Will your spouse ever be back to their old self? Has their personality changed? And if it has, will their personality revert to before the stroke? What help will they need? Will they be on a special diet? Will they need help with bathing?
Bringing a loved one home and the long road to recovery can be a daunting task. Early intervention has proven to increase positive outcomes and total recovery rates.
About 75 percent of stroke recovery happens in the first 3 to 4 months following the stroke. Physical and occupational therapy, along with emotional support, is vital.
To begin with, if you have a smartphone or a way to video conversations and instructions from visiting health professionals, please take advantage of doing this so you can refer to and review instructions. Of course, ask permission before recording!
- Before your loved one comes home, or if already home, take time to assess the following:
- Review Discharge Paperwork. What are the limitations, activities, diet, and medication changes once discharged? Start a journal with questions and observations that you can review when the home health nurse, occupational therapist, home health aide, or physical therapist comes to the home. Take this journal with you to doctor appointments as well.
- Assistance with Meals. Your loved one may not be able to use forks and spoons due to weak and shaking hand(s). Weighted spoons help a lot with this. Because your loved one may have difficulty feeding themselves, a plastic clothing protector may be needed for an extended time. Reassure your loved one that using one will help keep their clothing clean and avoid changes. In addition, they may need to have their meals pureed due to impaired swallowing post-stroke.
- Medication. New medications may have been prescribed. If you have a home health nurse coming to the home, be sure to ask how and when to give the medicines. A mediset with automatic features such as reminders and pill dispenser capability may be an option worth looking into.
- Physical Barriers and Ambulation. After a stroke, one side of the body is weak. Depending on the severity and early physical therapy intervention, the physical limitations can be challenging. Survey your home. Are there steps that your loved one will have to negotiate? Be sure to remove throw rugs and have rooms adequately lit. In the evening, night lights placed from the bedroom to the bathroom will help avoid falls.
- In the Bathroom. Grab bars in the bathtub, shower seats, and over-the-toilet seats can provide safety in the bathroom setting. Planning showers and simple tasks such as brushing teeth can be a challenge. In some instances, a home health aide can assist with bathing and provide support with Activities of Daily Living (ADLs). Have towels, toothbrushes, toothpaste, glass, and other toiletries set out and ready for your loved one to use as they are able.
- Your Loved One May Be Incontinent. this may be either temporary or permanent. Personal hygiene is always a priority. There are many incontinence products on the market, some are disposable, and others are washable. The selection and quality of incontinence products, such as wearable briefs, have greatly improved over the years.
- Furniture. Furniture, such as soft recliners and low-setting sofas, may prove a challenge for your loved one. Survey your living room and any furniture they may want to access. Take note if it may need to be moved or replaced.
- Wheelchairs, Canes, and Walkers. If your loved one is using any assistive devices to ambulate or gain mobility, be sure you and your loved one understand the care and use of the device. Canes come in assorted types and sizes and need to be fitted. Wheelchairs require maintenance and repair. Walkers must be stable. Take advantage of any education and teaching moments the occupational therapist or physical therapist provides.
- Clothing. The ability to clothe oneself with or without assistance can be challenging. Strokes can cause permanent or temporary one-sided weakness. This hinders the ability of the caregiver and the loved one to dress themselves properly. There are many different adaptive clothing lines available nowadays. From open backs, office wear, jackets, and dress pants, adaptive wear has come a long way from the baggy pants and sweatshirts of past eras (however, baggy pants and sweatshirts are so comfortable!)
- Socks and Shoes. These can also be a challenge. Work with the occupational and physical therapist on ways and tools to make that job easier.
- Your loved one may have personality changes. A stroke is essentially an oxygen-deprived brain. Depending on the type, location, and severity, your loved one may experience impulsive behavior, mood changes, emotional outbursts, anger, and disorientation. Up to 50 percent of stroke victims experience depression. Consult their care provider for a plan of action.
- Financial Considerations. Post-stroke recovery can take a financial toll on the family, even with excellent insurance. Access social service organizations for assistance in medication, specialized rehabilitative equipment, meals, caregiver assistance, and respite. If your loved one is a veteran, contact the local VA and ask for social service/caregiver support and respite programs. There are many services- both state and local community based available.
- Take Care of Yourself. As you step into your new role as a caregiver, your life has also dramatically changed. Don’t do this alone. Be sure to reach out to family and friends and organizations that are experienced with stroke victims and their needs. Caregiver burnout is real. Carve out time each day for working on a project you enjoy or read, or go on a daily walk. Plan time away as you are able. Focus on healthy eating and exercise.