A stroke is a stressful life event. Recovery requires time in hospital, and then most likely a rehabilitation center. Strokes affect people differently. Depending upon its severity, a stroke will impact mobility, speech, swallowing, cognition, and bowel and bladder function. It may also impact vision and hearing.

Learning how to care for a patient after a stroke at home is all about putting yourself in the survivor’s shoes.

Here are our top tips for stroke caregivers at home:

1. Encourage daily exercise
   Many stroke patients struggle with motor impairments, and these need attention when the patient goes home. Encouraging daily rehabilitation exercise helps rewire the brain and hasten recovery. Routine movement is key in rebuilding neural pathways for the brain and muscles.
   Our Personal Support Workers (PSW’s) work with clients to make a daily habit of the exercise routines prescribed by a physio or occupational therapist.  All our PSW’s are supervised by a Registered Nurse.
2. Monitor diet and medications
   Proper nutrition and hydration are vital to a stroke victim’s recovery. You may have to make major changes in a loved one’s diet in order to maintain steady recovery (alcohol consumption, processed foods, sugar, etc).
   Our PSW’s can prepare nutritious meals, keep your loved one hydrated, and provide medication reminders to ensure compliance with the discharge orders of the doctor. They are trained for feeding, especially with clients with dysphagia, and can monitor for unusual signs and symptoms.
3. Be helpful and foster independence
   If you see your loved one struggling to do something e.g., holding cups or utensils or donning shoes, only help if they ask, or if absolutely necessary. Again, the key is to retrain the mind and that means having the client work on simple tasks, while progressing to more difficult ones all on their own. Being too overbearing can and will impede their recovery.
4. Home modifications? Consult your Occupational Therapist!
   In Ontario, most, if not all, hospitals prepare each patient for discharge. This includes consulting with your medical doctor, pharmacy, physiotherapists (PT’s), and occupational therapists (OT’s).
   Upon discharge your OT will assess your living space in the next few days to ensure safety measures are in place. Clients who have survived a stroke are at high risk of falls due to common balance problems. Your OT will recommend installing grab bars, a shower chair, non-slip mats, and possibly mobility devices such as canes or walkers.
   Our PSW’s can be there for your loved one to ensure their safety and the routine use of these recommendations given by your OT.
5. Record side effects of medication and post-stroke
   Most stroke survivors are put on multiple forms of medication that each serve a different purpose (for example, blood thinners, cholesterol control, etc.). They may also exhibit other unexpected side effects not attributed to any of the medications. A caregiver who knows a client inside and out can pick up on these nuances and act accordingly. Our PSW’s document clinical notes, and these are made available to the nursing team and other medical professionals (geriatricians, neurologists, etc.), with the permission of the client.
6. Remain steadfast and patient
   Expect to see improvement over the coming months, especially if your loved one is keeping up with rehab exercises. One thing to remember is that stroke recovery is not linear. It will be a very emotional time for all parties involved. Constant support and patience during some periods of decline is what they will need. As long as there’s a general pattern of improvement, periods of progress and decline are to be expected.
7. Keep pushing past the plateau
   Many stroke survivors experience a period of slow recovery. This slowdown is typically seen after 3-5 months into recovery. Many therapists will say they’ve reached a plateau and will need to be reassessed. However, this is not a sign that recovery is stopping. It’s best to treat this signal as a need to reassess care and not as a reason to stop recovery. Continue to make small goals and necessary changes to care. Your brain is capable of healing decades after stroke. Recovery can only continue if we keep working on it.
8. Fall Prevention and Recovery
   Long after you’ve installed all the recommendations made by your OT, falls can still occur and be incredibly damaging to your loved one’s status and recovery.
   Always ensure that your home is properly adapted and maintained each day. Replacing worn down rugs, clearing clutter on the floors, proper lighting and wearing proper footwear can all aid in preventing falls.
   Despite all our efforts to ensure safety, falls can still happen. It can be difficult for stroke patients to get up off the floor, so falls should be taken very seriously. If a fall occurs, seek medical attention and rethink your home modifications.
9. Be supportive of emotional healing after stroke
   There are many emotional changes after stroke to be aware of. Sudden outbursts of crying or laughter could be the sign of pseudobulbar affect which can be treated with medication or it may resolve on its own.
   Other times, stroke patients might be dealing with the anxiety, depression, or grief that naturally occurs after stroke. Try to be understanding of this challenging time.
10. Join support groups
    It’s helpful to create connections with other stroke patients and caregivers on the road to recovery. You can look for some in your area, www.heartandstroke.ca
11. Celebrate Small Wins
    We understand that even with support in place, every client recovers at their own pace. Acknowledging your loved one’s progress no matter how big or small can help both you and your loved one stay motivated during recovery. Our caregivers are empathetic and always put the interest of our clients’ first. We work together as a team to care for each other like family!
    ComForCare North York is experienced in helping stroke victims recover. All of our care is supervised by a Registered Nurse. We can interact with doctors, physiotherapists, occupational therapists and others to provide a comprehensive level of care in the home. Call us today if you have any questions.

Craig Fossay, Owner of ComForCare North York