Having a stroke is a life-changing event in many ways. Even if yours was minor, you’ll likely have some lingering disability when you leave the hospital. The best way to meet this challenge is to make sure things are set up at home to help you safely ease back into your everyday life.
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You can expect to go home with new medications, rehabilitation plans and goals for keeping your risk factors, such as your cholesterol and blood pressure, in check. You’ll need a good support network, and your caregivers, family and friends can help right away by modifying your home for better safety and convenience.
Identifying areas of need
Before you go home, your healthcare team will help make sure you’re ready to manage things at home. They’ll review your social, psychological, medical and environmental situation, says neurologist Zeshaun Khawaja, MD.
There are several key questions the team will want to answer, he says.
Enviromental: Are there people who can assist you with daily activities? Do you have sufficient financial resources to support your continuing care (including medications, doctor’s visits and home modifications)?
Psychological: Are you coping well with the aftereffects of your stroke? Do you have signs of depression or anxiety that might keep you from participating in your treatment?
Medical: Are you stable enough to go home? Have your risk factors been identified and has a treatment plan been established?
Physical: Is therapy required? Are there any issues with mobility or self-care?
Is your home ready to meet your needs?
Another important consideration as you prepare to leave the hospital is your home safety evaluation. A social worker will do a walk-through at your home to review your needs and determine what home modifications can help meet them.
A case manager will work with you and members of your support network to purchase and install what you might need, including a walker or other assistive device, ramps or grab bars. Caregivers also can set up a calendar to help track appointments and medications, especially if you are having memory issues.
“Patient and family involvement and engagement in discharge planning after stroke is very important to ensure the patient has all the resources he or she may need to maximize recovery in a safe environment,” Dr. Khawaja says.
The American Stroke Association recommends several minor adaptations for each room in your house:
In the kitchen:
- Replace traditional shelves with baskets or pull-out shelves.
- Use a lazy susan to increase cabinet access.
- Use a microwave instead of the stove or oven.
- A small, wheeled cart can help transport groceries and other supplies.
- A large cutting board on an open kitchen drawer helps with seated food prep.
In the bathroom:
- Special door hinges called swing-clear hinges give enough room for a walker or wheelchair to pass through.
- A seat elevator can raise a low toilet seat.
- Single-lever faucets are easier to use with one hand.
- Toilet rail bars and grab bars near the toilet or in the shower make it easier to move around.
In the bedroom:
- Raise a low bed with risers.
- Lower a tall bed by removing casters or choosing a thinner mattress or box springs.
Making sure you’re ready to manage at home
Your doctor may recommend care at an acute rehabilitation facility before you go home. Here, intensive therapy five days a week will help prepare you for moving through your house and caring for yourself again.
If you don’t meet the criteria for a facility, your doctor may suggest that you have a family member stay with you for awhile. Home care is also available, but typically not 24/7.
“The goal of acute stroke treatment and rehabilitation for stroke survivors is to maximize recovery in a safe and productive manner and to ultimately achieve independence and freedom from disability,” Dr. Khawaja says.