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How to Develop an Effective Post-Stroke Care Plan

 

man in black and white

In the United States, approximately 795,000 people have a stroke each year. If you are the caregiver of a loved one who has suffered a stroke, you need to know how to care for their specific post-stroke health needs.

6 Things Every Caregiver Should Know About the Side Effects of a Stroke

The physical impact of a stroke can be slight or devastating, but all take great compassion in order to help your loved one recover from a stroke. Be aware that a stroke may cause:

  1. Weakness on one side of the body. This weakness may create problems with muscle function and movement. As a result, your loved one may have trouble walking and/or grasping objects.

  2. Joint pain and rigidity. The joints may become tight or lock up altogether on the side damaged by the stroke. Movement is essential to keep the joint from freezing and to make sure that it can move easily as strength returns. If muscle spasms occur, inform your loved one’s doctor right away. These may need to be addressed with medication, injections, or nerve blocks.

  3. Altered senses and spatial relationships. Stroke may cause the senior to feel pain, numbness or tingling in the limbs. It can also impair one’s sense of touch and the ability to feel hot and cold, which can be very dangerous. Do not allow your loved one to try to cook and turn down the temperature of hot water to prevent scalding.

  4. Problems judging the position of parts of the body. This may cause difficulties in judging the distance, size, position, or rate of movement of the arms and legs. This spatial disconnect can cause tripping, falling and knocking things over. Make sure your home is fall-proof to avoid further injuries.

  5. Problems with speech and language. These deficits are called “aphasia” and usually occur when the stroke damages the left side of the brain, which is the language center. Some people who have aphasia may not be able to understand written or spoken language or express their own thoughts through speech. Speech therapy may help to recover some or all of these language skills.

  6. A sense of grief. Fear, anxiety, anger, sadness, frustration, grief and depression are common after a stroke. Your loved one may feel a deep sense of grief for the active lifestyle they have lost. Face these worries with your loved one. Encourage them to stay in touch with friends and invite them to visit. Help your loved one to play games with you and practice new skills.

older man at hospital

10 Tips for a Post Stroke Care Plan

Stroke is a brain injury and as a result, some motor skills or speech lost to the stroke may never be recovered. Often the most significant progress is made in the days, weeks and months immediately after the stroke. However, small steps over the course of a lifetime stimulate the brain and lead to ongoing recovery with small improvements.

A post-stroke care plan should be created immediately after the stroke occurs and then altered over time as progress is made. Here are ten important things to keep in mind.

1. Ask questions.

Talk to the care manager at the healthcare facility where your loved one is receiving care. Ask the manager to give you all the resources you need for care, whether it is in print, online or in the community. Ask them to tell you, in detail, what the first steps should be when your loved one goes home. Ask for specific details on your loved one’s physical abilities and deficiencies and their recommendations for home care. Based on their input, you can prioritize care and develop a plan together.

2. Follow up on blood work.

Since strokes occur when there is a reduction in blood flow to the brain, anticoagulants will often be prescribed to facilitate recovery. The dosage is adjusted based on blood flow, so regular blood tests are essential to ensuring effectiveness and safety.

3. Determine where and how care will be provided.

First, you need to decide if you plan to bring your loved one back home during recovery. Make sure to consider the following:

  • How will you take care of your loved one’s needs at home?

  • Do you need to line up in-home nursing care?

  • Will you be able to help them with grooming and personal hygiene?

  • Can you take care of their medications and make sure they adhere to the schedule?

  • How will you get your loved one to various health care appointments?

  • How much time can your loved one be by themselves?

Once you answer those questions, consider what your schedule will look like and who will be included in it:

  • Will you be able to provide full-time care or do you need to put together a schedule of caregivers?

  • Do you have other family members nearby or will you need to hire professional caregivers?

4. Adapt your home.

beautiful blue house with yard

Stroke increases the risk of a fall, so your home may require modifications to keep your loved one safe and comfortable. When you return home, take an inventory of the house and things that may need to be adjusted or adapted to meet your loved one’s needs. Make a list of the changes that need to be made, who will make them and when. This will give you some sense of control over the changes.

Your list could include adding grab bars in the shower or moving your loved one’s bedroom to the ground floor to avoid stairs. You may need to install ramps to enter the house. All the changes may not be addressed by the time your loved one comes home but it’s good to get a head start.

5. Set appropriate goals for the stroke patient.

When putting together the elements and timetable of the post-stroke care plan, you should take into consideration the activity levels of the patient before the stroke, the mobility and speech impacted by the stroke, and the interests of the patient in rehabilitation.

You do not want the plan to be too ambitious, as that will discourage the patient. On the other hand, you do not want the goals to be too easy to achieve because that will not provide the patient with maximum rehabilitative benefits. Lastly, the plan must be enjoyable to the patient because he or she must be fully engaged and eager to do the hard work to meet rehabilitation goals.

6. Adapt daily activities.

Depending upon the deficiencies left by the stroke, your loved one may need assistance to carry out activities of daily living. If the stroke has disabled one side of your loved one’s body, new tools will be needed to make cooking with one hand possible. Walkers, canes and other assistive devices may be needed to assist with walking and prevent falls.

Talking with other stroke survivors is a great way to find solutions to these problems. Strokefocus.net is a nationwide group founded by stroke survivors and can help you to find support groups in your area. Their podcasts with stroke survivors will help your loved one learn how to find things like cooking equipment and other adaptive tools and devices.

7. Be versatile.

Depending upon the extent of the damage left by the stroke, your loved one is in a position to feel frustrated. Ongoing physical and occupational therapy is tiring. Physical deficiencies are frightening. Each day will be different so approach post-stroke care slowly and adapt as you do.

8. Determine what specialists are needed.

Identify exactly which specialists are needed to help achieve the goals of their care plan. These clinicians will begin working with your loved one before discharge and may continue services once he or she goes home. Some of the clinical specialists that work with stroke patients include:

  • Speech-language pathologist. Provides speech therapy and helps the patient learn to communicate in other ways if speech is lost. They also help the family learn to communicate with the patient and address any swallowing difficulties.

  • Occupational therapist. Helps the stroke patient to regain function in activities of daily living like bathing, housekeeping, doing the dishes and cooking.

  • Physical therapist. Helps with moving, balance, and coordination. Helps to improve the patient’s ability to walk, get in and out of bed or chairs, and teaches the family how to help the patient move and walk. Therapy needs may vary, but all stroke survivors should start as soon as possible, attend recommended appointments and complete exercises.

  • Social worker. Helps the patient and family make decisions about rehabilitation facilities or new living arrangements, answer questions about insurance, at-home services and other types of support.

  • Psychologist. Can help the patient and family deal with the emotional stress of a stroke. They can also help navigate the new dynamics between the patient, family and caregivers. Lastly, they are able to help treat memory or cognitive problems caused by the stroke.

  • In-home caregivers. Caregivers trained specifically in caring for stroke victims can provide important support for the patient and the family. In the early days after the stroke when friends and family members are changing work schedules in order to help provide support, professional caregivers can fill the gap. Over the long term, these trained caregivers can give family members important respite from caregiving duties.

9. Maintain a healthy diet.

Stroke can be the result of another medical condition, such as uncontrolled hypertension. To reduce unnecessary stress on your body, limit your intake of fat, cholesterol and sodium. A balanced diet and consistent meal schedule are critical to a healthy recovery.

10. Get additional support for the patient.

There is a nationwide community of stroke victims ready to help and support your loved one as he or she recovers from a stroke. Their families can also help your family adjust to the new post-stroke reality. Support communities can be found at the following online locations:

  • American Stroke Association

  • National Stroke Association

  • The Stroke Network

  • Strokefocus.net

Recovering from a stroke is a lifelong process made up of tiny steps over the course of many months and years. It is not a process with a specific time frame or goals that can be accomplished according to a set schedule. There will be good days and bad, with high points and low points along the way. A good stroke care plan will allow the patient and the family to see how much progress has been made and provide hope that there is more progress to come.

Our editor also recommends you read:

Read: Can You Identify the Signs of Stroke Fast?

Read: After a Stroke, Go Straight Home With Telerehab

Resources

Stroke Facts

American Stroke Association

National Stroke Association

Strokefocus.net

The Stroke Network