Many stroke survivors have impairments that make it more difficult to perform the tasks of everyday life. Structural changes, assistive devices and new ways of doing things help stroke survivors be as independent as possible.
PERSONAL CARE: Pressure sores - Eating - Dressing - Bowel & Bladder Function.
PERCEPTUAL PROBLEMS: Neglect - Speaking and seeing - Sensation.
PHYSICAL DIFFICULTIES: To meet the special needs of a stroke survivor with physical difficulties, consider some of these changes to your house.
Pressure sores. Pressure sores can be a serious problem for people who spend a lot of time in bed or in a wheelchair. Be sure the stroke survivor changes position regularly. Use pillows to support arms or legs that are disabled. Keep the skin clean and dry and apply lotion often. Examine the skin every day for signs of sores and wherever possible, relieve the pressure causing them. Let the doctor know if you see an irritated spot that isn't clearing up.
Eating. Look for special adaptive equipment such as plate guards and rocker knives, usually available through surgical supply stores. If the stroke survivor has difficulty sitting up straight to eat, pillows, arm troughs, lap boards or a tilted wheelchair may be helpful. For patients with little interest in eating, try soft foods or foods with strong flavors.
If the stroke survivor coughs, chokes or takes too long to eat, it may be an indication of serious swallowing problems. Contact your doctor.
Dressing. Encourage the stroke survivor to get dressed every day, rather than staying in pajamas: being neatly dressed enhances self-esteem. Avoid tight-fitting clothes and those that must be put on over the head. Velcro fasteners and clothes that fasten down the front are helpful.
Most stroke survivors will be most comfortable sitting to get dressed. Lay out the clothes in the order they will be put on and leave plenty of time for dressing. Check into adaptive devices and talk to an occupational therapist about techniques to make dressing easier.
Bowel and Bladder Function. To help re-establish bladder control, go to the bathroom at regular intervals - say, every two hours. Reduce the amount you drink before bed. Consider using a commode or urine collecting bottle at night. Special disposable bed pads and underclothing are also available. Grab bars on either side of the toilet make it easier to get on and off.
Some stroke survivors have trouble re-establishing regular bowel function. Privacy, the use of a toilet or commode and a diet with adequate fluid and fiber usually resolve these problems in time. Discuss more persistent problems with your doctor.
Neglect. This is a common condition in which the stroke survivor ignores or neglects the impaired side of the body, usually the left side. Encourage the patient to become aware of this side by touching it, talking about it or rubbing it gently with a towel. Rearrange the furniture so that the stroke survivor will be oriented to the unimpaired side.
Speaking and Seeing. Stroke can result in a variety of perceptual impairments. For example, a stroke survivor may have difficulty distinguishing foreground from background or judging distances. Keep the environment as organized and free of clutter as possible and arrange objects so that they are on surfaces of contrasting color. If there is blindness in one half of the eye, encourage the stroke survivor to learn compensatory techniques like turning the head to scan the environment.
Sensation. Some stroke survivors lose sensation in parts of their bodies. To avoid accidents, be vigilant about sharp object and utensils and heat from water or the stove. Remember that the sun can also be a burn hazard.
To meet the special needs of a stroke survivor with physical difficulties, consider some of these changes to your house. Base your decisions on individual needs and preferences.
Add a ramp for entrance to the house.
Arrange furniture to allow a wide corridor for wheelchair or walker.
Remove all throw and scatter rugs.
Secure telephone and electrical cords or run them under a carpet.
Ensure that light switches are close to room entrances and use remote controllers.
Widen doorways to accommodate walker or wheelchair (Just removing the molding and replacing the hinges with off-set hinges may produce enough extra space).
Add kick plates, corner guards and bumper guards on corners and doors which might be bumped by a wheelchair.
Add grab bars around toilet, tub and shower.
Consider a tub bench seat or hydraulic tub lift.
Install a telephone or buzzer near the bed or a speakers phone with large numbers and an automatic dial.
A wide range of assistive devices are available through surgical supply stores. In the kitchen, electric appliances like juicers and toaster ovens, may make life easier. Ask your occupational therapist or physiotherapist to suggest devices that would be useful.