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Planning home care after a stroke

Cavendish Homecare discuss post-stroke rehab and maximising independence



Stroke deaths Research

The team at Cavendish Homecare discuss how to spot signs of a stroke, post-stroke rehabilitation and support, and how the right care and interventions can help to rebuild independence

What is a stroke?

The rehabilitation required at home for a stroke patient is extremely important. However, before we cover those aspects, it is crucial to understand what is a stroke. 

A stroke is a medical condition that occurs when the blood supply to part of the brain is cut off. The brain does not receive the essential nutrients and oxygen, as a result, causes the brain to become damaged. 

In the UK it is estimated that 100,000 people suffer from strokes each year. Strokes are life-threatening, and medical treatment should be received immediately. The sooner medical attention is provided, the likelihood of damage to the patient is minimised. 

Tips for rehabilitation after a stroke

There can be physical, cognitive, emotional and behavioural changes for the stroke survivor and in some instances require 24-hour care.

Caring for a family member or friend that has suffered a stroke does come with some challenges. The level of care and rehabilitation can vary; however when back in the home there is some fundamental rehab support that will remain the same regardless of what type of stroke a person has suffered. 

Understanding the signs of a stroke

Unfortunately, stroke sufferers are at risk of having another stroke within the first three months, so it is important to understand what the signs of a stroke are such as; face drooping, arm weakness, slurred speech, sudden dizziness, changes in vision, and severe headache. If you notice any of these signs it’s important to seek medical attention urgently.

Preparation of the home 

Preparation of the home is vital for when the patient returns home after being hospitalised. Adaptations to the home may be required, which medical professionals can help support to ensure a safe and stress-free transition into a safe and comfortable home environment. Seeking a home visit prior by occupational therapists. 

Adaptations that may be required to support the stroke survivor at home can be:

  • Handrails around the home and especially in the bathroom
  • Turning down the water temperature to prevent burns / scalding
  • Reducing trip hazards by removing any rugs or throws, and taping down electrical cords
  • Moving around the furniture to allow for more space to move around
  • Ground floor bedroom (if possible) 
  • Easy access to a telephone. Looking for a cordless phone, or mobile phone in case of emergency the patient can contact someone or emergency services
  • Using a rubber mat in the bathroom for a non-slip surface and keeping the area dry

Rehabilitation exercises

Undergoing rehabilitation exercises is crucial, do not stop doing them. The rehab exercises help to rewire the brain and improve mobility long-term. If patients do not do their exercises their mobility may deteriorate. Exercises need to be consistent to avoid any setbacks.

Types of rehabilitation exercises 

Passive Rehabilitation Exercises

This form of exercise works well for patients that suffered from hemiplegia. This focuses on movement that is not initiated by the muscles. Instead, a therapist or caregiver moves your limbs for the patient. This form of exercise gets the affected limbs moving and discourages non-use. In addition, because the patient is not initiating the move it still stimulates the brain that controls muscle movement. This can help when the patient begins to feel agitated that they cannot complete all movements. So rather than stopping exercises completely, passive exercises still ensure movement is occurring.

Mental Rehabilitation Practice

If your loved one or family member is severely limited with their movement, visualisation of movement can also help. It involves the patient mentally visualising themselves moving and doing the exercises or walking, or running. Studies have shown that this can help spark changes in the affected area. Practicing mental exercises along with passive exercises for sufferers with severely limited mobility can actually benefit the patient.  

Music Therapy 

Music as a therapy in the general sense has been seen to have a positive impact on people; therefore using music for Stroke survivors is no different. Using rhythm and beats encourages patients to synchronise their movements. It can be used as a way to walk, every step equals a beat or even finger coordination to the beat. Music therapy is also fun, and allows some light entertainment through the rehab process.

Mirror therapy

Using a mirror to help move the affected body part. Placing a tabletop mirror over under the nonaffected hand and moving it. The reflection tricks the brain into thinking that you are moving both hands, which in turn helps to rewire the brain, into moving the hand or body part that has limited movement. This is an exercise that can be easily done in the home with the support of a caregiver.

Constraint Induced Movement Therapy (CIMT)

The CIMT approach can be seen as aggressive as it restricts the movement of the non-affected body in order to force the movement in the affected body part. This approach has been seen to improve movement, however, this can cause frustration from the patient and as a result, CIMT should always be tailored to ensure there is a challenge but at the same time, it should be completed in a safe and compliant environment from the patient. 

Electrical Stimulation

Electrical stimulation is used for not only stroke sufferers but in any person that requires muscle stimulation from an injury. Many sport athletes have used this such as ACL recovery patients to stimulate the muscle around the knee to support the activation of the muscle, ligaments, and tendons. The process can be the same for those recovering from a stroke. The electrodes are placed over the skin and send electrical impulses directly to the affected muscle. It not only helps to stimulate the brain but also initiates movement in the affected muscle.

Psychotherapy care

Suffering a stroke not only leaves physical limitations but also psychological ones. Seeking support through talk therapy is hugely important.

Some survivors can suffer from depression and anxiety through the consequences of a stroke – lack of independence, financial strain, and fear of another stroke. All these factors can lead to a person needing the support of therapy. This should never be underestimated, and can really help the survivor comes to terms with what has happened to them and provide them with the motivation to continue working to full recovery – or the fullest recovery they can achieve. 

The most important factor to remember in the care of a stroke survivor is that everyone is different, just as every brain is different, therefore each recovery process will vary. The brain is highly complex and when a person has suffered a stroke the circumstances and how soon treatment was able to be administered will affect the outcome. 

However, understanding and implementing a rehabilitation program for all stroke survivors can increase their level of recovery. It is a long journey and each stage of achievement should be acknowledged and celebrated. It is important to keep the person motivated to continue with their program. 

How can Cavendish Homecare help?

Cavendish Homecare has experience with supporting stroke survivors and assisting in the transition from either hospital or a rehab centre to the home. Our nurses work very closely with all therapists involved in the recovery process, as well as assisting hands-on with the necessary requirements. 

To understand more about how our services can help you contact us and speak with a nurse manager that can guide you through the process to achieve care at home for your family or friend after a stroke.