StrokeSurvivorBlog

I learned by “trial and error” how to care for a stroke survivor when my husband, Steve, had a massive stroke which completely disabled him. When he was in the hospital under the care of therapists and nurses, I observed what they did. However, nothing really prepared me for the daunting responsibility of caregiving until he came home. But I learned a few things that I’d like to pass on to you to help you care for someone who’s had a stroke.

Almost all stroke survivors have a loss of coordination and balance because of paralysis or one-sided weakness. Statistics show that approximately 40%-50% of them have serious falls after their stroke. The risk of falling is a major concern, and my husband’s safety is always my first priority.

Until he became stable on his feet, he wore a safety (gait) belt around his waist so I would have something to grab in case he lost his balance. It made him feel so secure and safe that he insisted on wearing it wherever he went.  While he learned to walk again, I assisted him with my hand on the gait belt every time he took a few steps to make sure he wouldn’t stumble and fall.

To ensure his safety, I also made the following modifications to our home to reduce the risk of falling:

• Installed grab bars in the bathroom
• Equipped the bathtub with a shower bench, hand-held sprayer and suction bath mat
• Added a new handrail system to the stairway of our 2-story home
• Attached a bed cane rail to our bed
• Removed tripping hazards like area rugs
• Installed a wheelchair ramp by the front entry
• Added a handrail in the garage for the step by the door
• Removed obstacles like the coffee table, shower doors, etc.             See pictures of other modifications made

Caring for a stroke survivor is much like caring for a child. A person who has one-sided paralysis or weakness needs help with almost everything ranging from toileting to eating meals. Some stroke survivors are incontinent or bed-fast, and their caregivers need to change diapers, clean up poop, and give a lot of sponge baths.

Fortunately, Steve isn’t in that last category, but when he came home he still needed help to do his bathroom duty when he woke up at night. A hand-held urinal was kept by the night table, but his balance was still unstable, so I helped him stand up and held the urinal for him. As his balance got better, he could pull himself up using the bed rail. Once standing, he could lean back on the bed rail for balance and use the urinal himself. Other caregivers have told me that they put a pail by the bed and keep the urinal in it to avoid spillage.

Even using a toilet is a challenge when your balance is off, so there were many times I had to wipe his butt after a bowel movement. Disposable gloves came in handy for this purpose, and as unsavory as this is, it’s the reality of caring for someone who’s had a stroke. It’s very humiliating for a stroke survivor to depend on someone else to help them with something so personal, so a caregiver must always show respect and understanding (not disgust) when performing these tasks.

To help my husband regain his toileting independence, I purchased stretchy, elastic waist pants that could be easily pulled up and down without having to fuss with buttons or closures. This allows him to use the toilet without my assistance now that his balance is better.

Bathing is something else that stroke survivors need help with. Steve can’t lift his leg high enough to get it over the side of the bathtub by himself. So I lift his leg up and over, and help him get seated on the shower bench. He uses the hand-held shower sprayer and a long-handled back scrubber to wash himself. I help him with the hard-to-reach places, and once he’s washed up and rinsed off, I help dry him off. Then he stands up for a few seconds so I can slip a dry folded towel under him to sit on. This towel helps him to pivot on the shower bench so I can lift his left leg over the side of the tub onto the floor. It’s safer this way because then he doesn’t have to risk falling by standing up to step out of the tub. While he’s still seated on the shower bench, I help him get dressed. He does as much as he can by himself using a long-handled grabber, but he still needs help putting on his arm sling, socks, shoes and leg brace.

Mealtimes can be a challenge since most stroke survivors can only eat with one hand, and it can be messy too. The left side of my husband’s mouth feels numb so he can’t feel food spilling from it. To protect his clothing from stains, I clip a towel around his neck like a bib, but I only do this in the privacy of our home. I cut big sandwiches into smaller portions, and he uses a special rocker knife to cut meats by himself. I could cut up everything for him, but that makes him only more dependent on me. Other adaptive plates and utensils are available to help stroke survivors eat without assistance.

There are so many other facets of caring for someone who’s had a stroke, including:

• dispensing medications
• clipping fingernails and toenails
• preparing and serving meals
• doing therapeutic exercises
• giving leg massages
• transporting to medical appointments, and
• giving hope and encouragement

Learning how to care for someone who’s had a stroke is not something you normally get training for. It’s usually thrust upon you quite unexpectedly, but it’s something you can learn to do by watching others, talking to therapists and other caregivers, and using common sense to find what works best for you.