1.) The first thing that is needed is a support system to help the care giver and the stroke survivor physically and emotionally. A good supply of family, friends and professionals will help. You are about to embark on a remarkable journey. A somewhat difficult and at times for some people an overwhelming one but it can also be very rewarding. In a somewhat positive vein, helpful to each other. By helping someone else with their health freely, people seem not to be so consumed with their own, there by getting themselves out of their own dilemma. I have seen this miracle work over and over again with the families and stroke survivors that I’ve worked with.( About 200 - 400 of them ranging in ages from 19 - 93, stroke victims and another 200 of other health related problems). In fact it’s worked miracles for me. I know this works, over the past couple of years I’ve only met one person it did not work for, a 19 year old, who to this day is no better off, probably worse. Only because he believed he didn’t have a chance, his mother and father enabled him to deteriorate. My only wish is that someday he believes he has a chance. Why am I telling you this? Because I have this saying (P.A.C.E.), it stands for a positive attitude changes everything. I can’t take credit for this saying, a good friend of mine used to use it, and for me, it became a way of life. Being ill over the last 12 years(several brain surgeries and strokes). I learned that getting your mind positive, helps in illness, business and even your personal life. That if you don’t believe you can, you never will. But if you believe you can and show up for life every day and put the effort in you will. I believe in this concept so much that it has helped me and several hundred other people.
2.) The appropriate size wheelchair
navigate it around the house with one hand, usually the patient only has use of one hand. This way you will find trouble spots that the patient will have to contend with and correct them.
3.)A walker, (when the stroke survivor is ready) The Physical Therapist will tell you when the stroke survivor is ready. Put a bicycle light on the front part of the walker in case the stroke survivor needs to navigate at night. Also, a small plastic basket attached to the front of the walker is also helpful to carry medicine or other small items room to room. Use two electrical ties to attach the basket.know
4.)A cane, (again when thestroke survivor is ready) The Physical Therapist will let you when.
5.)Be aware of chairs or other items in the household that may impede the stroke survivors passage
6.)If thestroke survivor is in a two story home, consider creating a temporary bedroom on the main floor.
7.)If a separate bedroom is needed, a method of calling the care giver is needed. (do not let this be abused) sometimes it is better to let the stroke survivor wait, the more trivial things they will figure out themselves.
8.)A hospital bed, may be required, if you need one, rent one with electrical controls so the stroke survivor can maneuver themselves. Make sure it has bed rails.
9 .)A handicap toilet seat, to put over the regular toilet with handrails to assist the patient getting up and down. Just using a regular toilet at this point may be to low for the stroke survivor to get up and down from.
10.)Install handrails, in the bathtub. The easiest way to do this is to picture the patient with their back faced to the shower nozzle while sitting on their tub chair. The low point of the hand rail should be at the end where it is centrally located but the lower end to be toward the nozzle. It should ascennd from the location centrally located at a 35 - 40 degree angle upward. If unsure ask the supply store that you buy thehandrail from, they will be happy to help you.
11.)A handicap seat for the bathtub, there are two types, get the longer one that extends out of the bathtub. This will facilitate and easier transfer from the wheel chair to the tub seat. Again, check with they will advise you based on their current evaluation of the stroke survivor.
12.)Install a hand held shower nozzle, This will be easier for the care giver and the stroke survivor to use.
13.)The subject of diapers,
A.)Always have a suitable amount so you do not run out. On a daily basis a patient can use anywhere from three to ten daily. Also make sure you have at least two containers of wipes at a time, you never know what you may harvest and it is always good to have a back up.
B.)This is an unpleasant process that both stroke survivor and care giver do not look at pleasantly. But, take comfort in the fact that this need not be a standard part of life in the future. Here is how to diminish or even eliminate the process. When the sttroke survivor can be navigated from bed to wheel chair with a certain degree of ease, (again consult the physical therapist for when the timing would be good for this) Encourage the patient to try to gauge time of necessity to time of arrival at the toilet. Keep trying periodically to get the stroke survivor back on track with meeting their own needs. This takes time and practice but it will pay off for both patient and care giver.
C.)A room deodorizer may come in handy at times.
D.)Make sure you have ample clothes and bed linens in case of accidents.
E.)Make sure to also have a bed pad and back ups which will go under the sheets to absorb any possible spills.
14.)Entertainment,
A.)A T.V. with hand held remote in the bedroom or where ever the stroke survivor would spend time.
B.)Possibly a VCR with favorite movie tapes. (A lot of these can be supplied by your local library.
C.)Books on tapes or CDs for the stroke survivor to listen to. CDs are better, usually the whole book can be put on one CD and with tapes there will be several of them that will need to be changed. Do yourself a favor get the CDs. Local libraries usually have a good selection.
***While thestroke survivor is sitting at a table have items that require the use of fine motor skills. There may be frustration on the part of the stroke survivor initially, encouragement here is very important. Here are some suggestions: Hand and finger therapy
1.)Simple jig saw puzzles.
2.)Lego’s
3.)Paper to practice writing or drawing on.
4.)A coffee can with a lot of alligator type clothes pins.Have the stroke survivor dump the clothes pins on a table and clip them to the lip of the can.15.)The patient may come home with EDEMA,
5.)Take a dish towel while sitting at the kitchen table and have someone or yourself flatten it out on the table in front of you a few inches from the edge. Have the person put the heal of their palm on the edge of the towel closest to the edge of the table. Then have the survivor walk the towel under his palm with his fingers. I hated this, it is hard to do at first but it works. Do not give up until you can walk the whole towel under your palm. Remember it is better to try than cry. Don’t give up, don’t ever give up. You may be surprised.
6.)Make pretend you are playing piano at the kitchen table moving your fingers in an alternating up and down motion. Singing is allowed and encouraged.
7.)Practice pointing your fingers one at a time. Just be careful when and who you do the bad one to.
8.)It took me three years to be able to snap my fingers but I can do it now as well as play a real piano (never got the singing don well) and paint pictures.
9.)Trying to draw is good exercise for your fingers.
10.)Writing your name over and over till you can.
11.)Practice pointing with alternating fingers till you can.
12.)Take a Louvre door and place it upside down and walk your fingers up and down it as far as you can and for as long as you can.
13.)Help dusting and waxing furniture where you can.
14.)If you finger grasp is real bad, try squeezing the bulb on a bicycle horn.
15.)Open and close doors with your hand turning the knob.
16.)Practice on twist off lids on plastic jars
17.)Finger paint.
18.)Practice typing on a computer.
19.)Do not give up do not ever give up you are worth this effort.
A.)Soak your hand in warm water to loosen your fingers and wrist up before starting.
B.)A good physical therapist will show you the method to massage the swelling areas to lessen the fluid build up. This procedure is most helpful before doing fine motor skills.
16.)Spastisity may occur in some stroke survivors where the limbs are affected by range of motion or where the hands tighten in a grip that is not in the stroke survivors control. Talk to the physical therapist on how to work with your stroke survivor on this at home.
17.)Long shoe horn, on shoes. Handicap or surgical stores sell a shoe horn that is approximately 2 and a half foot long. This will assist the stroke survivor to put on their shoes.
18.) Sock Aid,1
19.)Grabber,
20.)Encourage, encourage, encourage,
21.)If the stroke survivors speech -is floppy or garbled, you may want to consider a speech therapist, believe it they work wonders. There are also software companies that have speech programs for your computer and you may do this in the privacy of your own home. the patient. Most importantly make sure the care giver has a break, family support and others.
