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Returning Home After a Stroke

Returning Home After a Stroke

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Published by: heshell soneja on Nov 29, 2009
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12/31/2012

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Returning Home After a Stroke
How soon can you go home after being in the hospital or rehab facility? What condition can yourealistically expect to be in? The answers depend on the severity of your stroke, the areas of the brain it affected, and other factors.Some people who've had a stroke can return home after a few days in the hospital. Others willnot get home for many weeks if they needtreatment in a rehabilitation facility. A few stroke survivors require long-term nursing care. For most people who have had a stroke, living at homeis possible only if they can manage activities of daily living, such as dressing, eating, and usingthe toilet. You also have to follow medical advice and take prescribedmedications.But you will  probably need help even if you can perform activities of daily living. Don't try to do it alone, atleast not right away. Plan on having a relative, friend, or home-health aide stay with you for atleast the first night you're home and possibly longer. If you've been in a rehabilitation facility,chances are that someone in charge of discharge planning will visit your home ahead of time toevaluate what equipment and assistance you will need.Before returning home permanently, it's a good idea for you to visit for a day or a weekend sothat relatives or caregivers will have a chance to identify and correct potential problems. If youhave trouble getting around the house, for instance, furniture may need to be rearranged, throwrugs removed, and handrails built. If you need a wheelchair, doorways may have to be widenedand ramps or lifts installed.
Advice for Caregivers
 
If a relative, spouse, or a close friend has had a stroke, you are affected, too. You miss the person's companionship and worry about his or her well-being. But you have a vital role to playin the person's recovery. You may need to offer practical help with the person's care, and youwill certainly need to be supportive when your loved one's spirits fall. Your encouragement canmake the crucial difference between rehabilitation results that are mediocre and results that aresuccessful. When you step in to help, keep the following hints in mind:
Take care of yourself by eating well, getting enough rest, and taking time to do thingsthat you enjoy. Don't be afraid to ask for help from other family members and friends or to hire some help if you can.
Make everyone's life easier by learning about and using assistive devices that will helpyour loved one do as much alone as possible.
Take advantage of support groups and other resources for caregivers.
Learn as much as you can about stroke and rehabilitation.
Support your loved one's efforts to participate in decisions about rehabilitation.
If your loved one has trouble communicating, ask your doctor or a speech therapist for advice. For example, speaking slowly and allowing plenty of time for a response canhelp. So can using pictures, photographs, gestures, and sounds or computerizedcommunication devices.
Ask to attend some of the rehabilitation sessions to learn how the program works. Makesure the staff suggests activities that fit your loved one's needs and interests.
 
Encourage and help your loved one practice the skills learned in rehabilitation.
Find out what your loved one can do on his or her own, what he or she needs help with,and what he or she can't do at all. Then try not to do tasks that you know your loved onecan do without your help.
Consider adult day care. A local adult day care program can be a good option if your loved one is living at home but has some degree of mental impairment. Adult day carecan help give a few hours respite to a relative who is caring for a stroke patient at home.It would not be suitable for someone who is relatively self-sufficient.
Physical Therapy After a Stroke
Physical therapy retrains your muscles to do what they didbefore your stroke — but the process may require plenty of time and patience.
After astroke, muscles may not remember how to perform actions that were once simple, likesitting and walking. A stroke patient will need to relearn these skills with the help of physicaltherapy. Physical therapy retrains muscles and reminds them how to work together again.
Physical Therapy: Regaining Mobility
 Physical therapy focuses on getting the stroke patient to use limbs that have been weakened or  paralyzed by the stroke.Whileoccupational therapyconcentrates on helping patients learn to feed themselves, chew andswallow, and get dressed, the main goal of physical therapy is mobility. A physical therapistwants to teach the stroke patient how to walk, sit, stand, and get in and out of bed, a chair, and acar all on their own."Physical therapists evaluate and treat the deficits that stroke patients are left with, themusculoskeletal deficits. We will start in acute care, with early mobilization of the patient andexercises," says Mary Ann Owsley, PT, supervisor of the physical therapy stroke team for inpatient rehab at the Frazier Rehab Institute, a service of Jewish Hospital and St. Mary'sHealthCare in Louisville, Ky."We get them up and moving around as soon as possible, even if all they are able to do initiallyis sit up on the side of the bed and work on sitting balance. Then we progress to being moreindependent with all of their basic mobility — from getting in and out of the bed to thewheelchair, to walking with different types of assistive devices, like canes and walkers," saysOwsley.
Physical Therapy: Success Through Strength
Physical therapy involves using and strengthening the muscles, even before the patient can dothis on their own. Therapists use both active and passive range-of-motion and strengthening
 
exercises. Active exercises are ones the patient performs unassisted; passive exercises are performed or aided by the physical therapist. Both types help strengthen muscles.The physical therapist will create an exercise program for the patient to follow so that musclestrength can be maintained and new skills won't be lost.
Physical Therapy: Family Education
 Physical therapy also involves working with family members and caregivers. "We start workingwith the families as soon as we can to follow through with any of these techniques for  positioning and range of motion," says Owsley. "We do a lot of education with the stroke victimand their families as far as the limitations that they may be left with."
Physical Therapy: Following Through With a Plan
 Physical therapy often starts while the stroke patient is still in the hospital, so you can continue towork with the same physical therapist once you return home or move to the inpatient strokerehab center. However, if your initialtreatmentwas not at a primary stroke center with health providers specifically trained in stroke, you may want to find a physical therapist to help withyour stroke recovery at a certified stroke rehabilitation center .
Physical Therapy: Managing the Costs
 Often, private health insurance plans will cover either a percentage of the costs or a set number of physical therapy sessions. Medicare usually pays for physical therapy after a stroke. Find outabout your coverage before physical therapy begins so you understand what costs, if any, youwill be responsible for.Physical therapy works best when it is started early and is continued regularly, usually a fewtimes each week. Slowly but surely, your body will start to remember and respond, and repair thedamage done by stroke.
The Importance of Exercise After a Stroke
Excess weight, high blood pressure and cholesterol,depression — exercise can help deal with all of theseissues. And there are even more good reasons to exerciseafter you've had a stroke.
After astroke, you’re probably not anxious to put on your running shoes and go jogging. You’refacing other concerns — but you should know that exercise is very important for  stroke recovery  and for preventing another stroke.

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