Stroke is a leading cause of long-term disability in the world as well as in the UAE. One in four people will have stroke in their lifetime. However, optimal management and care of stroke survivors can reduce the risk of a second attack, and improve their quality of life significantly.
In this article, we will first briefly describe what happens in a stroke, why it is challenging for the patient and his or her caregivers, and what steps can be taken to optimize the quality of life and recovery of the patient, according to the latest available evidence. Finally, we will review the role of nursing at home to support patients after a stroke.
Understanding Stroke
A stroke is a sudden clinical event that happens usually due to a blockage of or bleeding from a blood vessel in our brains. You can think about it as a “Brain attack”. Depending on the part of the brain affected, there may be some degree of paralysis or loss of function to one side of the leg, arms, or both. Other functions such as speech, swallowing, and sensation can also be affected.
A stroke can be a life-changing event, and the road to recovery often involves adapting to a new normal. Optimal care at home, guided by expert medical advice, plays a crucial role in aiding recovery in stroke survivors. It is also important to improve the quality of life of both the patient and caregivers.
The Role of Rehabilitation
Rehabilitation, including targeted exercises guided by a physiotherapist and executed by a nurse or a caregiver, is the most important part of stroke recovery. The brain tries to adapt after a stroke, gradually using new or different areas and pathways to try to perform its functions. This is known as neuroplasticity of the brain – and regular rehabilitation exercises are vital to make this happen.
Creating a Comfortable Environment
Comfort is key when it comes to stroke care at home. We can start by arranging the living space to minimize obstacles and hazards. Simple modifications, such as removing loose rugs or securing handrails, can make a significant difference. Ensure that essential items are within easy reach to promote independence and reduce frustration.
Encouraging Mobility
Encouraging mobility will help patients regain their muscle functions faster and reduce the chance of developing bed sores. It is also a good way to promote independence, which can have important psychological effects. In the patient’s room, try to place his or her things on the side where the weakness is. This will promote mobility on that side, thereby improving the chances of recovery. Prolonged non-use of the muscles can make them atrophy or weaken, which can worsen stroke recovery.
Nutrition, Hydration, and Feeding
Diet is an important part of long-term stroke management. Blood cholesterol levels are a risk factor for stroke, and patients should cut down on ‘unhealthy’ fats, including fried foods, processed meat, and anything that contains saturated fat. Instead, foods that are rich in healthy fats, such as fish (especially oily fish such as Salmon and Tuna), nuts, and seeds should be part of the diet. Consuming a least five portions of fruits and vegetables a day is not only part of a well-balanced diet but will also improve bowel regularity by providing fiber. Limiting added salt to less than 5g/day is also important (and even less if you have certain heart problems). In addition, if the patient has other risk factors for stroke such as diabetes and high blood pressure, personalizing his or her diet becomes even more important. Always seek qualified professional guidance if you need help planning a healthy diet..
Some patients may have swallowing difficulties after a stroke. Swallowing should be assessed by a physician or a speech therapist, and depending on the assessment, the patient may need additional support such as a nasogastric (NG) tube for feeding or a specialized diet to prevent aspiration.
Medication Management
Managing medications can be a crucial aspect of stroke care. Some patients may already be taking medications for chronic conditions that contributed to a stroke, such as diabetes or high blood pressure. There may be new medications added to the patient’s regimen after a stroke to reduce the risk of it happening again.
Set up a reliable system for medication organization, such as a pillbox with compartments for each day of the week. Ensure that you understand the medication schedule and any potential side effects of the medicines. Regular communication with healthcare providers is essential to monitor and adjust medications as needed.
Mental Health Support
Stroke is an acute event, it is a sudden and unexpected change that can have a huge emotional impact on both the patient and his or her family. We should always prioritize creating a supportive environment by maintaining open communication and expressing empathy. Engaging in activities that bring joy and a sense of normalcy, encouraging social interactions with friends and family to combat feelings of isolation, and regular assessment by a qualified health professional are some of the steps that we can take to improve the mental well-being of both the patient and his or her family members.
Importance of Home Care Nursing
It can be stressful and difficult to consider all of the aspects of post-stroke care described above. That is where the help of a professional and experienced caregiver becomes important. Homecare nurses are trained and equipped with the skills to execute care plans considering all the above aspects and will support the patient and the loved ones to work towards recovery and a better quality of life. Skilled nurses and caregivers can help keep patients at home with their families and reduce the risk of future complications and costly hospital re-admissions.
If you or your loved one is in need of care after a stroke, our dedicated home nursing team is here to support you every step of the way.