What to Do After a Stroke at Home: A Guide for Caregivers

What to Do at Home After a Stroke: How Caregivers Can Help With Recovery

When a loved one has a stroke, the aftermath can feel overwhelming. Recovery may take weeks or even years and can be difficult for you and your family. 

This guide provides a thorough overview of what to do at home after a stroke, so you can make well-informed decisions that benefit everyone involved — especially your loved ones.

Understanding a Stroke

Strokes, sometimes called brain attacks, are the fifth leading cause of death(Opens in a new window) in the U.S. They can lead to lasting brain damage and long-term disability.

There are two main types(Opens in a new window) of strokes:

• An ischemic stroke occurs when a blood clot obstructs the flow of blood to the brain. It accounts for about 87% of all strokes(Opens in a new window).
• A hemorrhagic stroke(Opens in a new window) occurs when a blood vessel in the brain ruptures, leading to bleeding (hemorrhage) in or around the brain. It’s more likely to be fatal than an ischemic stroke.

A transient ischemic attack (TIA), sometimes called a mini stroke, occurs when there’s a temporary reduction in blood flow to the brain, typically caused by a blood clot or blood vessel blockage. A TIA is a warning sign that a person is at increased risk of a more serious stroke in the future and should be treated as a medical emergency.

At the hospital, your loved one will be treated for emergency care and symptoms and evaluated for the best course of care. They may be given a course of medications as well as exercise, diet and lifestyle modifications that should continue after they’re back home.

Medication Management for Stroke Survivors

Once your loved one leaves the hospital, their primary care team will likely provide a majority of post-stroke care(Opens in a new window). They can refer your loved one to a stroke specialist or neurologist — ideally, one they work with regularly.

When your loved one returns home, they may need to take several types of medications. Commonly prescribed stroke medications include:

• Anticoagulants such as warfarin to prevent clots
• Anti-hypertensives like beta-blockers to manage blood pressure
• Statins to reduce cholesterol and prevent artery plaque
• Antiplatelet drugs to stop clots from forming

Adhering to the prescribed regimen can manage symptoms and prevent a future stroke. Your loved one should also continue taking medications for other conditions. This is especially important for underlying conditions that pose a stroke risk, such as diabetes and hypertension(Opens in a new window).

Strategies for Managing Medication Schedules

Managing medication can feel overwhelming, but certain approaches can make it easier to organize and maintain. Here are a few tips: 

• Keep an updated medication list that includes the name of the medication, dosage, frequency and purpose of each drug.
• Administer medications at the same time every day when possible.
• Use pill organizers and reminder systems to keep your loved ones (and caregivers) on track.

Rehabilitation and Recovery

After a stroke, rehabilitation — including regular exercise, good nutrition and cognitive stimulation — can help your loved one regain their independence. Rehab may start as soon as 24 to 48 hours(Opens in a new window) after the stroke. The type of stroke rehab(Opens in a new window) you choose will depend on how the stroke affected your loved one. Let’s look at a few common types:

Physical Therapy (PT)

• Motor skill exercises and mobility training help strengthen muscles and improve coordination so loved ones can get back some of their independence. 
• Constraint-induced movement therapy(Opens in a new window) is used for regaining use of an arm affected by a stroke.
• Range-of-motion therapy helps maintain or increase flexibility and movement in joints and muscles.
• Therapists can also help assess what mobility equipment is the right fit for a person following a stroke. They’ll work with your loved one to learn how to use canes, walkers, wheelchairs, scooters, and more.

Occupational Therapy (OT)

• OT is used to improve daily activities such as eating, drinking and grooming.
• It can also help with cognitive abilities like memory, processing, problem-solving, social skills, judgment and safety awareness.

Speech and Language Therapy 

• Speech and language therapy is used to improve communication skills such as lost speaking, listening, writing and comprehension abilities
• Therapists can also help people who’ve developed troubles with swallowing after a stroke so they can regain and strengthen this function with exercises, coordination techniques, and positioning.

Recreational Therapy 

• Uses leisure and social activities — ranging from horseback riding to art and music classes — to promote physical and emotional well-being(Opens in a new window) 

Psychological therapy 

• Can address the cognitive and emotional challenges you and your loved one may be facing through individual counseling and support groups. 

Types of Stroke Rehabilitation Facilities

To choose the right rehabilitation facility(Opens in a new window), find out what’s available and what will best suit your needs. Here are some options to consider:

• Inpatient Rehabilitation Centers: If the stroke your loved one suffered was severe, your loved one may spend a few weeks in an inpatient center as part of an intensive rehabilitation program.
• Skilled Nursing Facilities: These residential facilities care for those who don’t need hospitalization but still require nursing services and rehabilitative therapies.
• Outpatient Rehab: For this treatment, your loved one lives at home but spends a few hours at a facility a couple of days a week.
• Home-Based Programs: At-home therapy is more flexible than other options, but it means limited access to some services and equipment. Insurance coverage for home-based programs varies, so check with your provider. Tele-rehabilitation is also becoming more common, especially for those without easy access to a facility.

Home Modifications for Safety and Accessibility

Many people who survive a stroke face mobility and balance issues. Most people fall at least once(Opens in a new window) during the first six months after their discharge.

You should plan to fall-proof your home(Opens in a new window) or theirs to minimize fall hazards. Here are a few suggestions to get started:

• Ensure all areas are well-lit.
• Arrange furniture to create clear, unobstructed pathways throughout the house.
• Remove trip hazards; secure area rugs to the floor, being mindful of corners.
• Install grab bars where needed, especially in bathrooms.(Opens in a new window)
• Use waterproof seating and rubber-backed mats in the shower.
• Consider walk-in showers with benches for sitting. 

Wearable technology can’t prevent falls, but it can alert you and others about incidents quickly so you can take action. These include dedicated fall-detection tools, fitness trackers, smartwatches and smartphone fall-detection apps.

The American Stroke Association(Opens in a new window), AARP(Opens in a new window), National Institute on Aging(Opens in a new window), NCOA(Opens in a new window) and other(Opens in a new window) organizations offer guidance and checklists for how to make your home safer.

Emotional Support for Stroke Survivors and Caregivers

The emotional and physical burden for caregivers and survivors can be significant. Anxiety, depression and frustration are common. Caregivers also risk burnout, which can lead to health problems(Opens in a new window) and decrease your effectiveness.

That’s why it’s important for caregivers and loved ones to stay connected with family and friends. Tap into community resources, such as stroke survivor and caregiver support groups(Opens in a new window). Also consider respite care(Opens in a new window), which provides short-term relief for caregivers. 

Other resources include:

• Northwestern Medical offers a post-stroke guide for caregivers(Opens in a new window). 
• The American Stroke Association features articles and guides for caregivers and patients(Opens in a new window).
• The Stroke Family Warmline (888-4-STROKE) connects survivors, families and caregivers with a team member who can provide support(Opens in a new window), information — or just listen. 

Long-Term Stroke Management and Prevention

Stroke recovery can take months or years. Plus, about 25% of survivors have another stroke within five years(Opens in a new window). This is why long-term management is crucial for prevention. Once they complete rehab, your loved one will still need regular follow-up appointments to monitor their progress and identify any new issues.

The good news is that up to 80% of strokes can be prevented(Opens in a new window) by managing blood pressure, cholesterol and diabetes. This requires making healthy choices, such as not smoking, being physically active, taking medications as prescribed and eating well.

Eating healthier by: 

• Limiting processed and fried foods and red meats
• Reducing salt, sugar, and refined carb intake
• Eating more whole foods such as fruit, vegetables, lean proteins, beans, nuts and seeds
• Read nutrition labels or talk to your doctor about creating a personalized nutrition plan

It’s also important to exercise your mind. Games and puzzles have been shown to improve cognition. Matching and memory activities can be particularly helpful.

Bringing It All Together: Successful Stroke Recovery at Home

Effectively managing stroke recovery requires a holistic approach that encompasses the physical, mental and emotional needs of both the stroke survivor and their caregiver. From consistent medical management and thoughtful lifestyle modifications to fostering strong social support, managing stroke recovery at home is a long-term commitment. But with this guide, you and your loved one can navigate the journey successfully.

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