Deciding Where to Live After a Stroke

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There are a number of factors that come into play when making a decision about whether a stroke survivor will go back to living at home or somewhere else after a stroke. It helps to have an understanding of the different types of living arrangements and to get some help in arranging for payment.

There are some gray areas when it comes to this decision. Doctors make recommendations based on medical necessity.

But, there are also some personal considerations that differ from one stroke survivor to another and from one family to another. This is often a highly emotional subject. Sometimes looking at some important factors can help with rational decision making and communication at this time of change.

Severe Disability

After a stroke, severe disability can impair a stroke survivor’s ability to walk, bath, eat and use the toilet. Bedridden stroke survivors need round the clock care and attention. A caring, energetic loved one who doesn’t have medical skills or background can sometimes learn to safely provide some of that care. But avoidable health complications can arise even under the most loving and attentive circumstances simply because of the subtleties of medical symptoms. Regularly scheduled home visits by a trained nurse can effectively catch some budding medical complications, allowing some severely disabled stroke survivors to remain at home.

However, family circumstances may make the home setting not the best option for severely disabled stroke survivors.

Dementia

Patients who suffer from severe strokes or who have sustained many strokes may develop dementia. This can make caring for a stroke survivor at home dangerous. People living with dementia often display poor judgment.

Even when poor judgment is temporary or intermittent, it can still be hazardous. This can lead to an unmanageable situation at home.

Self-Care

Self-care is an important part of maintaining health. Good self-care is crucial for maintaining nutrition and for prevention of infections. We often take for granted how much of our time and attention we devote to self-care. Stroke survivors may have serious trouble with adequate self-care and may need professionals to aid with care in order to safely eat, bath and use the toilet.

Living Alone

When a stroke survivor has a spouse, usually the spouse is the caregiver. However, some stroke survivors have lived alone prior to having a stroke. This can be more challenging and hazardous than when a stroke survivor lives with someone who is prepared to be a full-time caregiver.

Caregiver is Disabled or Can't Remember

Often, stroke survivors live with a spouse. However, the spouse may be elderly, ill, weak or suffer from dementia herself. In these instances, the spouse is not able to learn how to take care of the severely disabled stroke survivor.

When both partners are too ill for self-care, they cannot safely take care of each other, and thus different living arrangements must be prepared.

The Home is Unsafe

Prior to a stroke, many people are able to get around in homes with stairs or other features that may suddenly pose a serious challenge. After a stroke, most homes present some danger. Some of these unsafe features are adaptable, while some are not. It is important to make sure that the house is modified to a stroke survivor’s disability or to make sure that the stroke survivor finds a safer living environment.

Transportation

Sometimes, if a stroke survivor has been living in a remote area, transportation and communication and access to help pose an unsafe situation. While living out in the wilderness can suit the tastes of those who are independent, stroke survivors who have serious disability need to be in a situation with quick, easy access to resources and help whenever it is needed.

Other Options

There are other options for stroke survivors who are no longer suited for living home. Moving in with a capable relative, rehabilitation units, nursing homes and assisted living apartments are a variety of options that might better accommodate a stroke survivor who has severe disabilities.

Sources:

Place of residence after a stroke: results of the registration by the Belgian Sentinel Network of general practitioners, Francois S, Van Casteren V, Borgermans L, Devroey D, Romanian Journal of Internal Medicine, June 2014

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