Managing a Parent's Stroke When You Live Out of Town

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It can be stressful when one of your parents has a stroke. If your mother or father has recently had a stroke, you are likely very concerned about your parent and how he or she will get along in the face of a new disability. If you live far away from your parent, you may be even more worried about how to help when you are not nearby.

The issues that you need to consider when your parent is adjusting to life after a stroke involve health, safety, transportation and finances.

You can learn how to manage the main factors in dealing with life after a stroke so that you are better prepared to help guide your parents through the stroke adjustment period and into recovery, even if you are living out of town.

Driving 

Driving is one of the biggest lifestyle adjustments and safety issues after a stroke. Most people must drive in order to get to destinations outside the home.

If your parent becomes unable to drive, he or she may need to depend on others to get around and may have to plan outings well in advance. Your parent could begin to feel isolated and depressed if he or she has to spend more time at home than he or she wants to.

There are several reasons why many stroke survivors cannot drive. Vision changes after a stroke can involve loss of peripheral vision or loss of vision in one eye. Strokes can cause weakness of one side of the body, making the mechanical aspect of driving a challenge.

Some strokes impair judgment, and a stroke can interfere with awareness of the left or right side of the surroundings, a condition known as hemispatial neglect.

And sometimes, even when a stroke does not produce a physical handicap that impairs driving, a stroke can trigger post-stroke seizures, which may cause a stroke survivor to experience seizures while driving, potentially losing control of the car.

The consequences of stroke prevent some stroke survivors from being able to drive safely. These handicaps after a stroke can endanger the driver, his or her passengers, other drivers and passengers and pedestrians.

Yet, your mom or dad might not want to give up driving because of the resulting lack of independence. So, what should you do if you are concerned about your parent's ability to drive, but you aren’t sure if he or she can handle it? If you are concerned, it would be a good idea to ask your parent's physical therapist or occupational therapist to specifically assess your parent for driving ability.

If your parent is deemed unfit to drive, then your parent will most likely abide by that medical instruction. However, if your parent insists on driving despite medical orders, then the unpleasant responsibility of enforcing this restriction may fall on your shoulders.

It can help if you remind your parent that the car, maintenance, gas costs and insurance costs are expensive. Perhaps you can show your parent that the cost of a car vs. buses, trains, cabs and other transportation options are about equal by writing out the actual numbers so that your parent can see that being a passenger might not be that expensive.

And you can help while you are far away by hiring someone for a certain number of rides or a set number of driving hours and paying for it yourself. Many times, when parents know that their adult children have already 'pre paid' for something, they do not like to see that payment go to waste.

Home Safety 

After a stroke, some structures of the home may become challenging to navigate, and may even become unsafe. For example, stairs can pose a falling hazard if your parent has trouble with balance or has leg weakness. A stubborn stove knob or an exposed wire that was simply annoying prior to a stroke can become a new danger after a stroke.

Many stroke survivors are safer living in a one story home or apartment. However, when that is not possible, your parent might be able to safely walk up and down stairs, but might not be able to safely walk up and down stairs while carrying a heavy load, such as a laundry basket.

Some home maintenance tasks, such as changing a smoke alarm battery or a ceiling bulb, require standing on a ladder, which may be too much for your parent to handle.

There are a number of factors to consider when it comes to living arrangements after a stroke. There are also a number of options to consider.

It is common for a parent to become upset and defensive when his or her children suggest moving to a less independent environment. If your judgment tells you that your parent needs to move, do not be surprised if your parent has a negative reaction. This decision and the associated process is one of the most significant challenges of your role as the son or daughter of a stroke survivor.

Medical Appointments

If you are living far from your parent, you are most likely unable to go to your parent’s medical appointments. It may seem that things would be so much simpler if you could just tell the doctor what you have observed and hear the doctor’s opinions and advice firsthand.

However, due to HIPPA regulations, your parent’s privacy as a medical patient is protected, and you do not have the rights to access your parent’s medical records or to receive information from your parent’s medical team unless you get written authorization from your parent.

Every stroke survivor has a different attitude and decision regarding how much medical information he or she wants to share and whether adult sons and daughters should be granted access to medical records. Some stroke survivors want their adult kids to hear the information straight from the doctor and 'translate it' into down-to-earth talk, while others closely guard their health information from their adult children.

Your parents most likely fall somewhere in between the two extremes and will probably give you access to some information, but not all of it. It is a good idea for you to reach out to your parent’s doctor directly if you truly have a genuine concern about your mom or dad's decision-making competence, safety and ability to understand and properly follow medical instructions.

Prescriptions

Your parent’s prescriptions are important. When you are far away, you might not be able to ensure that your mother or father fills prescriptions as scheduled. If you do not think that your mom or dad will get to the pharmacy to get medication on time, it can help if you register your parents for a delivery program or at least some type of reminder program.

When it comes to taking scheduled medicine at home, it is easy for your parent to forget to take pills as instructed. Medications are more likely to cause serious reactions when taken improperly. There are a number of pill counters and pill devices to help your mother or father keep track of pills. And some services can even help place the pills in the pill counters for your parent.

Another important thing you can do with your parent is to preemptively have a plan in place so that your parent will know what to do in case he or she forgets a pill. For example, if your parent forgets to take certain pills for the day, he or she should not take an extra one. On the other hand, for some medications, it is important to 'catch up' on missed doses. Your parent’s doctor or pharmacist can spell this out ahead of time for you and your parent, which can help to avoid stress and scrambling for answers after the fact.

Nutrition 

After years of your parent telling you to eat healthy, after your parent has a stroke, you might be the one who is worried about whether your parent is eating healthy. Most of the time, after a stroke, the biggest nutritional concern involves a loss of appetite and a lack of initiative in getting food.

If you live far away, you can arrange for a friend to visit your parent to deliver healthy groceries. You can also arrange for a delivery service to deliver groceries or selected prepared dishes to your parents if you are concerned about your parent’s caloric intake.

Finances 

If your parent has become less attentive to detail or is otherwise unable to stay on top of financial matters and bills, you might need to step in. Perhaps automating some bills and setting yourself up for email notifications can help bridge a gap in your parent's attentiveness to financial matters.

Some parents become paranoid about money matters, concerned that adult children are out to prematurely ‘inherit’ money. As a way to reassure your parent, you can set up a system that allows you to receive alerts and to pay bills if they are late, but not to ‘take’ anything from your parent’s account.

Caregiver Issues

Your mother or father’s caregiver may be your parent’s spouse, a sibling or another relative. While it may provide you with a degree of relief if a trusted person is caring for your parent, it is also important to consider the caregivers burden.

There are a number of ways that you can reach out to your father or mother’s caregiver. You can consider video chatting, email or social media as a way to help ease the caregiver’s loneliness and offer support and live conversation.

Being Taken Advantage Of

Of course, if your parent is not regularly cared for by a trusted relative, you might have concerns about the sincerity of the people caring for your parent. The most effective way to deal with this is to develop a consistent rapport with as many people who are in your parent’s life as possible, so that they will all feel ready to contact you of any concern arises. And if you notice anything suspicious, it so helpful for you to have contacts whom you have grown to trust that you can reach out to.

Emotional Health

Depression and isolation are real problems that develop after stroke. Preemptively discussing these common effects can help ease the stigma for your parents. A conversation about preventative measures and a plan for how to reach medical professionals to deal with depression if it arises is an effective way to reduce the severity and impact of depression.

Behavioral Changes

If you are living far away, you can still be a part of your parent’s life and carefully watch for behavioral changes before they become dangerous.

Video chatting is a better way to get a handle on behavior than phone calls or texts or emails. Regular contact with the people in your mother or father’s life can make those people trust you and feel more comfortable reaching out to you if things come up. A number of behavioral changes associated with stroke include a lack of empathy, irrational jealousy and a diminished sense of humor. These changes can all impact day-to-day relationships in a substantial way if friends and family take the personality changes personally rather than understanding that these changes are caused by the stroke.

A Word From Verywell

If you are far away from a parent who has had a stroke, you may be going through a great deal of stress and feeling guilty and helpless about how to help your parent. However, you can be a part of your parent’s stroke recovery even if you live far away.

Sources:

Adult daughters providing post-stroke care to a parent: a qualitative study of the impact that role overload has on lifestyle, participation and family relationships, Bastawrous M, Gignac MA, Kapral MK, Cameron JI, Clinical Rehabilitation, 2015 Jun;29(6):592-600

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