Stroke

Leaving hospital

The length of stay in hospital after a stroke can vary from a few days to a number of months depending of the severity of the stroke and the support available at home. People were not usually discharged home until they were able to get around safely either in a wheelchair or walking and were able to get in and out of bed. If a person lived alone they were also assessed to see whether they could make a drink and a basic meal for themselves. Some people returned home and were provided with a care package (see 'Continuing care at home and institutional care').

A few people had discharged themselves from hospital early because they were not happy with the care, were desperate to get back to familiar surroundings or were concerned about things that needed to get done because no one else was available to do it. As a consequence they often encountered problems accessing rehabilitation services.

Preparation for going home
The rehabilitation in hospital was nearly always focussed on getting people physically fit enough to get home and preparing them for everyday tasks such as washing, dressing and preparing food (see 'Stroke recovery' Physical aspects and mobility' and 'Stroke recovery' Daily activities').

Part of this process can involve a visit home with the occupational therapist and sometimes a social worker. This visit was to assess the house and look at requirements for adaptations such as ramps to get in and out of the house, hand rails in the bathroom, shower and toilet seats and hand rails on the stairs. Some people were also assessed to see how they managed in the kitchen.

Weekend visits
Leading up to their discharge home some people we spoke to had been on one or more overnight or weekend visits or trips out, for example to a park or café. Weekend visits were generally a great boost although some found them difficult as the experience brought home to them the extent of their disability and made them feel vulnerable. They were often glad to return to the security of the hospital.

Although most people had achieved some mobility (either in a wheelchair or walking) by the time they went on these visits, they were often unable to negotiate stairs and it was sometimes necessary to have a temporary bed downstairs and a commode.

Adaptations for homes or moving to a new home
Many people talked about adaptation or aids for living at home such as stair rails, shower rails, stools and so on with an occupational therapist. Most were happy to have any adaptations; however, a few did not want their house to reflect their disability and refused adaptations. One woman later changed her mind and had a stair rail installed. Whilst most were entitled to some help with adaptations to their home, others were not, or were frustrated by the length of time that they had to wait for adaptation and had used large amounts of their own savings to have it done themselves. One woman was who had broken her leg since the stroke was still waiting for a toilet and shower downstairs which she found extremely frustrating.

One man explained that he had to move to a more suitable house. He found it difficult that his wife had to arrange decorators as he would have previously done the work himself. 

Feelings about being home 
Most people were really happy to be home back in a familiar environment without the disruptions of the hospital which could sometimes lead them to have sleepless nights.

Some people were, however, frightened of having another stroke and missed the security of being watched over by health professionals in the hospital. Others, particularly those who lived alone or those who had been in hospital for many months, missed the company of the other patients. One woman missed the excellent care in the hospital and initially found it difficult to rely on the Social Services department. Friends and families could sometimes find this indifference to being home difficult to understand. One man felt overwhelmed when first arriving at home, describing it as equivalent to "jumping off a cliff". It was an adjustment not only for him but his wife and young children.

People valued the support and help of their family on their return home as they were often surprised how tired they felt at doing even simple tasks such as dressing. This time could also be overwhelming for the person caring as they often had to take on new responsibilities. 


 

Last reviewed August 2013
Last updated August 2011

 

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