Because a stroke can cause the loss of control over an arm and a leg, people’s abilities to care for themselves in simple ways (things like washing or getting dressed) and to undertake taken for granted daily activities (things like preparing a meal, cleaning or going to the shops) are often affected.
Even the most simple tasks like brushing your teeth, shaving or getting toilet roll out of a dispenser became seemingly unmanageable.
Part of stroke rehabilitation is to help people relearn basic skills or to learn new techniques to look after themselves and to prepare for tasks like cooking and cleaning on their return home. This process was usually carried out hand in hand with exercises that helped restore physical function. A man describes how he can relate back to exercises he did lifting small pegs when he is doing tasks like making a cup of coffee.
He could see the importance of exercise to improve strength and things like lifting small pegs…
Learning to do things for themselves was important for most people, but family members sometimes found it difficult to watch their relative struggle. The wife of one man said it was part of their culture to help the less able. He, however, wanted to become independent.
Part of their culture is to help the less able when they are struggling, but the rehabilitation…
Most people were pleased and surprised at the practical help and advice they got in the hospital from occupational therapists and physiotherapists. Occasionally people were asked to do things that they did not find helpful for example a man was asked to practice filling a washing machine which he had not done before his stroke. Mostly people were given an option of the type of things they wanted to achieve and were asked to set goals that they could work towards.
With time people were able to extend their goals towards more complex tasks such as writing, using the computer, even DIY and shopping.
He explained that as time went on his list of things he cannot do has got smaller and he hopes to…
Washing and dressing
Washing and dressing was the first major challenge that people encountered. Most people were helped with this in the first few days after the stroke and then were gradually encouraged to do it themselves. Some had been surprised at how abruptly this had been done and questioned how they were meant to dress a paralysed part of the body. Generally people saw that this was being done for their own benefit to help them to become independent as quickly as possible.
She was quickly encouraged to try to wash and dress herself and was surprised how much she could…
People found ways to make tasks easier, for example men took to using an electric razor instead of a wet shave. Some things were not possible, for example, cutting finger nails on a non-affected hand was impossible, which some people found frustrating and annoying.
Over time people learnt the best way of dressing using techniques like putting the affected limb into the clothing first. Some also changed the type of clothing they wore, choosing things that were easier to put on like trousers with elasticated waists and t-shirts and getting shoes with a Velcro fastening. Equipment such as hooks to pull up trousers and do up buttons could also help. Some clothing still caused a problem, for example people often required help to do up buttons and women struggled with putting on and fastening a bra.
Even though it was a struggle and took much longer than before the stroke most people preferred to do things for themselves.
She finds it takes her longer to wash and dress but feels it is important to do it herself before…
Getting dressed particularly putting her bra on takes a long time but she feels it is important…
Cooking and cleaning
During the time in hospital most people were given the opportunity to practice tasks in the kitchen from simply making a cup of tea to preparing a full meal. Tasks like this gave people a great sense of achievement particularly when they were able to prepare something for a relative.
Practicing these skills once they had returned home was sometimes quite a challenge. Although some were happy for others to take on these tasks others wanted to relieve the burden on their relatives and even took on domestic tasks that they had not done before. A few people had had regular visits from a community occupational therapist or nurse who could help them with planning these tasks which they found reassuring and helped them build confidence. This kind of support is not always available.
Carrying hot pots and pans could be quite scary if the person did not have full control and preparing a meal or doing the cleaning was tiring.
He was worried about cooking a meal at home because of the safety but the occupational therapist…
Breaking tasks up into smaller chunks (called pacing), resting in between and taking more time could help people achieve the things that they wanted to do.
She still likes to do some of the cleaning but breaks it up now so she doesn’t get so tired.
Some people were provided with equipment to make things easier including an electric tin opener, spikes to hold vegetables, kettle tippers, perching stools so they could sit instead of stand and trolleys to carry things between rooms.
He has been given equipment make peeling vegetables with one hand easier.
Getting out and about
Gaining the confidence to get out and about after a stroke was important for some people because they wanted to be able to get out and do their own shopping. Again, setting and working towards goals and using pacing and taking regular rests could be a great help.