CARING FOR A STROKE SURVIVOR
1. In Hospital —
Family should meet doctor-in-charge.
- Find out cause of stroke (eg. was it high cholesterol, diabetes, high BP, smoking etc.) Only when the risk factor is known can the recovery be better managed.
- Ensure that there is follow up to identify and rule out other causes of stroke such as:
cardiac issues (issues of rhythm, heartbeat and valves).
narrowing and clots in other blood vessels in the brain or the heart and or other parts of the body that may cause another stroke.
if it was a hemorrhagic stroke find out if there are other vessels that may leak or burst.
Find out how to manage the risk factors and the cause (s) of the stroke to prevent the next stroke.
2. Advise the family —
Do not treat the strokee as a child or invalid. Make them part of the decision making if possible. Family can do things with strokee but where possible, not for them. Remind them that the other limb still works.
3. Advocate early rehabilitation —
Begin rehab as soon as patient is declared medically fit by doctor.
4. Preparations for stroke survivor’s discharge —
- Ensure that on discharge there is a discharge summary as this helps clinician and rehab team to manage recovery.
- Appointments are given for medical follow up and rehabilitation.
- Family has to already have decided where strokee is going. Some points to consider:
What is the condition of the stroke survivor?
- Is there a trachy (a breathing hole at throat) – this requires full time nursing care, so it is either a 24/7 professional nurse in residence or a Nursing Home with 24/7 nursing care.
- Mobility – Can strokee move around, will there be someone with him/her. If no one at home will nursing home will be needed.
- Returning to family home. Things to consider:
- Access, steps, doorways (wheelchair mobility) and ledges.
- Consider a mobile commode with wheels and brakes.
- If home modifications required (eg. ramp, handrails to be fixed) advise family to consult an occupational therapist.
- When looking at nursing homes:
- Is there a professional nurse in attendance (SRN) as only registered nurses can dispense medication and manage trachy cases. If the strokee is mobile and cognitively alert and able to manage his/her own medication, then an enrolled nurse (diploma) is fine.
- Is there a doctor in attendance? Nursing homes must have this in place.
- Therapist – if none, ask the Home if its fine for your own to go to the Home to attend to strokee.
- Go and inspect the Home to see how well it is run and if it suits your budget. Also look at:
- Hygiene and cleanliness.
- Are the residents happy.
- Is it crowded? What is the staff to patient ratio like? About 1:4 to 1:6 is nice.
- What is the food like.
- What activities do they have.
- When looking at nursing homes:
5. If the stroke is expected to cause long term disability, get an OKU card —
For NASAM members the Admin office assist to apply for one.
6. If strokee is young and was employed the family should check if he/she is eligible for help from SOCSO —
Click on the address to learn more https://www.perkeso.gov.my/en/