Continuing at Home
My Dad Left the Hospital
On a December morning in 2016 my dad, Hank, 68, left the hospital five days after his stroke. He was grateful to be alive, but I could tell he was worried how he and my mom would manage with him not working.
Questions to Ask a Doctor
- What should we know about his condition? Any test results?
- Side effects of medications need to be reported? Blood pressure; blood sugar numbers?
- Will you send his doctors hospital record?
What is a Stroke?
- Ischemic stroke (white stroke) stops the flow of blood. Largest number of strokes.
- Hemorrhagic stroke (red stroke) caused by bleeding in the brain.
Questions for a Nurse
- Written home care instructions you can give us?
- Written prescriptions for medications, physical, speech therapy, wheelchair, walker?
- How do I get a copy of hospital record?
Questions for Physical Therapist
- How to continue therapy until next appointment?
- Purpose of each exercise? How to do them?
- How often to do them? Benefits?
- When is the next therapy appointment?
Question for an Occupational Therapist
- Written instructions of tasks? Benefits?
Questions for a Speech Therapist
- How to continue speech therapy encouraging? Books? A plan to follow?
- Next appointment?
Take medications same time you do something regularly – like brushing teeth.
- Set an alarm as reminder to take medicine.
- Keep a backup supply at places you spend time away from home.
- Warm weather can affect strength of medication. Keep from being exposed to sun. Some drugs need to be refrigerated; others at room temperature.
- With a marking pen write name of medication, purpose, time to take it. Use a different color on each container. Use a medication organizer with days, some list time to take it.
- More than half of men and women who have a stroke, also have high blood pressure, coronary conditions and diabetes that must be monitored.
Bladder Training/Bowel Training
You will find support from primary care doctor, nurse, and a urologist, Causes of constipation include medications, inactivity, low-fiber diet, aging, decreased fluid intake.
- Benefits of having control of urination is, it increases comfort, independence, self-esteem.
- Training includes every 3 to 4 hours, while awake, urinate on schedule rather than wait for urge to void.
Bowel Elimination Training
- Training includes stimulating emptying at routine basis
Two numbers are recorded for blood pressure:
- Higher (systolic) pressure during a heartbeat lowest (diastolic) pressure between beats.
- Blood pressure higher than 120/80, lower than 140/90, you are pre-hypertensive.
- Blood pressure higher than 140/90, lower than 160/100, you have Stage 1 high blood pressure.
- blood pressure higher than 160/100, you have stage 2 high blood pressure.
A blood glucose test is used for someone who has diabetes. the doctor uses results to regulate drugs and diet. Ask what your numbers mean. Learn at what time to test. The high numbers to report.
Glucometer measures glucose. Test strip is used to apply a drop of blood. Use only side of your middle or ring fingertip, do not center that has nerve endings, makes testing painful. Use sterile blade without touching tip. Discard blade safely.
Wash every day for cleanliness and comfort. Keep the skin clean and dry to prevent skin breaking down and pressure sores.
- Massage skin and bony parts with a soothing lotion to increase circulation.
- Turn or reposition at least every two hours when in bed for an extended time.
- When moving someone in bed, lift- not pull across a sheet to prevent friction injuries.
- Report pressure sores immediately to the doctor for medication. check every day carefully, be especially alert when someone has poor circulation, decreased sensation, diabetes, fragile skin.
- Bedding, undergarments need to be kept dry to protect skin. Smooth out clothing, change clothing wet incontinence, perspiration.
- A wheelchair user needs to change positions often by pushing up by supporting weight on an armrest. Avoid pressure sores by shifting your position often to increase blood flow and regain correct balance.
To keep the soundness of the body, and prevent shortening of muscles around joints, rehabilitation physicians recommend the following:
- Head and neck need to be in alignment to maintain balance. Position of your head affects muscle tone of trunk, arms, legs.
- Have weight evenly distributed when sitting. If you lean to one side, prop up that side with pillows.
- When sitting bend at the hips, not lower back.
- Support affected shoulder in place supporting your forearms with a pillow. Slide shoulder blade away from spine, allow shoulder and arm to stretch forward.
- Hips, knees, ankles should not roll outward when sitting
- Change position often. Lift your leg to reposition your foot when it drops down, raise your affected arm with stronger arm to realign your position.