Stroke. How to care for patients who have suffered a stroke

Recommendations and treatment for relatives and carers

Communication

• Speak naturally, using simple words and short sentences, without shouting.
• In the first phase after a stroke, ask short, yes/no questions.
• Promote conversations about every-day life and familiar situations to stimulate the patient’s language.
• If necessary, accompany conversations with gestures to facilitate understanding.
• Items such as the radio or television should be turned off to avoid distractions.
• Respect the response time: avoid showing impatience or cutting off the patient.
• In serious cases, you can use alternative means of communication, such as boards with everyday images on them. There are also mobile apps that can help.

Movement

• Do the exercises recommended by the physiotherapist.
• Move joints and avoid incorrect positions.
• When moving a patient, never touch the affected side.
• It is important that the patient be out of bed for as long as possible.
• Pillows should be used to protect zones of friction and position should be changed every four hours.
• Before the patient drives again, a specialist should be consulted.

Sleep and rest

• It is recommended to sleep seven or eight hours a day.
• Provide a quiet environment and provide a point of light so the patient can orient themselves during the night.
• Create a day atmosphere (more active, bright) and a different, night atmosphere (quieter, darker). This helps in understanding the sleep pattern.
• Avoid letting them sleep during the day, except for a short afternoon nap.
• After a stroke, the patient may find themself more tired for a while. It is important to become more active but without forcing it.

Hygiene

• Encourage the patient to collaborate in their personal hygiene.
• Whenever possible, use a shower, instead of the bathtub, with a chair inside and a handle on the wall.
• The soap should be neutral and free of alcohol, as this can dry the skin.
• The skin should be dried properly, taking special care with folds. It should then be hydrated and protected.
• Maintain proper oral hygiene.
• Watch bony prominences to prevent pressure sores.

Getting dressed

• Wear comfortable clothes that are easy to put on and take off, such as sportswear with elastic and no buttons.
• Start dressing the patient on the affected side and undressing them on the side that is not affected. It is preferable to be seated.
• To put on trousers (pants), especially if the patient is in bed, it is easier to gather up the trousers, insert one leg at a time and then pull them up.
• Shoes should be closed, with no laces and non-slip soles, which fit the foot well. Shoehorns can make it easier to put on shoes.
• The patient feels the same degree of cold and heat as the carer, so do not give them too many layers.

 Physical obstacles

• Remove obstacles such as carpets or chairs to avoid tripping.
• Adapt the home to the new situation: install bars, a taller toilet or shower, etc.
• Adapt the home to improve patient autonomy and prevent falls. For example: have a high bed (70 cm) to make it easier for the patient to get up and down comfortably.

Leisure and recreational activities

• Maintaining social life and hobbies, while respecting the limitations of the patient, improves self-esteem and avoids isolation.
• Incorporate leisure activities gradually, according to the degree of autonomy and in consensus with the patient.

Sex

• Immediately after a stroke, sexual desire may decrease, but it will gradually recover. If in doubt, consult a doctor.
• Paralysis may make sex trickier, but not impossible.
• Fear of suffering another stroke during sex is generally unfounded.
• It is important to talk to your partner about any fears or worries that may arise.

Return to work

• The return to work must be planned, together with the company, so it is gradual, both in terms of demands and time.
• After re-joining the workplace, the situation should be re-evaluated in case changes or adaptations need to be made to improve patient performance and ability.

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