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Daily living

When you return home after a stroke, you will need to make sure you are able to take care of yourself, or at least have someone care for you.

Grooming

The goal of a rehab program is to get you functioning as well as possible. An important part of that is daily self-care, including:  

Looking at your abilities

There are many scales and tests that determine your functional abilities. The healthcare team looks at all of the tests results. They put that together with what they know about you to help them make a plan for your recovery.

Who can help?

Occupational therapists play a key role on your healthcare team in helping and supporting you as you return to daily life. The rest of the team will also take part in this area of care.

Dressing

What you wear often says a lot about who you are and how you are feeling. What you choose to wear should reflect who you are. The effects of a stroke might mean you have to:

  • choose the right type of clothes
  • adapt your clothes so getting dressed is easier
Helpful tips
  • To dress, use your unaffected arm to dress the affected side first.
  • To undress, take the clothing off the unaffected side first and then remove it from the affected side.
  • Use a long-handled shoehorn to put on shoes. There is also a device to help pull on stockings. Talk to your occupational therapist about these devices.
  • Remind the person who is assisting you to let you know what will happen next so you can help and not feel startled.
When choosing clothes
  • Avoid tight-fitting sleeves, arm holes, pant legs and waistlines.
  • Take a pass on clothes that have to be put on over your head.
  • Look for clothes that fasten in front. They are often easier to manage.
  • Replace buttons, zippers, and shoelaces with Velcro fasteners.
  • Choose coats and jackets lined with slippery fabrics like satin, silk or nylon that are easier to put on than unlined garments.
  • Opt for knit fabrics. They wrinkle less than woven ones, so you won’t have to iron as much.

Skin care

The skin is the body’s largest organ. It defends against infection. It is important to keep your skin healthy. A stroke can increase your risk of skin damage because of:

  • loss of feeling an ability to move
  • dry skin
  • poor nutrition
  • dehydration
  • friction on the skin because of positioning
  • moisture from perspiration or incontinence (loss of bladder and bowel control).

Helpful tips to prevent skin damage

Check your skin each day
Pay attention to bony areas such as heels, hips and elbows. Look for redness and signs of pressure, abrasion, scraping or bruising. If you can’t check your skin, get a healthcare team member to help.

Wash regularly
Use mild cleansing agents. Clean soiled skin right away. Do not scrub the skin. Rinse carefully and thoroughly because soap residue can irritate the skin.

Protect your skin from dryness and moisture
Treat dry skin with moisturizers. Ask your healthcare team about ways to protect your skin from moisture caused by incontinence, perspiration or wound drainage.

Eat a healthy diet
Make sure you are eating a healthy diet and drinking enough fluids. If you need help, ask your dietitian.You may also wish to view our exclusive heart-healthy recipe file for meal ideas.

Protect your skin from friction

  • Use proper positioning, mobility, transfer, and turning techniques to minimize skin injury due to friction. Your nurse or physiotherapist can teach you and your family the proper techniques.
  • Turn in bed at least every two hours. Sitting or lying in one position for long periods of time may irritate your skin.
  • Ask your healthcare team about using special aids if you are in bed for long periods of time. Examples include water pillows, thick foam, gel cushions for your buttocks, a specialty boot to relieve pressure on the heels, pressure-reduction mattresses, alternating air mattresses, elbow pads, and pressure reduction seat cushions for wheelchairs.

Foot care

You may have experienced changes in the way you walk after a stroke. These changes can eventually lead to problems with your feet. However, you can avoid most of these problems by taking a few, very simple steps.

Helpful tips 

  • Check your feet every day for cracks, blisters, sores, swelling or any changes in skin colour. This is especially important if you have diabetes, circulation problems or reduced feeling in your feet. Any sign of infection, such as redness, swelling, or discharge (oozing), should be seen by your family doctor or your chiropodist (foot specialist).
  • Always wear socks. Socks made of wool, a natural fibre will help to absorb perspiration and keep the feet cool and dry.
  • Buy shoes that are wide and deep enough, and fit snugly at the heel. Ideal shoes for stroke patients have low heels, shock absorbing soles, Velcro fasteners, deep, rounded toe boxes, and leather or canvas uppers.
  • Shop for shoes at the end of the day when your feet are naturally swollen. Be sure to have both feet measured.
  • Keep toe nails trimmed. Look for a chiropodist or foot care clinic in your community.

Hand care

A stroke can cause lack of feeling or movement in your hand. Because the hand is not being used, fluids may pool in it. This causes swelling and can result in pain and skin problems.

Helpful tips 

  • Support your affected arm on a lap tray or on a device called an arm trough when you are sitting. If you can, use your other hand to position the affected hand. It should be in front of you, with the fingers opened and the wrist supported.
  • Use foam wedges or arm supports placed on the tray to raise the hand. This reduces swelling.
  • Gently bend and open the fingers of your affected hand with your other hand.
  • Gently stroke the back of the hand and wrist if your hand is tightly closed or spastic. Do not force it open. This should help the fingers to relax.
  • Ask your healthcare team if squeezing a soft ball is right for you.

Bathing

Before your stroke, you may have had a preference for using a shower or bathtub. However, after your stroke, you may find that you have to adapt. Choose a routine that is safe and allows you as much independence as possible.

Helpful tips 

  • Install grab bars near the tub and shower.
  • Put non-skid tape or a suction mat on the bottom of bathtubs and showers.
  • Cover exposed hot water pipes if you have decreased feeling sensation.
  • Use a chair the same height as the tub to help you get in and out. If you find it hard to safely get in and out of the bathtub, think about a tub bench and a hand-held, flexible shower hose.
  • Get all you need ready before you bathe. Collect towels, clothing, soaps, and shampoos before you get wet.
  • Test the water before getting in. If you have decreased feeling on one side of the body, you might not notice that the water is too hot.
  • Try using soap-on-a-rope, a bath mitt and long-handled brush.
  • Opt for a sponge bath if getting in and out of the bathtub or shower is unsafe.

Mouth care 

The right mouth care helps to keep you comfortable. Oral hygiene is especially important for people with dysphagia.

Things to do

  • Brush teeth every morning and at bedtime.
  • Remove and clean dentures. Store them in clean water in a denture cup.

Household chores

For many, living at home includes performing household chores as part of  your daily routine. Whether preparing meals, laundry or cleaning, these tasks are all important in the quality of your life. A stroke can affect your ability to do any or all of these chores. Whether you have mobility challenges or fatigue, it is important to look at what needs to happen in your home and explore options to get it all done.

Looking at your abilities

There are many scales and tests that determine your functional abilities. The healthcare team looks at all of the tests results. They put that together with what they know about you, where you live and who is available to support you in your recovery at home.

Helpful tips 

  • Make a list of chores, then identify who can do them.
  • For the stroke survivor, identify if there is a need to adapt or look at other ways to get your chores finished. For example, to fold laundry, it might be easier to have a chair beside the dryer.
  • Are there others who can help? Family? Friends? Community service organizations?

Who can help

Occupational therapists play a key role on your healthcare team in helping and supporting you as you return to daily life. The rest of the team will also take part in this area of care.

Once a plan is in place, there are many support services in the community to help you manage household chores. Some of the services charge fees, while others rely on volunteers or are part of a government-paid home-care program. These might include: 

  • Meals on wheels – a service that delivers hot meals to your home
  • Housekeeping or home support services – organizations that can help with cleaning and laundry
  • Gardening and snow services – people who can look after your property
  • Telephone or on-line grocery stores

Talk to you healthcare team about what services are available in your community.

Recreation

After a stroke, you do not have to give up the hobbies you once enjoyed, but you may have to adapt them. You can also learn new ones.

Looking at your abilities

You will be asked about your activities and interests. Using the results of your other assessments, the healthcare team will work with you to adapt your activities if possible.

Helpful tips

Here are some ways of adapting popular activities:

Cards: Card holders can help you handle small objects. You can find them at a games store or online.

Reading: Book holders, large-print books, and books on tape can make reading fun again.

Photography: Most cameras can be used with one hand.

Needlework: Many special devices can help you work with needle and thread. Spring clamps can help to hold things in place.

Physical activity

Being physically active is good for your mental and physical health. It is a great way to maintain a healthy weight, reduce high blood pressure, lower cholesterol levels, manage stress, and cut your risk of heart disease and stroke.

Physical activity can also help reduce the risk of another stroke. Be sure to talk to your healthcare team before you go back to or start any new activity.

Where to start

Bowling, lawn bowling, croquet, horseshoes or shuffleboard: These activities can all be played with one hand.

Golf: Special equipment is available that makes it easier for stroke patients to enjoy the sport.

Walking / wheeling: This is an inexpensive and easy way to stay in shape. All you need is a pair of good walking shoes for walking. When the weather is bad, just move your walks indoors. For instance, many shopping malls are open early. If you are on wheelchairs, you can try wheeling.

Yoga, Pilates or Tai chi: These gentle practices are ideal because they focus on going at your own pace and comfort level. Some clubs offer special classes for people with disabilities.

Gardening: Digging and planting are a great way to get outdoors and be active all spring, summer and fall.

Who can help

The entire healthcare team can help you to find and adapt your leisure and recreational activities. Recreational therapists, physiotherapists and occupational therapists may play a key role in supporting you.

StrokEngine provides information on stroke rehabilitation and interventions from quality articles, websites and systematic reviews. Visit StrokEngine to learn more about leisure activities.

Driving

People recover at different rates after a stroke. Some people will be back driving after a month. Others may take longer. Studies suggest that about half of those who have a stroke return to driving.

You or a family member needs to talk to your healthcare team about driving. Ask your doctor or an occupational therapist for information. Your readiness for driving must be assessed. This is important for your safety and the safety of others.

StrokEngine provides information on stroke rehabilitation and interventions from quality articles, websites and systematic reviews. Visit StrokEngine to learn more about driving after a stroke.

The Heart and Stroke Foundation provides practical knowledge and skills to help care for stroke survivors. Tips and Tools for Everyday Living: A Guide for Stroke Caregivers is designed for healthcare providers and is also a useful reference for family caregivers. Read more about the Guide.

The Heart and Stroke Foundation has a Living with StrokeTM program for stroke survivors who have completed their active rehabilitation and are living in the community. It focuses on building skills, sharing experiences and lending support. Find a Living with StrokeTM program in your area. 

Last reviewed: November 2010.