What does it feel like to bring someone home after a stroke?
Frightening, and also hopeful. You are glad he is home, and you are afraid of the stairs, the bathroom, the next night and the words you do not understand.
Some Ipoh families add another worry: the children work in KL or Singapore, and the person at home is a tired spouse or a helper. All of this is normal, and there are practical steps.
Is it normal to be dependent at discharge?
Yes. In a Malaysian National Stroke Registry analysis of 9,361 first-ever stroke patients (2009 to 2017), 36.2% were independent at discharge, 53.1% were dependent and 10.8% had died [1].
So most people leave hospital needing help. That is the starting point of rehabilitation, not a final verdict.
What should I ask the stroke team before leaving?
Write the answers down.
- Which medicines and when, including for blood pressure?
- What can he eat and drink safely, and is a swallowing review done?
- What can he do alone, and what needs a helper?
- Which exercises should we continue, and for the arm too?
- Who reviews him next, and who follows up rehabilitation?
- What are the warning signs, and who do we call?
Our page on questions to ask before discharge has the longer list.
How do we prepare the house?
Think about the route from the car to the bed and the bathroom. Ipoh terrace houses have a front step, a first-floor bedroom and a wet bathroom, so decide early where he will sleep.
- Move his bed downstairs if the stairs are unsafe.
- Remove loose mats and keep a clear path.
- Add a stool or chair in the bathroom and grab support.
- Keep medicines, water and a phone within reach.
- Light the path at night.
Our home safety checklist goes through the house.
When does rehabilitation start at home?
From the first day. The World Health Organization (WHO) says stroke rehabilitation should begin as soon as the patient is medically stable, ideally within the first few days, and involve a team including physiotherapy [2].
Continue the ward exercises at the pace given. Then arrange a physiotherapy visit within the first days, with the stroke team’s agreement. See continuing hospital physio at home.
What does home rehab involve?
We look at how he stands, walks and balances, how the weak arm moves and how he gets on and off the bed, toilet and chair. We set small goals, such as reaching the bathroom alone, and teach the family safe ways to help.
Read our guides to stroke recovery in the first three months and the Ipoh stroke family guide. Our stroke rehabilitation at home page explains the approach.
What about the caregiver?
The person at home needs care too. Share the tasks, rest when the helper is there and ask the doctor about extra support if you are exhausted.
Our Canning Garden centre, near Fatimah Hospital, is opening soon. Home visits across Ipoh are available now, and we quote prices on WhatsApp.