What should the family understand first?
A stroke happens when blood supply to part of the brain is cut off. What it affects depends on where, so two people with a stroke can look very different. The doctor will explain the type, and recovery varies from person to person.
You are not alone. In Malaysia in 2019 there were an estimated 47,911 new stroke cases [1]. That is a lot of families learning the same lessons you are learning now.
Who does what in the family?
Strokes pull families into new roles overnight. Naming the roles early prevents arguments later.
- One person speaks to the ward team and passes news to the rest.
- One or two people are the daily carers, such as a spouse, a daughter living nearby or a helper.
- One person handles money, forms and insurance.
- The child in KL or Singapore researches, books services and joins calls, and visits when possible.
Say out loud that the daily carer needs rest. Our guide on caregiver strain and back care is for the person who is lifting and turning every day.
What should you ask the ward before discharge?
Ask before the date is fixed, not on the morning of discharge. The ward team at Hospital Raja Permaisuri Bainun, or at a private hospital such as Fatimah or Pantai, can answer most of these:
- What can he do on his own now, and what needs one person or two?
- Is he safe to eat and drink normally, or does swallowing need checking?
- What equipment will he need at home, such as a walking frame or a commode?
- Which medicines change, and when is the next review?
- Who continues rehabilitation after discharge, and how soon?
Our checklist on questions to ask before discharge goes further.
How do you prepare an Ipoh home?
Start with how he gets in and out. A terrace house usually has a gate step and a porch step. A ramp, a rail or a firm helper at each step makes the first trip home safer.
If the bedroom is upstairs, consider a bed on the ground floor for the first weeks. Clear loose rugs and cables, add a night light, and keep the path to the toilet short.
A non-slip mat in the bathroom and a stable plastic chair for showering help too. Use our home safety checklist to go room by room.
Where can rehabilitation help come from?
From more than one place, and they can work together. The hospital may offer outpatient physiotherapy and follow-up reviews. Private insurance may cover some sessions, so ask your insurer what it needs.
If the patient was a worker insured by the Social Security Organisation (PERKESO), ask about their rehabilitation options. A Sultan Nazrin Shah PERKESO Rehabilitation Centre operates in Ipoh, offering physiotherapy and an intensive rehabilitation programme [3]; eligibility is not stated, so confirm it with them. Our guide to PERKESO and physiotherapy in Ipoh explains how to ask.
Why does it matter that rehabilitation continues at home?
In a Malaysian stroke registry of 9,361 first-time patients, 36.2% were independent at discharge and 53.1% were still dependent on others [2]. Going home is where the next gains are made, in the real bathroom, on the real stairs, at the real dining table.
Home physiotherapy fits that gap. The physiotherapist comes to the house, sees the layout and teaches the family and helper how to assist safely.
How can we help?
We offer home physiotherapy across Ipoh now, and see more on stroke rehabilitation at home. Our Canning Garden centre, near Fatimah Hospital, is opening soon for people who can travel.
Tell us the hospital, the date of discharge and what he can do now. Prices for home and centre differ, and we quote after a short description on WhatsApp.