Wednesday, May 1st, 2019
For someone recovering from a stroke, the transition from a hospital or rehabilitation center to a residence can be difficult. While healthcare institutions are equipped to deal with people who have disabilities, most homes are not. Before a stroke survivor returns home, it is important that a physical or occupational therapist visit and make recommendations on adapting the residence to the stroke patient’s special needs. The goal of this evaluation is to ensure that daily living tasks can be performed easily and safely. Once the evaluation is complete, the therapist will meet with the patient, caregiver, family, and/or friends to discuss the home modifications required. While some of these modifications may be as simple as adding grab bars to a shower or installing a raised toilet seat, others may be more extensive, such as construction of a ramp, changes to flooring, or widening of doorways.
Before evaluating the home, a therapist will first assess the stroke survivor’s overall condition and mobility. In particular, therapists check for weakness, paralysis, pain, numbness, balance problems, difficulty with coordinating movement, memory loss or memory deficits, fatigue, difficulty with thinking, and bladder or bowel dysfunction. All of these factors may impact the patient’s ability to function safely at home and what modifications will be necessary. Once in the home, the therapist will focus on three main living areas — the kitchen, the bathrooms, and the bedroom — as well as checking for anything that may impede an individual’s ability to move safely around, into, or out of the home. Factors such as the availability of a caregiver or live-in relative, or the possibility of continued recovery, may also influence the extent to which home modifications are required. It is important that this evaluation occur prior to a patient’s discharge so that any necessary modifications can be made in a timely manner.
Bathrooms tend to be where the most safety issues arise. Many bathrooms are small, making them difficult to navigate with wheelchairs and other assistive devices. In addition, the use of water in a shower or bathtub often results in slippery surfaces, significantly increasing the risk of falls. Bathrooms are evaluated not only for fall risk, but also for the ease of transfer to the toilet, shower or bathtub, and access to the sink, mirror, and cabinets. Common areas of modification include:
Photo by: The Lighting Judge
Generally, bedrooms are evaluated for ease of transfer, fall risk, safe sleeping conditions, and ease of access to closets, clothing, and personal items. Common areas of modification include:
For a stroke survivor, the kitchen can be a dangerous place. Kitchen size can limit movement, and hot or sharp objects may be difficult to handle. From a wheelchair, cabinets, counters, and cooktops may be too high to access easily. Common areas of modification include:
The well-being of a stroke survivor depends on understanding traffic patterns and keeping all paths to the bedroom, bathroom, kitchen, and other living areas clear. Failure to do so can result in falls and related injuries. Fall risks can be greatly reduced by removing or securing rugs, moving furniture out of the way, and keeping pathways free of clutter. Adding lifts or risers to chairs and sofas can make transferring easier and more comfortable. If children are present in the home, having a designated room for play will help keep toys off of the floors and out of the way. Homes with smaller doorways or stairs create special problems. Doorways narrower than 32 inches will need to be widened if the patient uses a wheelchair, and stairs may require two railings or a stair lift. Smaller changes of elevation at entrances or within the home, such as sunken living rooms or step-ups to recreational areas, may be manageable with the use of ramps.
Many of the items required for home modification can be purchased at home medical supply stores, on Amazon.com, or at secondhand stores, such as Goodwill. Some organizations may offer borrowing programs for temporary equipment needs. Volunteer, loan, and grant programs are often available for major home modifications, including ramp installation and kitchen and bath remodeling. Contact your local stroke organizations, and agencies on disabilities and aging, for a complete list of resources.
Here at Saebo, we are committed to stroke support and recovery for all survivors and their families. Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.
For more information on home modifications:
“Essential Devices for Adapting the Home After Stroke,” https://www.saebo.com/essential-devices-adapting-home-stroke/
“Taking Back Your Independence After Stroke,” https://www.saebo.com/taking-back-independence-stroke/
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.