At home
- Lauren McDunphy and Melissa Gannon, Stroke Nurse Specialists
- 8 minute read
- Last updated: September 2023
Many people are keen to return home after a stroke. However you may not be able to get back to “normal life” right away. Take your time, and concentrate on following the advice and routines that will help you recover well.
What should I expect after returning home from hospital?
You may need support during the first days and weeks after you come home from hospital. Practical help could include things like making sure that your medication is collected from the pharmacy and your home is free from trip hazards. Someone may have to get your groceries, keeping in mind any dietary changes suggested by your hospital care team. You may need help with house cleaning and doing the laundry.
Some patients are teamed up with an Early Supported Discharge (ESD) team. If this is the case, therapists will come to your home to help with recovery of mobility, washing, dressing practice or other everyday tasks.
Keep on top of your care
It is normal to feel emotional and anxious when you get back home. Relaxation exercises, getting out and about and returning to normal routines as much as possible will help. For peace of mind, keep your emergency contact numbers at hand. You can also get in touch with the Irish Heart Foundation for advice, reassurance and support.
Visit your GP (family doctor) regularly. Your GP is your primary caregiver and needs to be up to date on how you are progressing. They will assess you and make sure that any issues are dealt with before they cause problems. Also, the hospital will only issue a prescription when you are going home; repeat prescriptions will need to be written by your GP.
Medication management
Remember how important it is that you take your medications as prescribed. They are proven to reduce your risk of stroke. Some people find it helpful to put an alarm on their phone to remind them of when they need to be taken.
Ask your pharmacist to provide your medications in blister-pack form. This makes it less likely you will miss a dose or take the wrong dose. Each labelled section in a blister pack contains only those medications prescribed for a specific time of the day or night.
Order your medications from your pharmacy a couple of days in advance to avoid running out. If you have a medical/long-term illness card, you will need to ask your GP to add any new medications to your list.
If you don’t have a medical/long-term illness card, you can join the Drugs Payment Scheme. This can save you money on prescription medications and approved medical appliances through the HSE.
Always keep an up-to-date list of your medications and doses in your wallet or take a photo and have it on your phone. Be aware of why you are on certain medications. If changes are made, ask why and change the list.
Lifestyle changes
Be honest with yourself and with your medical team about the things that you do that increase your risk of stroke. Changing those behaviours can make a big difference. Think about quitting smoking, reducing your alcohol intake, eating healthily, losing weight and exercising more.
It is very important to keep going with any exercise plan that you got in the hospital from your physiotherapist/occupational therapist. This will help you to regain movement, strength and functions.
Diet and nutrition
Having a healthy diet can reduce your risk of stroke. Include a variety of fruit, vegetables, wholegrains, lean proteins such as chicken and low-fat dairy products. Limit salt, sugars and processed foods.
Follow a specific diet plan if you have one. This can involve adding thickener to fluid if your swallow is weak or following a low-fat diet if your cholesterol level is high.
If you are on certain medications, such as warfarin, you may be asked to avoid specific foods which can interfere with the tablet’s absorption.
Know your weight, height and body mass index (BMI). Make it a goal to be within the normal BMI range if possible.
Calculate your BMI using this calculator by Safefood.net
Safety concerns
Make sure your home is safe and easy to get around. Your family or friends can look at your living spaces and identify anything that could cause a fall, such as rugs or clutter.
Your occupational therapist may organise a home visit before you are discharged from hospital to find out what adaptions need to be made. Certain equipment may need to be in place before you go home, such as handrails and non-slip mats. If stairs or access to the bathroom is an issue, downstairs living may be recommended.
Measuring blood pressure
High blood pressure is one of the most important risk factors for stroke. You will be advised to buy a blood pressure monitor and shown how to use it.
The hospital you attended should give you and your GP specific target ranges for acceptable blood pressure. If you are regularly above these targets, or if you are getting very low readings and feeling dizzy, weak or lightheaded, you need to contact your stroke team. You may need a change to your medications.
Often a 24-hour blood pressure monitor will be advised to be done within six weeks of returning home from hospital.
- This will typically be organised by your GP or at the hospital you were treated.
- Your stroke team may decide to change your medications after seeing the results. If this happens, then a further 24-hour blood pressure monitor and/or home monitoring of blood pressure may be advised to ensure the medication changes have been effective.
- If you have new symptoms after the change in medications you should contact your GP or stroke team to ensure you have not developed side effects from the medication change.
Social Support
Joining stroke support groups for peer support and/or counselling can relieve your stress and fear, and help you process what has happened. The Irish Heart Foundation can help you with this.
Feelings of loneliness and isolation are common after stroke. There are several community organisations that can help you find new interests and make new friends. You can find more information on the supports available of this website.
Follow-up appointments
It is very important not to miss your hospital appointments. If for some reason you can’t attend, let the hospital know. It should be possible to reschedule or perhaps have a virtual consultation.
It is always a good idea to be accompanied to hospital appointments, especially if you have memory issues. Your companion may be able to help give an accurate history of events.
Hospital appointments monitor your progress and determine whether changes to your treatment plans are needed. You are free to ask questions about any aspect of your care. It is a good idea to write those questions down before your appointment, in case you forget on the day.
If you have appointments with multiple consultants, put reminders in your diary, calendar or phone to help you remember them.
Stroke education
Make sure you know the signs and symptoms of stroke
Learn the signs of stroke and about BEFAST
Don’t ignore stroke signs – get emergency attention right away. Call an ambulance, which will bring you to your nearest stroke hospital. Don’t drive yourself or get anyone else to drive you, as this can cause a delay. An ambulance can bypass any queue in the emergency department if the ambulance crew feel you are having an acute stroke.
Make a note of the time that symptoms started, as some stroke treatments are time sensitive. Bring your medication list with you. If possible, let the team know if you are taking strong blood thinners called anticoagulants.
Independence
Depending on how your stroke has affected you, it may take time and repetition to relearn skills and retrain your brain. Your therapist will set goals for you. If you have questions, be sure to ask them before you leave the hospital.
Be patient with yourself. It is frustrating to relearn skills, but you will gain confidence and independence by following your stroke team’s and therapists’ advice.
Driving
You should not drive for at least one month after your stroke. You will be advised by the hospital about when you will be to drive again.
