Key Aspects of In Home Care for Elderly Stroke Survivors
September 2, 2015
A stroke can turn not only your life but also an entire family upside down. Roles reverse. Living arrangements change. Finances and care arrangements become intimidating.
While every family member’s life adjusts in a different way, all face a brand new future. The stroke patient must shape life around new limitations. Spouses, parents, siblings and children all determine what role they should play. Everyone involved needs extra understanding and patience. The pressure on family caregivers providing in home care can be overwhelming.
Organize the approach to caring for the elderly stroke victim through the prism of Maslow’s hierarchy of needs.
Those providing support to the stroke patient might want to consider organizing their in home care plan and efforts via Maslow’s Hierarchy of Needs. Teachers, human resources managers and many more still use this perspective on human motivation constructed by psychologist Abraham Maslow in the 1940s.
The general idea is that most humans must have basic survival needs met before they can aim to satisfy more complex needs. An individual must have food and water to get into a safe shelter. Only once food and protection are in place can someone search for love and belonging. Achieving these latter goals prompts the individual to strive for self-esteem and the esteem of society. Finally, with all previous needs satisfied, the individual grows into the most complete version of himself or herself. Maslow called this final stage “self-actualization.” Maslow felt those with enough opportunities to self-actualize found the greatest life satisfaction.
The Elderly Stroke Patient’s Physiological Needs
While the healthcare team—doctors, hospital social workers, physical therapists, psychologists—shoulders the majority of the responsibility for the stroke patient’s physiological needs, family members and even the neighborhood pharmacist have a place on that team as well.
Before discharge, the healthcare team should go over the care plan with family members. Social workers should ensure that the stroke patient will have appropriate care at home. They discuss with family options for paying for care, getting medications, options for paid in home care for elderly stroke patients and more. Depending on the level of disability, hospitals will often recommend an in home care agency to help family carry out the responsibilities. If your loved one qualifies for Medicare, our previous blog post “How Does Medicare Pay for In Home Care Services?” should clear up any questions you may have. Generally, when the doctor orders in home personal care like bathing, grooming and toileting to support the healthcare measures, Medicaid may help pay the costs if the individual qualifies financially.
Beyond all healthcare issues, a plan in place ensuring the stroke patient will get adequate nutrition and water goes far to relieve stress on everyone’s part and prevent further health complications. Stroke survivors who still have a moderate level of mobility and cognitive abilities often choose to remain in their homes. The families of those who cannot contribute to their care at all may need to consider the option of assisted living facility. The healthcare team can help the family learn about and consider these difficult choices.
The Elderly Stroke Patient’s Safety Needs
A coordinated plan about where the senior will live for the next three months, six months and even one year enables family to divide responsibilities up front, thereby decreasing conflict. If the senior plans to live at home alone or with a spouse, an agreed upon schedule dividing visits and duties between family and non-family or paid care gives everyone opportunity to choose their preferred involvement. It also makes clear what will be required to spend on hired caregivers.
With logistics out of the way, family should discuss how to make the home safe to maximize mobility and independence for the stroke victim. With the proper tools and accessibility many stroke victims can continue to enjoy their own home and some activities they had prior to the stroke in a safe manner. A sense of self-sufficiency will be critical in supporting the patient’s mood over the next few months. Extension cords, clutter and area rugs could be removed to prevent falls. Clutter and excess furniture should be removed if a wheelchair is in the plans. A carpenter or handy family member can render cabinet, refrigerator and stove knobs more accessible. Adjustments should be made to bedroom, bathroom and other rooms as well.
The Elderly Stroke Patient’s Love and Belonging Needs
As independent as Americans long to be, no one does well without a sense of love and belonging. Family members can show that love by cooperating so that the loved one isn’t alone for more than a day at a time, particularly just after hospitalization. Socialization is important but engaging with friends, neighbors and activities might not be practical for a while. This is where family comes in. A schedule of family member phone calls and visits ensures the senior is neither overwhelmed with calls nor abandoned.
This said, each family member could find a partner in the neighborhood or among the friends of the senior. Many find great satisfaction in helping. If the family member cannot make their shift, his or her double could step up. This move keeps everyone less stressed. Seniors who’ve had a stroke may be beset by fear of having another with no help close by. Help your loved one transition back to life as normal by providing family, friend or paid companionship as much as they feel comfortable with. As time goes by, this fear subsides.
Finally, while the senior stroke patient’s activities may be curtailed for a bit, helping to keep him or her involved in church, hobby and club activities by sharing emails, photos and more brightens mood, particularly if the family member mentions how fun it will be to rejoin those activities eventually.
The Elderly Stroke Patient’s Esteem Needs
Seniors can recover more quickly when they feel respected and cared for. Because of the changes the stroke creates, reflecting a positive image back to the stroke survivor can be a challenge.
Stroke survivors can experience personality changes caused by depression, fear, pain and even medication side-effects. If the senior realizes he or she has changed, experts recommend caregivers help them understand these changes are due to the stroke and emphasize that a more upbeat or typical personality should return.
This said, caregivers who feel themselves mourning the loss of the loved one’s previous personality should consider therapy and support groups to deal with these feelings. The American Heart Association and American Stroke Association provides a support group tool that lists all support groups when you enter your zip code. The National Stroke Association’s search tool also delivers the stroke patient and caregiver support groups by zipcode. Accepting how the senior is now can be healthier than for the trying to force the situation back to the way it was before. Sometimes the family in home care provider must resort to cherishing treasured memories and move forward in a new way.
The Elderly Stroke Patient’s Self-Actualization Needs
As the stroke patient’s condition improves there might be opportunity to start planning how to get back into his or her old routine. Is work an option? Volunteer opportunities? If not, do other opportunities exist that will provide satisfaction and connection? Looking at some of the activities that made them happy or provided satisfaction and considering ways they can hopefully engage in them again in some form can help improve both their physical and mental condition.
Physical therapy and occupational therapy often helps stroke survivors regain skills and even mobility. When family members aren’t successful in getting the senior to tackle his or her exercises, the therapists often can. Even so, stroke survivors should re-enter their former activities only under a doctor’s supervision.
My Care Match Adds Helps Complete the In Home Care for Elderly Stroke Patients
Many of the agencies and independent caregivers on MyCareMatch.com have years or even decades experience providing meaningful in home care to elderly stroke patients. When you complete your profile with MyCareMatch.com, explain your loved one’s condition. Agencies and care providers can approach you and you can review caregiver profiles to locate and contact a care match meeting your needs. Have a specific need or question? Feel free to leave a message here. We look forward to helping stroke survivors and their families handle the challenges ahead with grace and planning.
About the Author
Doug Breuer is co-founder of MyCareMatch.com and has worked in senior care for the last 9 years for the State of Oregon. From investigating cases of elder abuse to managing the delivery of long term care to residents of Central Oregon, Doug has been involved in all aspects of senior care.
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