You are getting ready to go home after having a stroke. Going home can be a time of uncertainty as you learn to navigate life after your stroke. Developing a plan and setting goals can help with this uncertainty. It is helpful to have someone to talk to about your stroke and to support you in working toward your goals.
This section will help to prepare you to go home by answering the following questions:
- How do I recover from my stroke?
- How do I stay safe at home after a stroke?
- How do I manage my medications after discharge home?
- What follow-up tests and appointments can I expect?
- How do I return to life after stroke?
- Who can I call if I have questions at home?
How do I recover from a stroke?
A stroke is an injury to a part of the brain. The effects of the stroke depend on the type of stroke, where the injury occurred and how much of the brain was affected. The effects can be physical, mental and emotional. The recovery process after stroke is different for each person.
Over time, the part of the brain that is not injured can learn to take over some of the functions of the injured area. This re-learning process takes time, energy and repetition. As your brain is re-learning, you may become tired easily. If you become tired take a break and try the activity again when you have more energy.
Depending on the effects of your stroke, you may require rehabilitation therapy. Rehabilitation can take place either as an outpatient or at home. Some patients do not need any formal rehabilitation services after discharge from hospital.
Everybody recovers from stroke differently in their own time. It often takes longer to start adapting to the effects of your stroke than you expect.
Fatigue after stroke
Post-stroke fatigue is a sense of intense tiredness that does not get better with sleep. You may not feel tired in hospital but you may notice it when you get home. Fatigue or feeling tired is one of the most common effects of a stroke and can range from mild to severe. It has been described as the most difficult or upsetting problem that people deal with after stroke. Recovering from your stroke takes a lot of energy. Feeling tired for a few weeks is normal. Talk to your stroke team or family doctor if you have any questions or concerns about fatigue.
Tips to help manage fatigue:
- Give yourself plenty of time to complete activities or tasks; the more you push yourself the worse you are likely to feel.
- Do not try to do all of the things that you used to do and at the same speed. Pace yourself – start off doing less for a while so that you may slowly and steadily attempt to build stamina.
- Take breaks before and after activities. Even tasks that do not require much energy can make you feel tired such as riding in a car or eating a meal.
- Try not to push yourself if you are having a better day. You may feel exhausted the next day or longer.
- Listen to your body; rest during the day if you need to.
- Maintain some level of exercise. Go for a short walk or use a stationary bike for a few minutes. Being active may help improve fatigue.
- Make healthy food choices.
- If you are able to return to work after stroke, it may be helpful to start with less hours at first. Slowly build up to your regular work schedule as tolerated.
Emotional Changes After Stroke
A stroke can change the way a person behaves and feels. You may not notice these changes as much as the physical changes of the stroke. These changes are normal after a major life event or illness. You may have feelings of anxiety, anger or depression. The stroke may affect your emotions and your ability to control them. Talk to your care partner, your stroke team or family doctor if you are having changes to your mood or have questions or concerns about your emotions. Information, support and management strategies are available.
Changes in Thinking After Stroke
A stroke can change the way a person thinks. You might not notice these changes while you are in hospital but you might notice subtle difference in your thinking after discharge.
Some of the changes you might see after you go home are:
- Difficulty concentrating
- Short attention span
- Needing more time to think and respond during conversations
- Being easily distracted
- Forgetfulness or not able to recall information
There are a number of strategies that can help with these changes in thinking. Talk to your stroke team if you have questions or concerns.
How do I stay safe at home?
The stroke team will assess if you need help with your daily personal care tasks such as bathing or dressing after you go home from hospital and will put supports in place if required. If you are concerned with how you will manage your daily activities at home, talk with your stroke team. It is normal to need support as you adapt in your stroke recovery.
After a stroke, you may find you are higher risk of falls due to changes in leg strength, balance and coordination. It is important to consider ways to keep yourself safe and prevent injury at home. Talk with your stroke team before you leave the hospital if you have any questions about ways to keep safe in your home.
How do I manage my medications after discharge home?
After a stroke, medications may help lower your risk of having another stroke. You may need medications to:
- Help prevent blood clots
- Lower your blood pressure
- Lower your cholesterol
- Manage your diabetes
- Help slow your heart rate and restore the normal rhythm
You will receive a prescription from your stroke team for the initial supply of your medications. When you see your family doctor or nurse practitioner, ask for your prescriptions to be re-filled.
It is important you understand why you are taking your medications, how to take your medications and any potential side effects. It is important to take your medications as ordered by the doctor or nurse practitioner.
What follow-up tests and appointments can I expect?
Family Doctor
Contact your family doctor to book an appointment to discuss your hospital stay, review strategies for reducing your risk of stroke and arrange any follow-up required.
If you do not have a family doctor please speak to your stroke team or visit https://www.ontario.ca/page/find-family-doctor-or-nurse-practitioner or call 1-800-445-1822.
Stroke Rehabilitation and Home Support:
If you were not referred to the LHIN Home and Community Care service and feel you could benefit from this service you can self-refer by calling the number listed.
Follow-up diagnostic appointments:
After discharge from the hospital, you may have additional follow-up diagnostic tests. If you require additional follow-up tests, these will be booked before you are discharged home. If the doctor ordered further cardiac monitoring, the monitoring device should arrive within 1 – 2 weeks after discharge. You will receive a call 24 – 48 hours after leaving hospital to arrange delivery of the monitoring device.
Community Resources:
If you are looking for community resources that are available to persons after stroke or you need assistance navigating these resources, call the March of Dimes/Stroke Recovery Canada Warmline at 1-888-540-6666.
How do I return to my life after stroke?
Driving After a Stroke
In Ontario, your doctor must report to the Ministry of Transportation (MTO) that you had a stroke. This is because it might be dangerous for you to drive a car.
The rules in Ontario are:
- You cannot drive for at least one month
- Your doctor or nurse practitioner MUST assess your readiness to return to driving
- If your doctor or nurse practitioner is not sure if you are ready to drive, you may need to go to a special driving centre for more testing
- After assessment, your family doctor or nurse practitioner may determine you can return to driving if you have no major changes in:
- your vision
- your physical skills
- your thinking such as problem solving or judgment
- The process to return to driving, if appropriate, may take several months
It is illegal to drive with a suspended licence
You can check the MTO to determine the status of your license by either calling the Driver Medical Review Office at 1-800-268-1481 or checking the link: https://www.dlc.rus.mto.gov.on.ca/dlc/enter-details.
You can contact the Driver Medical Review Office to request the neurological condition form to be sent to you via mail for your stroke doctor or family doctor to complete. The MTO requires this form to re-instate your license.
If you require assistance getting to appointments or getting groceries or medications while you cannot drive, speak with the stroke team before discharge. Services are available to assist with transportation and may require an application.
Return to Work and Financial Supports
A successful return to work starts with understanding how the effects of your stroke may impact you at work. Speak with a member of your stroke team or family doctor if you have questions about when and how to return to work safely.
Speak to a member of the stroke team before leaving hospital, if any of the following apply to you:
- You require medical clearance for work
- You are unable to return to work
- You require financial assistance
- You require assistance completing paperwork related to your stroke
- You have questions or concerns about the cost of your medications or devices for your stroke
- Your caregiver is unable to return to work or requires financial assistance
You may be eligible for financial support from your work or the government.
Relationships
Having support after stroke is important for your health and recovery. It can reduce your stress and improve your overall wellbeing.
It can be difficult to connect with people after a stroke. A stroke may affect your confidence and make you want to avoid certain social situations. If you find it hard to connect with other people, talk to your support system, family doctor or stroke team about what you are feeling.
The person who has had the stroke needs to focus on recovery and others in the home may need to take on extra roles and responsibilities such as child care, making meals or doing household chores.
Many individuals with stroke have said that it helps to talk to others who have experienced a stroke. Peer support and other post-stroke programs are available for you and your support system.
Sex and Intimacy
It is up to each person to decide when to return to having sex. After a stroke, you may experience changes that can affect your sexual relationships and intimacy.
Some of these changes include:
- Fatigue, depression, fear
- Lost feeling on one side of your body
- Difficulty communicating with your partner
- Changes related to obtaining an erection
- If you’ve used medication in the past, please talk to your doctor prior to re-starting.
- Changes related to vaginal dryness
- Water-based lubricating jelly is okay. Avoid lubricants such as oils or petroleum jelly because they can lead to infection in your vagina.