Three sailing steps
Preparations for Discharge
Arrangements for Household Modification
The hospital’s occupational therapist will arrange family visits for the household assessment. Appropriate household modifications can improve the self-dependency of rehabilitees and household safety. In general, purchases of assistive devices, removal of thresholds, installation of railings and bed rails will be recommended.
Discussion of Care Arrangements
For the effective division of care, discuss the care arrangements for the rehabilitee with other family members. In the discussion, consider the capacity and time of each family member, find appropriate community resources, respect the will of the rehabilitee, reach a consensus, and maintain virtuous communication.
Purchase of Assistive Devices
The occupational therapist or physiotherapist will recommend assistive devices based on the needs of the rehabilitee. Family members may either buy or rent them. Most importantly, family members should acquire correctly, use and maintain assistive devices.
Walking aids include crutches, quadruped walking canes, walker frames and wheelchairs.
Eating and drinking aids include chopsticks helpers, caring spoon and anti-slip plastic mats.
Toilet aids include commode chairs and urinals.
Bathroom aids include bath boards, tub transfer benches, body/back washers and back strap towels.
Dressing aids include Velcro and button hooks.
Bed aids include medical air bed mattress.
Follow-Up of Rehabilitation
Before a rehabilitee is discharged from the hospital, ask for his/her home rehabilitation plan from the medical/nursing staff or social workers, and make appropriate referrals. Referrals requiring the assistance of medical/nursing staff include language therapy, day care centre, geriatric day hospital, specialist rehabilitation training, community rehabilitation day centre, support for elderly persons discharged from public hospitals after treatment, and community nurse homecare services. In addition, families should understand the future follow-up consultation and drug use guidelines.
Seeking Community Assistance
Comprehensive services are available within communities to help family members take care of rehabilitees. Please visit the ‘Family Decision’ section on this site for the details. Other community service information, such as patient resource centres, on-duty medical/nursing staff, social workers, integrated family services centres, neighbourhood elderly centres and district elderly community centres are also available for enquiry.
Life Adjustment
Four Steps of Follow-Up Consultation
Condition Enquiry
Diagnosis
Enquire about the types, causes, symptoms and potential complications of stroke.
Examination
Enquire about the purposes, advantages and disadvantages of and preparations for the related examinations, and when the reports are ready.
Treatment
Enquire about the details, advantages and disadvantages of medications and treatments.
Follow-Up
Enquire about the needs for follow-up consultations and the follow-up services provided by other community units.
Key to Follow-Up Consultations
Prepare
Prepare the required documents, items and transport.
Enquire
Proactively question the doctor.
Recap
(itulate)
Recap(itulate) and mark down the key points to facilitate future follow-up.
Act
Act as instructed by the doctor.
Care Techniques
Swallowing and Diet Adjustment
If the rehabilitee has difficulty swallowing (dysphagia), follow the advice of the language therapist and dietician to adopt the appropriate diet adjustment. Avoid foods that are too hard, too hot, too dry, too crispy or sticky, too smooth, easy to melt, or granular foods. Encourage family members to learn food skills, such as using suitable feeding utensils, sitting at the same level as the rehabilitee when feeding, and how to clean the mouth after feeding.
Depression and Emotion Management
Mood swings and depression are common in rehabilitees. Family members should be more patient and encourage rehabilitees to talk more about their problems. In addition, family members should listen to the feelings that rehabilitees want to share, show empathy for and accept them, and avoid criticizing them.
Lifting and Daily Living Care
Correct methods make care more productive and safer. Family members can consult professionals, observe, and practice at appropriate times. Before helping a rehabilitee, inform him/her in advance and ask for his/her cooperation. Family members should make sure if they are using the correct methods, keep their waist in an upright position, and apply force with the lower extremities (legs). Do not let the rehabilitee get overdependent on the healthy limb(s). Family members should avoid pulling the affected limb(s) of the rehabilitee.
Stress and Self-Care
Besides caring for the rehabilitee, family members should also take care of their own condition. Appropriately relieve tension and make some private time. After stress symptoms are detected, such as insomnia or bad temper, do not neglect the stress but make immediate, timely relief or seek assistance from others.
Starting A New Life
Community Integration
Both rehabilitees and their family are members of a community. They are entitled and need to communicate with the community. Therefore, based on own physical condition, we advise families with stroke patients to integrate themselves into the community in terms of three aspects: personal, socialization and community. We encourage rehabilitees to learn about community resources, participate in community rehabilitation training and community activities. Based on own experience, both rehabilitees and their family can help other families with stroke patients in the community to contribute to the community.
Healthy Life
A healthy lifestyle, such as developing an exercise habit and maintaining a healthy diet, can lower the risk of recurrent stroke.
Regular exercise can help develop cardiopulmonary function, promote blood circulation, and relieve stress. We can integrate exercise into the daily life to maintain regular exercise. For example, we can put exercise in our schedule or exercise with the family on holidays. Those without an exercise habit can start with simple exercise to progressively develop the exercise habit.
Dietarily, stroke is highly associated with hypertension, hyperglycaemia and hyperlipemia. Therefore, a healthy and balanced diet can quickly lower the risk of these cardiovascular diseases and stroke.
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