After a stroke there is a temptation to lie in bed, waiting to get better
and instead becoming weaker and more dependent on others. As soon as the
doctor allows, the patient should get out of bed, if only to sit in a chair, and
progress to getting dressed and beginning to join in the normal activities of
the household.
The first step of rehabilitation will be to help the patient cope once
again with daily living without being waited on hand and foot. The value of
independence may need stressing, because sometimes patients are opposed to
the planned withdrawal of help and get annoyed and upset by any such
attempts.
One of the best ways of encouraging independence is to find out what
the patient most wants to do. People will work much harder towards a goal of
their own choosing than towards one set by someone else. This may mean
working for personal independence in the area in which the patient most
dislikes being dependent, for example, managing to use the toilet unaided. It
may mean gaining independence in other areas, for example, improving,
mobility so that it is possible to get out of the house. It may mean striving for
independence in an activity that was previously enjoyed leaving the more
difficult or disliked jobs for other people. It may mean striving for
independence in an activity that the home help or family do badly, such as
cleaning the floors, while leaving the home help to cook and wash up.
This short chapter can only outline some of the ways of coping more
easily after a stroke. “Help Yourselves, a handbook for hemiplegics and
their families” by Peggy Jay, published by lan Henry, gives far more
information. The Chest, Heart and Stroke Association publishes several
books and pamphlets to help stroke patients. Their head office is at
Tavistock House North, Tavistock Square, London WC1H 9IE. Occupational
therapists employed by local authority Social Services departments should
be able to give advice and arrange for the provision of aids, equipment or
house adaptations.