This site is intended to provide basic information to stroke survivors and their families about potential problems with the physical aspects of the home.
The effects of a stroke are different for everyone, depending on the part of the brain injured, how bad the injury is, and the person’s general health. Effects such as weakness, paralysis, problems with balance or coordination, pain or numbness, problems with memory or thinking, tiredness, and problems with bladder or bowel control can all change the way a person functions in the home. It is a good idea for the patient to have a trial visit at home before they are discharged from the hospital so that changes and corrections can be made before returning home. Some disabilities may not be noticed until the stroke survivor returns to daily tasks. Since each person is unique, changes to the home are most effective when they meet one’s specific needs. A professional occupational therapist, available through most hospitals, medical centers, and community clinics, can help to determine the best home modifications to suit your situation. The suggestions and options presented here are very general and are intended to guide you in seeking professional assistance.
The information in this section is organized by rooms in the home. Although many of the suggestions seem simple, the effects of such alterations have the potential to greatly increase the safety, independence, and general comfort level of the stroke patient.
Home Assessment Profile
Virginia recently had a stroke. Since Virginia, 67, will be staying with her sister Mary, 65, for a few weeks, this visit was to Mary’s home. The sisters agree that Virginia’s return to her own house will be a challenge. Although she does not require a wheelchair, walker or cane, Virginia moves much slower than she did before the stroke. Virginia’s home has stairs to enter the house and more stairs to reach the bathrooms. Virginia has been working on climbing stairs with her physical therapist, and says that she can do it, but, like everything else, “it takes forever.” Also, when Virginia finally moves home she will be alone much of the time because her son works outside the home and won’t always be there to help.
Mary seems to accept her care giving role very naturally. She already cares for her baby nephew, who sleeps in a crib in her room, and her nine-year-old nephew who is autistic. She also cares for her granddaughter and babysits for other relatives. She describes her role in Virginia’s care as that of an observer. Virginia is fortunate that she can do most things on her own despite the stroke although she may be slower now.
It is evident that Mary and Virginia have a very close family. Relatives drive them whenever they need to leave the house. Mary told us of the barbecue held at her home last weekend for Memorial Day, pointing out the remains of a huge sheet cake on a dining room side table. Everyone likes to gather at Mary’s home for barbecues because of the space, she told me. After meeting Mary, though, I think the real reason people visit is her obvious instinct for hospitality and caring. Mary admitted that she needs to take better care of herself—she has vertigo, arthritis, and a small brain tumor that seemed to be causing her pain during our visit.
Life after Stroke
Before the stroke, Virginia was a cook for a living. Virginia feeds herself as well, although she is working with a speech therapist to help with swallowing and coughing problems. Virginia has had only one fall, which occurred about a week ago in the bathroom. Fortunately, she was not seriously hurt but did admit that she was still sore. More than anything, she said, the fall was embarrassing. She bathes herself in the shower equipped with a shower chair, grab bars, and a hand held shower head. She also uses the toilet by herself, but has learned to go as soon as she feels she might have to in order to make it in time because the whole process takes a lot longer than it used to. She has a plastic toilet seat riser with side handles that fits on the toilet seat to make getting on and off of the seat easier. However, she admits that she would like to have a different kind — one more like a chair, with handles on the side like the one she had in the hospital. Julie, an occupational therapist who visited Mary’s home to meet with Virginia and assess Virginia’s needs, offered to bring a catalog on her next visit to see if they could find what she’s looking for. Virginia dresses herself slowly (the buttons take the longest, she said) but she manages.
Assessment of Functions
Virginia proved that the debilitating effects of her stroke were fairly minimal. Julie’s testing showed that she had no memory problems (she was able to quickly list the months of the year in backwards order), no hearing problems (she was able to repeat what Julie said even when her mouth was covered with a sheet of paper so Virginia could not read her lips), no problems with touch or determining the temperature of things, and no vision problems that she hadn’t had before the stroke. Her strength was normal as well. It was her speech and general movement that had been changed since the stroke. When asked, Virginia did admit that her writing, affected by her movement difficulties, was worse than before.
Julie asked Virginia what specific things she would most like to improve. Virginia’s responses were to speak better, to move more safely around her home, and to bathe more safely, especially when she returns to her own home. She also wants to be able to feed herself less slowly without swallowing and coughing. Julie then asked Virginia to rank these things from one to ten in terms of their importance, with ten being the most important. Virginia said that for her, speaking better and moving safely were tens, and bathing safely was an eight. Virginia felt that her present speech deserved a score of five, her ability to move safely a seven, and her ability to bathe safely an eight. However, when she was asked to rank her satisfaction with these things, she gave speech a one and movement and bathing fives. Next time Julie meets with her, she will see if any of these rankings change.
Virginia is working with speech, physical, and occupational therapists to improve functions in these areas. Julie was there to suggest changes that could be made in Mary’s home as well as changes to Virginia’s home to help with these problems. Mary and Virginia gave us a tour of the home, and Julie asked questions along the way about how Virginia did certain things. In the bathroom, the shower chair, grab bars, and hand held shower head were great, Julie said, but she suggested removing the shower doors, which were complemented with a shower curtain, so that Virginia could change the way she entered the shower. She had Virginia demonstrate how she normally did this, and Julie expressed her concern when she saw that at one point, she was on one foot, which could easily lead to imbalance that could result in falling. Instead, when the shower doors are removed, Virginia will be able to sit down on the chair while standing on the mat outside the shower (which Julie noted was good because it had a non-slick backing) and then swing her legs around, never having to stand in the potentially slick shower or to be on only one leg. She also suggested that Virginia get off the chair by sliding her hands underneath herself and pushing on the chair, which would be easier and take less strength than trying to pull herself up by grabbing onto something. They also talked about how the chair could work in Virginia’s bathtub at her home—she would be able to enter the bathtub in the same way to prevent losing her balance. When Mary and Virginia said that they left the bathroom light on at night, Julie said that that was good, and that they should make sure there was enough lighting at night for Virginia to be able to get up if she needed to.
Julie said she would return in a week to see how the changes in the bathroom were working and to bring them a catalog that includes alternate types of toilet seats and chairs. Virginia is used to doing things on her own, and Julie will continue to try to help her to live as independently and safely as possible.
The bathroom is the most dangerous part of the house for anyone with physical disabilities. It is difficult to move about on small, slippery surfaces, and falls onto hard tile can cause significant injury. Stroke survivors may need considerable personal assistance to complete the most basic activities of daily living. Fortunately, there are many approaches that make it easier and safer to use the bath, sink or toilet.
Your occupational and physical therapists can provide training in personal care techniques. Some home modifications and devices are described below. Many simple items, such as non-slip flooring and scrub brushes, are easy to purchase and install. Important safety devices like tub benches and toilet chairs are available from medical supply stores and home health services by prescription, and may be covered by your insurance. Professional installation will be required for major bathroom modifications, such as sturdy handrails and replacement fixtures. Please be sure to discuss bathroom safety with your stroke care team before moving to any new home environment.
Balance and Stability while Bathing
When getting into a shower or tub, the use of a cane, walker, wheelchair, or scooter can be supplemented by grab bars secured to the walls. Grab bars assist with stability when one is getting into or out of the bathtub or shower as well as balance while standing in a bathtub or shower. A person with good upper body strength can hold on to the grab bars while moving or standing to provide more support to the body. A bathmat or non-skid bath decals on the floor of a shower or tub can help a person feel more stable while getting into and out of wet and often slick area. Flooring outside the bathtub or shower should be a non-buckling and non-slick surface, which can be obtained by the use of rugs with non-slip backing.
A transfer tub bench is a seating device in the tub that extends beyond the side of the tub. The extended part of the bench is used for sitting and sliding across into the tub without having to step into the tub. The person must lift their legs over the side of the tub instead. This device is often used with a hand-held shower, since the person remains seated while showering. A shower chair provides a place to sit in either a shower or bathtub. This bath device usually has rubber tips on the legs to prevent sliding. A shower chair can provide stability for someone with difficulty balancing and a place to rest for those who have difficulty standing for long periods of time. When used with an adjustable showerhead, the person can remain seated for bathing. A foldout bath bench can be used in either a walk-in or roll-in shower to enable easy transfers from a wheelchair or a walker. This provides a place to sit rather than stand, which lessens the likelihood of a fall. A roll-in shower eliminates the hazard of stepping over the side of a conventional tub. A person can safely enter the shower with her walker or wheelchair as needed.
Being unable to control water while bathing is a potential safety hazard for stroke patients. To prevent burning, water control knobs and handles should be easy to operate. Levers on controls have long handles that can be easily operated using the whole arm. To allow a person to turn on the water before entering the tub, one can use offset faucet handles, which are controls placed closer to the side of entry. This reduces the distance a person must reach to turn on the water.
For stroke patients with impaired vision, adjustments may need to be made to allow them to read the heat settings on a water control knob. Knobs with high color contrast and large words are easier to read. It may be helpful to mark desired settings with colored stickers to ensure that the individual can set the control to the correct temperature. The use of a thermometer to prevent burning may be necessary for individuals whose sense of touch is less sensitive due to their stroke.
An adjustable shower head or a hand held shower allows the stream of water to be raised or lowered. This is especially useful when using a bath chair or bench, as a person who is seated is much lower than one who is standing in the shower.
Washing and Drying
When an individual has limited movement, it may be difficult for him to wash some parts of his body. To aid in this process, one can use a long-handled sponge. The sponge holds soap and water and releases it with little needed pressure. A large sponge may be used to wash large areas such as the back, legs, and feet. A small sponge with a brush may be used for getting between body spaces such as under nails and between toes.
It may also be difficult for a stroke patient to access soap. Squeeze bottles and soap pumps may be easier to use than bar soap, which is slick and can easily be dropped. These containers can be secured with suction pads, Velcro or in some cases, mounted directly to the walls. Once these containers are stabilized, the soap can be dispensed using only one hand. In order to ensure that towels can be easily accessed, they should be located at heights that are best suited for the individual. A lower bar or additional hooks may be necessary.
Using the Toilet
Many of the same problems a stroke patient may face when entering the bathtub or shower are associated with using the toilet. Therefore, the similar use of a cane, walker, wheelchair, scooter, handrails, or grab bars can help an individual to stabilize herself when sitting on and getting up from the toilet. In addition, the floor surrounding the toilet should not be slick. If bath rugs are in front of a toilet, they should have some sort of backing to prevent sliding, such as non-skid tape.
Changing the height of the toilet may make using the toilet less difficult. A raised toilet seat or a toilet seat riser reduces the distance from a standing to sitting position so a person does not have to squat or bend down as far to reach the seat. Risers are usually made of plastic and can be placed on top of the toilet seat or between the seat and toilet rim. Some have grab bars attached or are part of a commode chair.
A three-in-one commode chair has three features: a raised seat, grab bars on both sides of the chair, and a removable bucket. This proves to be very useful for an individual who has difficulty getting to the bathroom, as it can be kept nearby the bed or sitting area. The grab bars on either side can prevent a person from falling and also can be used to push up on or lower the body down to the seat. This combination chair can also be used over an existing toilet with the bucket removed.
Because accidents due to incontinence are often unavoidable, it is a good idea to keep a pair of clean garments in all bathrooms. Stroke survivors may also feel more comfortable if they wear disposable under-garments.
Using the Bathroom Sink
Faucets are often easier to use when the handles are lever handles, which allow a person to turn water on and off with a fist or arm movement. Finger movements and grasping is often difficult for stroke survivors, so handles that require these types of movements may need to be replaced.
A person in a wheelchair will find it difficult to reach the sink unless the sink is a cut-out or roll under sink, which provides room for legs underneath the seat while in a seated position. Someone who uses a walker or cane may find it helpful to use a roll under sink so they can sit on a chair while at the bathroom sink. A cabinet under a sink may be removed to provide the space. In addition, pipes should be covered or insulated to avoid leg burns.
Someone who is forced to use only one hand will find it difficult to use items such as nail brushes and soap bottles. Suction pads can be used to hold tools in place on a counter top. Using the suction pad as a stabilizer reduces the need for using a hand to hold the object. Squeeze bottles and soap pumps may be easier to use than products’ original containers. Brushing teeth can be made easier by increasing the size of the toothbrush handle and using a flip-top for dispensing toothpaste. A toothpaste squeezer may also be helpful for people with limited grasping ability.
To ensure that the individual is able to set the water to the correct temperature, it may be useful to mark the desired settings just as one with limited vision or feeling would do for their bath faucet. When shaving, an electric razor may be easier to handle and safer than a regular razor.
Of all the rooms in the house, it seems most important that your bedroom be a place where you can feel comfortable and safe. Because this is a private area of the home for you, it should be tailored to meet your needs.
To increase your independence in your bedroom, you may need to reorganize your clothing and personal items so that they are accessible by you, the stroke survivor. To increase your safety, you need to be sure that help is within reach if needed. It is also important to consider the room from a nighttime perspective: adequate lighting, clear pathways, and access to a toilet are essential in order to avoid accidents in the dark.
Storing and Accessing Clothes
When a stroke survivor returns home, he may find himself unable to access his clothes due to where or how they are stored. By changing the type of handle from one that requires fine finger movements to open the door or drawer to one such as a cabinet handle or d-loop, which can be opened with a fist, the person may again be able to access his clothing with little or no assistance.
The height of clothes in a closet or drawers in a dresser may also be a problem for stroke survivors. This problem can often be solved or lessened by lowering the closet bar or organizing the dresser so that frequently used clothes are in the most easily accessible drawers.
To eliminate difficulties in getting dressed, stroke survivors can avoid clothing that may be difficult to put on. The National Stroke Association suggests to “avoid tight-fitting sleeves, armholes, pant legs and waistlines, as well as clothes which must be put on over the head.” Clothes should fasten in the front. Velcro fasteners or elastic in place of buttons, zippers and shoelaces can make fastening clothes easier.
Dressing aids are also available. A reacher, button hook, dressing stick (for putting on clothing and socks and reaching items from a closet), mirror that hangs around the neck, sock aid (which is used to put on socks when someone has difficulty reaching his feet), long handled shoe horn, and elastic shoe strings can all be used in this process.
To avoid accidents in the night due to being unable to get to the bathroom soon enough, a stroke survivor may want to keep a commode chair near the bed. A three-in-one commode chair has three features: a raised seat, grab bars on both sides of the chair, and a removable bucket. During the day or when it is not needed, the commode chair can be kept in a nearby closet.
Stroke survivors must understand that accidents are sometimes unavoidable. To deal with them, blue pads can be placed underneath sheets on the bed. Blue pads are pads, often washable and reusable, with a cloth and waterproof side to prevent staining on furniture.
Keep bedspread clear of walking paths.
Keep a telephone and light switch or lamp within easy reach of the bed.
The kitchen can be a dangerous place for stroke survivors with movement limitations or decreased sensation. Kitchens are often small spaces with counters and appliances that are difficult to access from a seated position. Hot or sharp objects as well as any type of object that is difficult to reach can pose serious safety hazards for anyone, but often more serious for people with disabilities.
In order to prevent accidents, it is important to consider every aspect of the kitchen that you will come into contact with on a daily basis. With some thoughtful planning, you may be able to feel safe enough to prepare your own food or at least be able to do things in the kitchen with some help. Some of the suggestions below involve major construction changes; others are simple organizational ideas that may make kitchen activities more feasible.
Using the Stove
When stove controls are placed at the front of the stove, one does not have to reach over the burners to adjust the temperature. Push button controls eliminate the need to turn the hand or wrist if this movement is difficult for the person, but, on the other hand, these controls may be more cognitively demanding. Controls arranged in the same location as burners simplify the thought processes needed to turn on the correct burner. Automatic shut off controls can be installed to stoves to increase the safety for people who may forget to turn of the stove.
An over-the-stove mirror can be used to reflect the contents inside of pots and pans on the stovetop so that someone in a seated position can see despite the height of the stove. A person with decreased mobility will most likely encounter obstacles when trying to use a stove—obstacles that could be safety hazards if not addressed. Just as one may turn their bath-room sink into a roll-under sink, one can create a roll-under stove by removing cupboards or moving the oven so the stove can be accessed from a wheelchair or other chair.
People with reduced sensation or less ability to detect temperature change are at a greater risk for burning themselves. Oven mittens or hot pads should have a place near the oven and stove for easy access. Although oven mitts and hot pads can protect the skin from burns, they may also make it more difficult to hold a pot or pan.
A clear space near the stove or oven also needs to be available to place the dish quickly to prevent spills, which could lead to burns. A nearby cart with a heat resistant cutting board or a heat resistant cutting board to hold in one’s lap are possible solutions. A fire extinguisher should be within easy reach.
Kitchen Sink and Countertops
The height and depth of normal kitchen sinks often prove to be obstacles for stroke survivors with limited movement. A roll-under sink allows a person in a wheelchair to approach the sink with the chair facing the sink, as it provides room for one’s knees to fit underneath. Covered or insulated pipes are needed to prevent leg burns. Lowering the height of the sink can also increase the accessibility of the sink for a person in a wheelchair, but must be high enough for the person’s knees to fit under the sink. In addition, a shallow sink can be helpful for a person in a wheelchair, as it does not require the person to reach down too far. If the sink has a roll-under space, the shallow sink may also allow for more legroom underneath the sink. Lever handles allow a person to turn water on and off with the use of a fist or arm movement rather than finger movements or grasping.
The height of countertops can be modified for a person in a wheelchair as well, since the standard countertop height of 36 inches is usually too high for a person to reach from a seated position. Counters of different heights may provide spaces for all household members to use in the kitchen. Roll-under countertops, like roll-under sinks, allow a person in a wheelchair or standard chair to more easily work at the countertop in a seated position.
Storing and Accessing Food
When it comes to food storage and access, organization is the key. A side-by-side refrigerator, which has the freezer on one side and the refrigerator on the other, allows a person in a seated position the ability to access both the freezer and the refrigerator. When the freezer is stacked on top of the refrigerator, frozen foods can be difficult to reach and may even fall on a person’s head as they are pulling down items.
A person with impaired vision may be unable to read some of the labels on food and spice containers. Labeling containers with black bold letters in all caps on a white background may help to make identifying foods easier. Plenty of spacing between bottles makes for easy identification and removal from the shelf or rack. Switching some foods or spices to containers with larger-sized lids may help to make the containers easier to open.
Cutting food can be dangerous if the stroke survivor has trouble using their hands. Purchasing pre-sliced foods may be the safest solution to this problem. Weighted handles or built up handles make utensils and cooking tools easier to handle. A spiked cutting board or a non-skid surface holding the cutting board can also decrease the chance of being cut.
To avoid outdated or spoiled food, leftover food should be dated and perishable foods should be disposed when expired.
Being unable to enjoy activities that you once did because of recent disabilities can be extremely frustrating. For many stroke survivors, dining is one such activity. Using utensils, sitting up to the table, and swallowing are often difficult following a stroke. In addition to help from health professionals such as a speech therapist and a nutritionist, specialized utensils and dishes are available that may make dining less frustrating and more enjoyable. Whatever the obstacle, patience plays a key role in improving your dining experience.
A plate guard or scooped plate can be used to scoop food onto a utensil. The guard attaches to most plates and is commonly used by people who have controlled movement with only one hand. Food can be pushed by a utensil against this wall-like device that curves along the edge of one side of the plate. A damp washcloth or rubber product can be used to stabilize the dish to make dining easier as well.
Stroke survivors often find it difficult to control their food. This can be made easier by using utensils with built-up, bendable, or weighted handles. Built up handles increase the surface area of the utensils to reduce the need for a fine pinch to hold the utensil, instead only requiring a gross motor grasp. Rubberized handles prevent the grip from slipping. Weighted handles are useful for a person who has tremors or uncontrolled movements that cause spilling. The heavy weight of the handle can reduce the amount of movement in a shaking hand.
Swivel forks or spoons keep food in the same position while the handle of the utensil moves. This is useful for a person with unwanted hand movements to decrease spilling food before it reaches her mouth. People who have difficulty holding utensils can also use universal cuff utensils. The cuff fits around the hand and the utensils are attached to the cuff, requiring only arm movements to control the food. It is often necessary for people with limited or compromised hand movements, such as being unable to pinch or grasp, to use these utensils.
Drinking can be made easier by using a cup with a lid and straw. This replaces sipping from the side of a cup, which is important for a person with reduced muscle control at the mouth. This reduces the risk of spilling or dribbling. A weighted cup is similar to weighted handles on utensils. This weighs down a hand with tremors or uncontrolled movement, reducing spills.
For a person who is not in a wheelchair but has trouble controlling their body posture, it is important for them to have a chair that supports their posture while at the dining room table. It is also important for them to have adequate cushioning that properly fits the chair. To make dining as comfortable as possible, a person in a wheelchair should have access to a table that is of a proper height for the wheelchair.
In addition to using specialized utensils and tools, survivors of severe strokes may need to have their food chopped, ground, or pureed. Sometimes, liquids need to be thickened. A speech therapist can give advice on how to avoid swallowing or choking problems. The patient’s physician or a nutritionist can help to develop a specialized diet and fluid intake amount to lessen the chance of additional strokes.
Household tasks such as cleaning and doing laundry may be impossible or difficult for stroke survivors with severe disabilities. However, some modifications may make these or some of these tasks possible or less difficult. Before you return home, a plan should be in place for ensuring that regular home cleaning will be taken care of, as an unclean environment in any room of the house is a health and safety hazard for anyone.
After a stroke, when the survivor has less energy and endurance, everyday cleaning tasks such as sweeping, mopping, washing counters, walls and other surfaces, garbage disposal, and general tidying may need to be done while seated. Working in small areas and taking frequent breaks can make these tasks more manageable. Products are available to simplify steps in cleaning processes, such as disposable wipes presoaked in cleaning solutions or multipurpose solutions for cleaning multiple objects.
The weight of items such as garbage and buckets of cleaning water may be too heavy for someone with decreased strength. Smaller containers, wheeled push carts, and lightweight mops and brooms require less energy and strength to handle. Cleaning supplies may need to be switched to more easily handled containers such as sprayers or soap pumps, depending on the limitations of the individual’s movement. Long handled brushes and sponges and vacuums with extensions can be useful aids for hard-to-reach places. All frequently needed items should be placed on shelves or in drawers at optimal height.
Even if the stroke survivor is limited to a wheelchair, with a few changes, he may still be able to do his own laundry. In order for this to work, the machines may need to be relocated to the main floor of the home if they were previously on a different floor and it is difficult or not possible for the person to climb stairs. To provide enough space, stackable washing machines may need to be used. Front loading washing machines are usually more reachable for someone doing laundry while seated. The arm movements required for loading the front of the machine differ from the arm movements for loading into the top of a machine; in general, front loading requires a smaller range of motion.
Visible markings for wash settings, such as colored stickers, can provide cueing for people with low vision or with memory or problem solving difficulties. Furthermore, the larger the dial or knob, the easier it will be for the person to change the wash setting. Buttons rather than knobs may be necessary for stroke survivors who are unable to produce a turning motion with their hand or wrist.
A nearby table or cart of adequate height can make doing laundry easier, as wet clothing is heavy and often difficult for someone with low endurance and decreased strength to transport. This way, fewer items can be removed at a time and placed nearby, saving time and energy. A fold down ironing board may take up less space and requires less energy and fewer movements to assemble and disassemble. Well-organized supplies in easily accessible containers such as clearly labeled squeeze bottles and soap pumps can ease the laundry process as well.
Safety and Mobility
Below are some items you may want to address before you return home . You may need to make modifications that require professional installation, especially if you are in a wheelchair.
Entryways and hallways should have a 32-inch clearance to accommodate people in wheelchairs. When doors do not open as wide as hinges were designed, application of a lubricant allows the hinges to work as they were designed. This extra space can allow a person using a wheelchair or walker to fit through the doorway. The edges of a swelled door may need to be shaved to allow for extra space as well. An uneven threshold should be fixed or changed to prevent tripping and allow easier wheelchair access. A portable ramp is often an affordable solution.
Stroke survivors who are unable to grasp with their fingers or twist their wrists to open doors can use a downward movement of their fist to open lever door handles more easily than regular doorknobs. The location of the knob may need to be moved as well. Swing away hinges, folding doors, or pocket doors can make passage through doors less difficult. To provide more space or clearance in doorways, doors between rooms can be removed.
To allow for movement in a wheelchair, furniture may need to be moved and thick rugs may need to be replaced. Rugs should be moved unless they are sufficiently secured to the floor with some sort of non-skid tape.
While slick surfaces should be avoided when possible, wearing non-skid shoes can prevent slipping. Secure carpets or runners can be installed in hallways or stairwells for traction. Handrails provide support while going up and down stairs. They may be attached to reinforced walls or the floor or ground. Outdoor handrails need to withstand weather conditions. A ramp may need to be added as well.
A stair glide or stair lift is a way to transport a person up or down stairs while the person is seated. A person transfers to the seat and rides up or down the stairs on a track. This electrical technology may cost several thousand dollars to install. A platform lift, on the other hand, is similar to a small elevator. This lift transports a person up or down stairs. The person can step onto the platform or roll a wheelchair onto the platform and then the platform electrically moves the person to a different level. Platform lifts are available for indoors or outdoors.
Pathways should be clear of clutter and electrical cords. Extension cords can be used to reroute cords along walls, and cords should be secured to the floor or walls when possible. Cords with frayed ends should be discarded and replaced.
Individuals who do not require a wheelchair but find it difficult to move from place to place on their own may need to use a cane, walker, or scooter. They may feel more comfortable if handrails or grab bars are mounted to the walls of the home.
Phones should be easily accessible for the stroke survivor in every room of the house. A cordless phone or a wearable call button may be necessary and would prevent tripping on a phone cord. Emergency phone numbers should be posted in a highly visible area. A large button phone is easier to read and use for patients with limited movement or vision problems. High contrast such as dark on light or light on dark also helps people with vision problems to read the numbers and words on phones. A picture phone reduces the need to remember phone numbers or to press several buttons to make a call. The phone can be programmed to fit a person’s individual needs. A symbol, drawing, or photograph corresponds to emergency numbers and numbers of family or friends.
Install smoke detectors and carbon monoxide detectors and check them regularly. Have a well-thought-out and posted fire escape plan.
This section was developed by the Internet Stroke Center and the Program in Occupational Therapy at Washington University in St. Louis School of Medicine. The research and writing for this site was prepared by Dory Sabata (currently a program specialist at the Leonard Davis School of Gerontology at the University of Southern California), with additional contributions from Laura Butler of the Internet Stroke Center.
M. Carolyn Baum, PhD, OTR/L, FAOTA
Director, Program in Occupational Therapy
Washington University School of Medicine
Dorothy Edwards, PhD
Associate Professor of Occupational Therapy and Neurology
Washington University School of Medicine
Susan Stark, PhD, OTR/L
Instructor in the Program in Occupational Therapy
Washington University School of Medicine
Mark Goldberg, MD
Professor and Chair, Department of Neurology and Neurotherapeutics; Director, Internet Stroke Center
UT Southwestern Medical Center
Program Director, Stroke Caregiver Support Program,
Washington University School of Medicine