Home care after a stroke: a family guide to the first months

Recovery from a stroke does not end at hospital discharge; the fastest progress is often in the first months, with regular rehabilitation. Every stroke is different: one person has a weak arm, another has problems with speech, swallowing or memory. This guide covers what families and caregivers can arrange at home; agree exercise and eating plans with the physiotherapist, speech and language therapist and doctor.

Recognise a new stroke: FAST

• Face: does one side of the face droop when they smile?
• Arms: when they raise both arms, does one drift down or not lift at all?
• Speech: is their speech slurred, unclear or making no sense?
• Time: if you see even one of these signs, call your local emergency number (112 in Türkiye and across the EU) immediately and note the time the symptoms started.

Even if the symptoms pass within minutes, urgent assessment is needed; a brief attack can be a warning of a new stroke.

What to arrange before they come home

• If possible, put the bed, toilet and sitting area on the same floor.
• Clear rugs, cables and clutter from walking routes; add a night light.
• Ask a specialist about grab rails, non-slip mats and a shower chair for the bathroom and toilet.
• Set the bed at a height that makes standing up easier.
• Keep the discharge letter, medicine list and appointment dates in one folder.

Safe movement and transfers

Moving from bed to chair, standing up and walking are the moments with the highest fall risk. Learn the technique the physiotherapist shows you and never lift your relative by pulling on the affected arm, as this can injure the shoulder. Let them do whatever part they can themselves: doing everything for them can slow recovery. Repeat exercises every day in short, regular sessions.

Swallowing problems: a silent risk

A stroke can affect the swallowing muscles. Coughing or choking while eating, a “wet” sounding voice, food pocketed in the mouth or repeated chest infections can signal a swallowing problem. Use the textures the speech and language therapist recommends (thickened fluids, purée and so on) and do not change them yourself. Sit upright to eat, stay upright for about 30 minutes afterwards and reduce distractions.

Communication difficulties

• Use short sentences and ask one question at a time.
• Yes/no questions and picture cards help.
• Allow time to answer; do not finish their sentences.
• Being unable to speak does not mean being unable to understand; do not talk about them in the third person in front of them.

Emotional changes and fatigue

Fatigue, sudden bouts of crying or laughing, anger and depression are common after a stroke and can be treated. Tell the doctor if loss of interest, a marked change in sleep or expressions of hopelessness last more than two weeks. It is also normal for carers to feel intense stress in the first months; share the tasks.

Preventing another stroke

Blood pressure control, taking medicines regularly (especially blood thinners and cholesterol medicines), stopping smoking, managing diabetes and following the doctor’s activity plan all reduce the risk of recurrence. For someone on blood thinners, see a doctor after a fall with a head injury, or if you notice bruising or bleeding.