Stroke
Leaving hospital after a stroke
The length of stay in hospital after a stroke can vary from a few days to a number of months depending of the severity of the stroke and the support available at home. People were not usually discharged home until they were able to get around safely either in a wheelchair or walking and were able to get in and out of bed. If a person lived alone they were also assessed to see whether they could make a drink and a basic meal for themselves. Some people returned home and were provided with a care package (see 'Continuing care at home and institutional care').
A few people had discharged themselves from hospital early because they were not happy with the care, were desperate to get back to familiar surroundings or were concerned about things that needed to get done because no one else was available to do it. As a consequence they often encountered problems accessing rehabilitation services.
Ralph discharged himself from hospital because he was concerned about the tasks that needed to be...
Ralph discharged himself from hospital because he was concerned about the tasks that needed to be...
Discharged herself from hospital because she was desperate to get home and didn't want to be on a...
Discharged herself from hospital because she was desperate to get home and didn't want to be on a...
How about, did you discuss this at all with your GP?
It's difficult because I suppose it, I felt a bit guilty because my GP I actually worked, worked for at the time and he had arranged for this, the admission and everything, so it looked a bit ungrateful to turn round and say, 'By the way, I'm at home now, I discharged myself' but, and when I told him about, you know, the geriatric ward he could quite plainly see why I did it [laughter] and I think he was, you know, as a GP, he was irritated to think that other people needed the bed far more than I did and they wouldn't let me go as an outpatient and have the treatment I needed.
Preparation for going home
The rehabilitation in hospital was nearly always focussed on getting people physically fit enough to get home and preparing them for everyday tasks such as washing, dressing and preparing food (see 'Stroke recovery: physical aspects and mobility' and 'Stroke recovery: daily activities').
Part of this process can involve a visit home with the occupational therapist and sometimes a social worker. This visit was to assess the house and look at requirements for adaptations such as ramps to get in and out of the house, hand rails in the bathroom, shower and toilet seats and hand rails on the stairs. Some people were also assessed to see how they managed in the kitchen.
On her home visit they assessed her home to see what adaptations she needed and how she coped in...
On her home visit they assessed her home to see what adaptations she needed and how she coped in...
Oh yes. Before they let me home, I had, they came up one day with the, the physiotherapist and the social, well no, was it the social worker and the occupational therapist, they came up with me and were in the house for one morning and I had to make a cup of tea and I had to do little simple tasks to prove that I could do it before they would let me home and to climb the stair because the back bedroom is up the stairs. I've got a toilet and shower down but the back bedroom is up the stairs and, and so they put, they had hand rails put on either side of the stair for me. They did that and they put hand rails in the shower which is very helpful. I couldn't manage to take a shower without them now but the stair now is no problem because I have this hand rail. I don't find it a problem at all.
Weekend visits
Leading up to their discharge home some people we spoke to had been on one or more overnight or weekend visits or trips out, for example to a park or café. Weekend visits were generally a great boost although some found them difficult as the experience brought home to them the extent of their disability and made them feel vulnerable. They were often glad to return to the security of the hospital.
When he came home for the weekend they moved his bed downstairs and he had to use a commode but...
When he came home for the weekend they moved his bed downstairs and he had to use a commode but...
Enjoyed visits home from the hospital and out in the evening, although they made him very aware...
Enjoyed visits home from the hospital and out in the evening, although they made him very aware...
And when I was in hospital, well, it was at the time of the European championships football, so I can remember one of the matches that was on, some friends had come up and said they were arranging to go out and watch the game in the pub and they said, 'Do you want to come?' and I said, 'Well, yeah, OK', so I asked the staff on the ward, the doctor and he said, 'Yeah, that's fine, if you want to go, go, just don't come back too late and not too drunk', so I said, 'OK then' so they came and got me in my chair and had to push me. It's a fair old way from the hospital to the pub we went to, but we went there and watched the football.
One of the times as well when, the disability sort of really caught up on me and it was kind of when I appreciated how much, what effect it was going to have on my normal things in life because I wanted to go on the slot machine in the, when I was in the pub and I managed to put my good leg and with one hand, just pushed my chair a little bit towards the machine and got there, then couldn't reach to put my money in, so I had to stop somebody walking past and say, 'Can you just put my money in for me?' And it was just one of those things where I thought, 'I'm going to have so many problems, just small things', things that perhaps you just take for granted that you can do that are going to become major events for me for the rest of my life. So that was a bit of a shock in a way.
Although most people had achieved some mobility (either in a wheelchair or walking) by the time they went on these visits, they were often unable to negotiate stairs and it was sometimes necessary to have a temporary bed downstairs and a commode.
Adaptations for homes or moving to a new home
Many people talked about adaptation or aids for living at home such as stair rails, shower rails, stools and so on with an occupational therapist. Most were happy to have any adaptations; however, a few did not want their house to reflect their disability and refused adaptations. One woman later changed her mind and had a stair rail installed. Whilst most were entitled to some help with adaptations to their home, others were not, or were frustrated by the length of time that they had to wait for adaptation and had used large amounts of their own savings to have it done themselves. One woman was who had broken her leg since the stroke was still waiting for a toilet and shower downstairs which she found extremely frustrating.
She refused to have adaptations made to her house because she did not want it to reflect her...
She refused to have adaptations made to her house because she did not want it to reflect her...
She has been waiting a long time for a bathroom to be put in downstairs. In the mean time she has...
She has been waiting a long time for a bathroom to be put in downstairs. In the mean time she has...
You just want a toilet downstairs is that it?
I'd like a toilet and shower for bathing downstairs I don't need anything else, I just need this and nothing else.
And for walking?
I can walk little, slowly slowly I can go to the toilet but if the toilet is far I can't make it then, now. The toilet is upstairs how can I climb the stairs to go upstairs, if I want a bath how can I climb upstairs. I come here especially to have a bath.
They should have given me toilet bath, so I could shower. Now I've stayed home 6/7 months. They gave me bath towel, with bath towel you can't get rid of the smell not until you use water properly. They used to wash my hair-using bucket, they can't bath me in a bucket. I used to smell that's why I started coming here.
Here they bath you?
Yes they bath me here.
One man explained that he had to move to a more suitable house. He found it difficult that his wife had to arrange decorators as he would have previously done the work himself.
He moved to a more suitable house because of his mobility problems and found it hard.
He moved to a more suitable house because of his mobility problems and found it hard.
Did you come home at all during that time?
I, for a couple of weekends, that's all.
Mmm. And how'
Because, because we couldn't get, we had to, we had to move, because, well we, we stayed two up.
Oh right, you had to move house?
Yeah, yeah. Yeah.
So you came back to visit a different house?
No. I didn't [my partner], my partner, she had everything done she had to do everything a painter, she got a painter and all that and new carpets and all that because I had, I couldn't do anything.
Yeah. That must have been hard?
Yeah, yeah. I hated it for I can't do anything.
And had you always done that in the past?
Yeah. I always, I done it myself all the time.
Feelings about being home
Most people were really happy to be home back in a familiar environment without the disruptions of the hospital which could sometimes lead them to have sleepless nights.
Some people were, however, frightened of having another stroke and missed the security of being watched over by health professionals in the hospital. Others, particularly those who lived alone or those who had been in hospital for many months, missed the company of the other patients. One woman missed the excellent care in the hospital and initially found it difficult to rely on the Social Services department. Friends and families could sometimes find this indifference to being home difficult to understand. One man felt overwhelmed when first arriving at home, describing it as equivalent to "jumping off a cliff". It was an adjustment not only for him but his wife and young children.
The transition home was difficult for Gavin and his family as they all had to adjust together.
The transition home was difficult for Gavin and his family as they all had to adjust together.
When she came home she missed the company and the support of the hospital staff.
When she came home she missed the company and the support of the hospital staff.
Not very nice. Not very happy for a while' because I, everything had been so wonderful in that hospital, I had such good care and then I came home and you're relying on the social work department to send you a helper and however it's turned out that I'm very happy, excuse me, I'm very lucky because I've got a carer who comes in four times a week, a day sorry [laughs], four times a day. So I'm very lucky.
But now I've been back home for what, two or three' two or three months, I can't remember which, I'm OK, I'm settled in fine, you know. I wasn't looking forward to come home because I wasn't, I live on my own, you see. So, however, aye, I like the company but.
She felt very vulnerable and frightened at being home and thinks her husband did not understand....
She felt very vulnerable and frightened at being home and thinks her husband did not understand....
Now again, my husband couldn't understand that the day I came home I should have been absolutely overjoyed because I was home but I think it's something to do with a feeling of insecurity. You're very frightened that you're going to have another stroke and that you haven't got nurses around you. Whereas in hospital, you feel very safe. I mean, there were a couple of times when I did think I might be having another stroke and they were there immediately, the doctor came you felt very safe. But immediately you come home, you are on your own and it's a very frightening experience and I think if you are told that you wouldn't be excited to be home and it takes a long time to get yourself into the right sort of way of feeling, I think that would help lots of people. And, unfortunately, this little group we were going to set up, unfortunately as my husband died, I wasn't able to, to get more involved in it, which I, it was a great shame because I think that is a very good idea. I think it would help lots of people.
People valued the support and help of their family on their return home as they were often surprised how tired they felt at doing even simple tasks such as dressing. This time could also be overwhelming for the person caring as they often had to take on new responsibilities.
When he first got home he found even getting washed and dressed very tiring and was very...
When he first got home he found even getting washed and dressed very tiring and was very...
But, like everything else, like, like the speech coming back, your throat's getting stronger , my muscles got stronger, physically got stronger and things became easier and easier and easier and you've just got to keep doing it and doing it and doing it and doing it, you know. Sorry, I was going to say I was very, very dependent on, on my wife because I couldn't make coffee, I couldn't make tea, I couldn't make soup, I couldn't make you know, meals or anything. I couldn't do anything about the house or, you know, once I was dressed, I could, manage, just manage to dress myself. It was the devil's own job trying to put a pair of shoes on socks or slippers or anything like that, you know. It was really, really difficult and I was totally dependent.
Last reviewed June 2017.
Last updated August 2011
Copyright © 2024 University of Oxford. All rights reserved.