DISCHARGE
PLANNING OF
STROKE PATIENTS
PRESENTED BY:
MISS. SHWETA SHARMA
AIIMS, JODHPUR

WHAT IS STROKE????
A stroke occurs when a blood vessel in
the brain ruptures and bleeds, or when
there’s a blockage in the blood supply
to the brain.
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TYPES OF STROKE
Transient ischemic attack (TIA)
Ischemic stroke
Hemorrhagic stroke
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DISCHARGE PLANNING
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PHYSIOTHERAPY
• Exercises to keep elbows, shoulders, and other
joints loose
• Watching for joint tightening (contractures)
• Making sure splints are used in the correct way
• Making sure arms and legs are in a good position
when sitting or lying
• Check every day for pressure sores at the heels,
ankles, knees, hips, tailbone, and elbows.
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DIET
After a stroke, the patient may have:
• Problems using arm or hand, making it difficult to eat and
drink.
• Problems with memory and thinking, which might mean the
patient forgets to eat and drink.
• Loss of appetite
• Swallowing problems (dysphagia)
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If patient has problems with arm or hand,
or with memory and thinking, an
occupational therapist can help with aids
and with strategies to help remember. If
patient has dysphagia, a speech
pathologist can recommend strategies to
help eat and drink safely. The patient may
need food and drinks with a different
consistency.
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Ryle’s tube feeding
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THINGS TO
LIMIT
AFTER
STROKE
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BOWEL CARE
• Pick a regular time, such as after a
meal or a warm bath, to try to have
a bowel movement.
• Be patient. It may take 15 to 45
minutes to have bowel movements.
•Try gently rubbing stomach to help
stool move through your colon.
•Avoid constipation.
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SPEECH AND LANGUAGE THERAPY
•Stroke survivors may have trouble speaking, finding words, or
understanding what other people are saying. This is called
aphasia.
•Therapy may include repeating words as well as reading and
writing exercises.
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Top 5 Speech Therapy Exercises for
Patients Who Have Suffered a Stroke
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To improve communication :
Keep distractions and noise down. Keep voice lower. Move to a quieter
room.
Allow plenty of time for the person to answer questions and
understand instructions.
Use simple words and sentences. Ask questions in a way that can be
answered with a yes or no. When possible, give clear choices. Do not
give too many options.
Break down instructions into small and simple steps.
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Repeat if needed. Use familiar names and places.
Make eye contact before touching or speaking if
possible.
Use an electronic device, such as a tablet, computer or
cell phone, to show pictures to help with
communication.
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PSYCHOTHERAPY
Stroke can cause chemical changes in the brain
that affect the way a person thinks, feels, and
behaves.
• Talk therapy
• Positive psychology
• Mindfulness
• Cognitive behavior therapy (CBT)
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OCCUPATIONAL THERAPY
• Holistic approach- mind, body, spirit and emotion
• Basic ADL such as feeding, grooming, bathing, dressing and toileting, managing
medication.
• Instrumental activities of daily living such as cooking, driving
• Range of motion including improving muscle strength, tone and control and
coordination.
• Cognition skills such as thinking, processing and interpreting visual and spatial
(space) information.
• Movement and mobility when performing ADL.
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HOME CARE
Keep walkways and floors clear of clutter.
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Make sure electrical cords are safely tucked
away.
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Secure rugs with non skid pads under the rugs
or by taping rugs to floors.
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Keep common items such as dishware, food items,
or medication within easy reach and design utensils
in assistive way
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Plate guards help keep food on the plate.
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Consider installing rails or assistive bars near
the toilet or shower.
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FOLLOW UP
• Follow the scheduled appointments after discharge.
• Close follow-up is important to stroke rehabilitation and recovery.
• Call emergency right away if you have any of the following symptoms
of stroke:
 Weakness, tingling, or loss of feeling on one side of face or body
 Sudden double vision or trouble seeing in one or both eyes
 Sudden trouble talking or slurred speech
 Trouble understanding others
 Sudden, severe headache
 Dizziness, loss of balance, or a sense of falling
 Blackouts or seizures
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