When my mother suffered a stroke, we struggled to come to terms with many things. While we were grateful that we got her to the ER in time and that she would recover some of her physical abilities, it was devastating to deal with the fact that my once-active mother would need daily help with activities such as bathing, getting dressed, laundry and cooking. No one prepares you for this.
While Maa was in rehab, all my focus was on supporting her care there – getting her the meals she liked, following up on her daily progress, advocating for her to receive all the in-patient therapy her insurance would cover. As her rehab progressed and she got closer to the discharge date, we were faced with a different, larger challenge… setting up her in-home care.
The questions I was faced with included:
- Was the home set up to make it easier for her to move around and prevent falls?
- How do we find a personal care aide?
- Will insurance pay any part of the aide services?
Today, I will talk about getting the home ready.
There were an abundance of things to think about around the home to make it friendly to someone who had limited mobility or was not very stable on their feet. Things to think about:
Preventing falls around the house
One of Maa’s rehab therapists shared that over 70% of falls happen inside homes. This was eye opening. I knew accessibility in the community (e.g., subway stops, stores, sidewalks) can sometimes be challenging. But this was a good reminder that falls happen anywhere. Further, as I took a step back, I realized if Maa was going to now spend more time at home and that’s where she may be alone for periods of time, that’s where we need to make sure we set things up for her. Practically that meant:
- Removing any throw rugs
- Creating more open space between furniture (if you live in a tiny NYC apartment, you know what I mean!)
- Ensuring nothing is left on the floor even by mistake – no books, toys, pillows
- Equipping the bathroom properly (more below)
- Getting her a walking cane or a walker and placing it at the correct location
Setting up the bathroom
Falls in the bathroom can be especially dangerous, as you can imagine. It was important to get this right. Here are things we put in place, and some others you may need based on your loved one’s situation:
- Grab Bars: Grab bars come in different sizes and thickness. You’ll need to check which ones work best for your loved one. We got ours at Home Depot. They are available at every big box store and on Amazon. My wife and I mimicked Maa’s movement getting in and out of the bathtub and decided on two grab bars – a long, horizontal one to help her get out of her bath chair (see below) and another, shorter, vertical one to help her get out of the bath tub itself.
- Bath chair: This may depend on the needs of your loved one. We got one for Maa to make it easier for her to take a shower given the post-stroke weakness in her left leg. These come in different sizes though so make sure you measure the width of your bathtub or shower area, adn adjust the height accordingly!
- Hand shower: We needed to add a hand shower as it was easier for an aide to give Maa a shower or for my Maa herself to do as much as she could on her own.
- Elevated toilet seat: This may or may not be needed depending on the patient’s mobility, strength and your toilet setup. You’ll need to check whether the patient would be able to get up from the toilet seat in the current setup with the elevated toilet (eg. holding on to the sink if it was close and by their stronger side) or whether (NYC problems again) there’s enough space to add the elevated toilet seat on top of the regular toilet – this was a challenge in our apartment.
Support for walking
Like the other steps, it’s crucial you get this right. Options include a walking stick/cane, a walker (see five different types of walkers as illustrated by the Mayo Clinic), or a wheelchair. You want your loved one to have the support they need, but at the same time, not unnecessarily stymie their progress in gaining back some mobility by getting them to rely on a more elaborate form of support, if a simpler version will do. For Maa, we got two canes: one she uses indoors to aid with getting in out of bed or up from the coach, the other is for outdoors. This way the indoor one was by her bed or couch, and not, say, left by the door when she sits down to untie her shoelaces.
Emergency response systems
These are important so that your loved one can reach emergency services in case they have an accident or fall inside the house when no one is around or they don’t have a phone next to them. Our insurance covered one so we got it installed for Maa. I have heard of others using trackers such as the Apple Watch for detecting falls. Whatever your preferences, it is important to consider getting one of these.
Medication management
When your loved one leaves the hospital or rehab to come home, your doctors would have given you detailed instructions on their medication schedule and ordered prescriptions for you to pick up at the pharmacy. If they don’t share a medication box with you, get one ASAP! They will help keep your loved one’s medication organized so they don’t miss any doses. We got one from the hospital before Maa was discharged but when the labels on there faded, I ordered one easily from Amazon to replace it. You also get these at your local pharmacy.
There are many other improvements that one can consider to make a home safe to age at-home. For example, lowering the kitchen countertops, installing ramps or a lift if you live in a house, keeping things at an accessible height for your loved one or getting paper cups to replace heavy glasses. I rent the apartment Maa lives in so we weren’t making wholesale changes, but we did our share to make aging at home more comfortable for her and do our best to minimize accidents and falls.
Please let us know if these tips/insights were helpful, and please share what you’ve done differently to make things easier for your loved one!
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