Taking care of yourself is an important daily activity, but a stroke can make it difficult to perform. Listed below are common problems associated with self-care and solutions to help you on your road to independence. Complete the Barthel Index for Activities of Daily Living to measure your performance in daily activities.  

Problems:

Hemiparesis:

This means having one side of the body weaker or more paralyzed than the other side. Self-care tasks that require two hands become more difficult. Hemiparesis can also impact safety with getting in and out of bed and performing your toileting and bathing routine.

Loss of sensation:

A stroke can cause a loss of sensation on the affected side of your body. Being unaware of water temperature, sharp items, and the position of your hand or foot can cause injury.

Vision and perception:

A stroke can cause loss of vision on your affected side and decreased awareness and attention of the affected side. It can also lead to difficulty finding objects which blend into the background and difficulty distinguishing between right and left. Vision and perceptual problems can greatly impact the ability to perform self-care activities.

Apraxia:

This means inability to plan out movements despite having the necessary range of motion, strength, and coordination. It may cause difficulty in using your unaffected arm or leg to perform self-care. Examples include placing your arms in the head-hole of a shirt, positioning a toothbrush incorrectly in the mouth, or missing your mouth when eating.

Perseveration:

A stroke can cause difficulty moving from one activity to the next. An example is bathing just one arm for 10 minutes and not moving on to bathing the rest of your body. 

Memory and attention:

A stroke can cause you to forget to perform certain self-care tasks or repeat the same self-care task. An example is forgetting that you took your morning medications and taking them again. Lack of attention can cause a person to stray off-track during self-care tasks and have difficulty getting re-focused.

Solutions:

Toileting: Use your walking device and leg orthotic (AFO) when walking to and from the bathroom, install grab bars, a raised toilet seat, and a bidet on the toilet. Place a commode chair with removable bucket next to the bed. Keep wet wipes and a urinal within reach next to the bed. Use disposable underwear in case of an accident. Keep a change of clothing handy in the bathroom or with you for the unexpected.

Bathing: Install sturdy hand rails or grab bars in the tub or shower. Install non-slip flooring strips inside the tub and on the bathroom floor. Use a shower chair or tub bench. Install a hand held shower head. Place bathing supplies within easy each. Check the temperature of the bath water with your unaffected hand before getting your body wet.

Dressing: Sit in a sturdy chair to dress. Lay your clothing out in front of you to orient yourself to the position. Use a dressing checklist and check off after each task is completed. Arrange clothing items in order. Use color contrasting clothing. Dress your affected side first. Avoid tight fitting clothing. Replace buttons and laces with Velcro or magnetic fasteners. Attach key rings to zippers to make them easier to grasp.

Grooming: Use automatic soap dispensers. Use suction pads to hold grooming tools in place on counter. Use flip-open toothpaste tubes and an electric toothbrush. Use a grooming checklist and check off after each task is completed. Arrange grooming items in order. An electric razor can be safer to use.

Eating: Use silverware with larger handles or cylindrical grips that are easier to grasp. Use plate guards to keep food from migrating off the plate. Cut foods using a one-handed rocker knife. Use a shelf liner under the plate to keep it from sliding around. Place a brightly colored napkin to the left or right of the plate (your affected side) to draw attention toward the affected side. Place food on the plate using the clock-method (Meat at 12:00, Fruit at 3:00, vegetables at 6:00, starch at 9:00) and cue the person to locate all of the quadrants while eating. When eating lighter-colored foods, use a darker colored plate.

One-Handed Dressing Techniques

Putting on a Pullover Shirt With One Arm

Putting on a Sock With One Hand

Bathing

Toileting

Dressing

Grooming

Oral Hygiene

Eating

Medication Management