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Bathing

Balance and Stability  
  • When getting into a shower or tub, the use of a cane, walker, wheelchair, or scooter can be supplemented by grab bars secured to the walls. Grab bars assist with stability when one is getting into or out of the bathtub or shower as well as balance while standing in a bathtub or shower. A person with good upper body strength can hold on to the grab bars while moving or standing to provide more support to the body.

Grab Bar

  • A bathmat or non-skid bath decals on the floor of a shower or tub can help a person feel more stable while getting into and out of a wet and often slick area. Flooring outside the bathtub or shower should be a non-buckling and non-slick surface, which can be obtained by the use of rugs with non-slip backing.

Tubu Mat

  • The transfer tub bench is a seating device in the tub that extends beyond the side of the tub. The extended part of the bench is used for sitting and sliding across into the tub without having to step into the tub. The person must lift his/her legs over the side of the tub instead. This device is often used with a hand-held shower, since the person remains seated while showering. A shower chair provides a place to sit in either a shower or bathtub. This bath device usually has rubber tips on the legs to prevent sliding. A shower chair can provide stability for someone with difficulty balancing and a place to rest for those who have difficulty standing for long periods of time. When used with an adjustable showerhead, the person can remain seated for bathing.
Transfer Bench
  • The foldout bath bench can be used in either a walk-in or roll-in shower to enable easy transfers from a wheelchair or a walker. This provides a place to sit rather than stand, which lessens the likelihood of a fall.

Shower Bench

  • A roll-in shower eliminates the hazard of stepping over the side of a conventional tub. A person can safely enter the shower with his/her walker or wheelchair as needed.

Roll In Shower

Water Control  
  • Being unable to control water while bathing is a potential safety hazard for stroke patients. To prevent burning, water control knobs and handles should be easy to operate. Levers on controls have long handles that can be easily operated using the whole arm. To allow a person to turn on the water before entering the tub, one can use offset faucet handles, which are controls placed closer to the side of entry. This reduces the distance a person must reach to turn on the water.

Lever Handle

  • For stroke patients with impaired vision, adjustments may need to be made to allow them to read the heat settings on a water control knob. Knobs with high color contrast and large words are easier to read. It may be helpful to mark desired settings with colored stickers to ensure that the individual can set the control to the correct temperature. The use of a thermometer to prevent burning may be necessary for individuals whose sense of touch is less sensitive due to their stroke.

Contrast Handle

  • An adjustable showerhead or a hand held shower allows the stream of water to be raised or lowered. This is especially useful when using a bath chair or bench, as a person who is seated is much lower than one who is standing in the shower.
Adjustable Shower Head
Washing and Drying  
  • When an individual has limited movement, it may be difficult for him to wash some parts of his body. To aid in this process, one can use a long handled sponge. The sponge holds soap and water and releases it with little needed pressure. A large sponge may be used to wash large areas such as the back, legs, and feet. A small sponge with a brush may be used for getting between body spaces such as under nails and between toes.

Scrubbies

  • It may also be difficult for a stroke patient to access soap. Squeeze bottles and soap pumps may be easier to use than bar soap, which is slick and can easily be dropped. These containers can be secured with suction pads or Velcro, or, in some cases, mounted directly to the walls. Once these containers are stabilized, the soap can be dispensed using only one hand.

Soap Pump

  • In order to ensure that towels can be easily accessed, they should be located at heights that are best suited for the individual. A lowering bar or additional hooks may be necessary.
 
Using the Toilet  
  • Many of the same problems a stroke patient may face when entering the bathtub or shower are associated with using the toilet. Therefore, the similar use of a cane, walker, wheelchair, scooter, handrails, or grab bars can help an individual to stabilize herself when sitting on and getting up from the toilet. In addition, the floor surrounding the toilet should not be slick. If bath rugs are in front of a toilet, they should have some sort of backing to prevent sliding, such as non-skid tape.

Walker

  • Changing the height of the toilet may make using it less difficult. A raised toilet seat or a toilet seat riser reduces the distance from a standing to sitting position so a person does not have to squat or bend down as far to reach the seat. Risers are usually made of plastic and can be placed on top of the toilet seat or between the seat and toilet rim. Some have grab bars attached or are part of a commode chair.

Raised Seat

  • A three-in-one commode chair has three features: a raised seat, grab bars on both sides of the chair, and a removable bucket. This proves to be very useful for an individual who has difficulty getting to the bathroom, as it can be kept nearby the bed or sitting area. The grab bars on either side can prevent a person from falling and also can be used to push up on or lower the body down to the seat. This combination chair can also be used over an existing toilet with the bucket removed.

Commode Chair

  • Because accidents are often unavoidable, it is a good idea to keep a pair of clean garments in all bathrooms. Stroke survivors may also feel more comfortable if they wear disposable under-garments. 'Dealing With Incontinence, Stroke Family Caregiving For African Americans' includes helpful suggestions on what can be done to help the stroke survivor feel more comfortable about this condition and how to make it appear less noticeable.
 
Grooming  
Using the Bathroom Sink  
  • Faucets are often easier to use when the handles are lever handles, which allow a person to turn water on and off with a fist or arm movement. Finger movements and grasping is often difficult for stroke survivors, so handles that require these types of movements may need to be replaced.

Lever Handle

  • A person in a wheelchair will find it difficult to reach the sink unless the sink is a cut-out or roll under sink, which provides room for legs underneath the seat while in a seated position. Someone who uses a walker or cane may find it helpful to use a roll- under sink so they can sit on a chair while at the bathroom sink. A cabinet under a sink may be removed to provide the space. In addition, pipes should be covered or insulated to avoid leg burns.

Roll Under Bath

  • Someone who is forced to use only one hand will find it difficult to use items such as nail brushes and soap bottles. Suction pads can be used to hold tools in place on a counter top. Using the suction pad as a stabilizer reduces the need for using a hand to hold the object. Squeeze bottles and soap pumps may be easier to use than the products’ original containers.

Suction Pad

  • Brushing teeth can be made easier by increasing the size of the toothbrush handle and using a flip-top for dispensing toothpaste. A toothpaste squeezer may also be helpful for people with limited grasping ability.

Paste Squeezer

  • To ensure that the individual is able to set the water to the correct temperature, it may be useful to mark the desired settings just as one with limited vision or feeling would do for their bath faucet.

 

  • When shaving, an electric razor may be easier to handle and safer than a regular razor.
 
The Bedroom  
Storing and Accessing Clothes  
  • When a stroke survivor returns home, he may find himself unable to access his clothes due to where or how they are stored. By changing the type of handle from one that requires fine finger movements to open the door or drawer to one such as a cabinet handle or d-loop, which can be opened with a fist, the person may again be able to access his clothing with little or no assistance.

Cabinet Handle

  • The height of clothes in a closet or drawers in a dresser may also be a problem for stroke survivors. This problem can often be solved or lessened by lowering the closet bar or organizing the dresser so that frequently used clothes are in the most easily accessible drawers.
 
Dressing  
  • To eliminate the difficulties in getting dressed, stroke survivors can avoid clothing that may be difficult to put on. The National Stroke Association suggests to “avoid tight-fitting sleeves, armholes, pant legs and waistlines; as well as clothes which must be put on over the head.” Clothes should have fasteners in the front. To make fastening clothes easier, Velcro fasteners or elastic can be used in place of buttons, zippers and shoe laces.

Elastic Laces

  • Dressing aids are also available. A reacher, button hook, dressing stick (for putting on clothing and socks and reaching items from a closet), mirror that hangs around the neck, sock aid (which is used to put on socks when someone has difficulty reaching his feet), long handled shoe horn, and elastic shoe strings can all be used in this process. See web links section for Internet sites at which you can purchase such items.
Dressing Kit
Sleeping  
  • To avoid accidents in the night due to being unable to get to the bathroom soon enough, a stroke survivor may want to keep a commode chair near the bed. A three-in-one commode chair has three features: a raised seat, grab bars on both sides of the chair, and a removable bucket. During the day or when it is not needed, the commode chair can be kept in a nearby closet.

Commode Chair

  • Stroke survivors must also understand that accidents are often unavoidable. To make accidents easier, blue pads can be placed underneath sheets on the bed. Blue pads are pads, often washable and reusable, with a cloth and waterproof side to prevent staining on furniture.

Blue Pads

  • Keep bedspread clear of walking paths.

 

  • Keep a telephone and light switch or lamp within easy reach of the bed.
 
Dining Room  
  • A plate guard or scooped plate can be used to scoop food onto a utensil. The guard attaches to most plates and is commonly used by people who have controlled movement with only one hand. Food can be pushed by a utensil against this wall-like device that curves along the edge of one side of the plate. A damp washcloth or rubber product can be used to stabilize the dish to make dining easier as well.

Scoop Plates

  • Stroke survivors often find it difficult to control their food. This can be made easier by using utensils with built-up, bendable, or weighted handles. Built up handles increase the surface area of the utensils to reduce the need for a fine pinch to hold the utensil, instead only requiring a gross motor grasp. Rubberized handles prevent the grip from slipping. Weighted handles are useful for a person who has tremors or uncontrolled movements that cause spilling. The heavy weight of the handle can reduce the amount of movement in a shaking hand.

Utensils Buitup

  • Swivel forks or spoons keep food in the same position while the handle of the utensil moves. This is useful for a person with unwanted hand movements to decrease spilling food before it reaches her mouth. People who have difficulty holding utensils can also use universal cuff utensils. The cuff fits around the hand and the utensils are attached to the cuff, requiring only arm movements to control the food. It is often necessary for people with limited or compromised hand movements, such as being unable to pinch or grasp, to use these utensils.

Utensils Padded

  • Drinking can be made easier by using a cup with a lid and straw. This replaces sipping from the side of a cup, which is important for a person with reduced muscle control at the mouth. This reduces the risk of spilling or dribbling. A weighted cup is similar to weighted handles on utensils. This weighs down a hand with tremors or uncontrolled movement, reducing spills.

Sip Cups

  • For a person who is not in a wheelchair but has trouble controlling their body posture, it is important for them to have a chair that supports their posture while at the dining room table. It is also important for them to have adequate cushioning that properly fits the chair. To make dining as comfortable as possible, a person in a wheelchair should have access to a table that is of a proper height for the wheelchair.

Chair

  • In addition to using specialized utensils and tools, survivors of severe strokes may need to have their food chopped, ground, or pureed. Sometimes, liquids need to be thickened. A speech therapist can give advice on how to avoid swallowing or choking problems. The patient’s physician or a nutritionist can help to develop a specialized diet and fluid intake amount to lessen the chance of additional strokes.