Stroke: Should I Move My Loved One Into Long-Term Care?

When brain cells are damaged or die, the body parts controlled by those cells don't work like they did before. The loss of function may be mild or severe. It could be short-term or permanent. How well your loved one recovers depends on how much of the brain is damaged, where the damage is, and how fast the blood supply returns to the damaged cells.

Many people who have a stroke recover well enough to go home from the hospital. But a stroke can cause very serious problems. Some people need long-term care in a center.

Your ability to care for a loved one at home will depend on his or her level of disability, your health, and the amount of support that you have from family members or outside help.

After a stroke, your loved one may have trouble with:

• Movement. Your loved one may not be able to walk or to use his or her arms. This is usually because of weakness or paralysis on one side of the body.
• Speech and language. Your loved one may not be able to speak, read, or write. Also, he or she may not be able to understand what someone else is saying.
• Thinking and reasoning. He or she may not be able to think clearly. The stroke may cause changes in behavior.
• Senses. Your loved one may not be able to feel when something or someone touches parts of his or her body, such as the arms or legs.

It could take a long time for your loved one to regain speech and other skills. And some skills may not come back completely.

Many people who have a stroke will have some long-term problems with talking, understanding, and decision-making. They also may have behavior problems that affect their relationships with family and friends. They may need help learning how to act in social situations.

Your loved one could have other problems that happen right away or within months to years after a stroke. They include:

• Weight loss, if the person has trouble swallowing and does not eat well.
• Seizures.
• Skin sores (pressure injuries) or blood clots within deep veins if the person sits or lies in one position for a long time.
• Shoulder pain.
• A stiff joint that cannot be straightened if the person holds the affected arm or leg in the same position for a long time.
• Depression.
• Infection, especially pneumonia or a urinary tract infection.
• Tight muscles and muscle spasms in the affected arm or leg.

People who have had a stroke may act differently than they did before. They may be slow, cautious, and disorganized when they do unfamiliar activities. They may seem anxious.

The level of care and help your loved one needs may increase if his or her condition gets worse. Basic activities like eating, dressing, bathing, using the bathroom, and simply moving around may be harder or impossible for the person to do alone.

Taking care of your loved one at home may get too hard for you, both physically and emotionally.

"Nursing home" is a phrase commonly used to refer to any long-term care center, but there are several kinds of long-term care. Each provides different levels of care, assistance, and services. The quality and costs of care and services at long-term care facilities vary widely, and options vary from community to community.

• Assisted-living and residential care facilities usually offer private housing and provide a wide range of services, including meals and cleaning services.
• Skilled nursing facilities provide nursing care, up to 24 hours a day. This type of long-term care includes medical care in addition to meals, cleaning, and personal needs.
• Special care units focus on the needs of people with dementia.
• Continuing-care communities offer several levels of care. They offer assisted-living care to full nursing care in the same place.
• Home health care can range from physical and speech therapy to nursing care at home. A family member can also provide home care.

Some people find that part-time help allows them to keep their loved one at home for a longer time. Part-time care may take place either at home or in an adult day care.

As in long-term care centers, home care can provide whatever help a person needs. For example, a home health aide can help the person bathe and wash clothes and linens.

Adult day care and respite services take care of the person so that the regular caregiver can take a break. This may relieve some of the stress of caregiving.

Your loved one's doctor may suggest long-term care if:

• Your loved one's health gets worse, and he or she needs more care than you can give.
• Your loved one has several health problems that require skilled nursing care.
• Your own health is at risk, or you could get injured from caring for your loved one (such as from lifting).
• Long-term care may offer a safer, more controlled situation.