Caring for a stroke patient at home in Lagos

What recovery usually looks like

Every stroke is different, and so is every recovery. Some people recover in days or weeks. Others take months or years, and some live with lasting changes. What the research shows clearly is that most improvement happens early.

In the Copenhagen Stroke Study, which followed nearly 1,200 people, 80 in 100 reached their best level of daily function within six weeks and 95 in 100 within about 12 weeks. People with severe strokes took longer, up to around 20 weeks. Speech and hand use can keep improving for longer, sometimes years.

This is why the first three months matter so much. It is the time to get physiotherapy started, keep your parent moving safely, and prevent the complications that set recovery back.

Before your parent leaves hospital

Ask the hospital team these questions, ideally in writing:

• What type of stroke was it, and what part of the brain was affected?
• Can they swallow safely? What food and drink textures are safe?
• Which medicines should they take, at what times, and which old ones should stop?
• Do they need physiotherapy, and who can provide it near home?
• Do they need help with speech?
• What signs mean we should bring them back straight away?
• When and where is the follow-up appointment?

Bring the discharge letter and medicine list home and give copies to everyone who will help care for your parent.

Swallowing, eating and choking

Swallowing problems, called dysphagia, are very common after a stroke. Depending on how they are measured, they affect between about a third and three quarters of stroke patients. Food or drink going into the lungs can cause pneumonia, and people with swallowing problems are around three times more likely to get it.

Signs of a swallowing problem include:

• Coughing or choking when eating or drinking
• A wet or gurgly voice after swallowing
• Food coming back up, or pocketing food in the cheek
• Weight loss, dehydration or repeated chest infections

If you see any of these, tell the doctor. A speech and language therapist can assess swallowing and advise on safe textures. At home:

• Sit your parent fully upright to eat and drink, and keep them upright for about 30 minutes afterwards
• Give food and drink only in the textures advised, for example soft or thickened
• Give small mouthfuls, slowly, and check each one is swallowed before the next
• Never give food or drink to someone who is very drowsy
• Keep the mouth clean, twice a day. Poor mouth hygiene raises the risk of chest infections

Moving safely and preventing falls

Weakness on one side of the body, poor balance and tiredness all make falls more likely after a stroke. A fall can cause a fracture and set recovery back by weeks.

• Clear walkways, remove loose rugs and keep the floor dry
• Put a night light between the bed and the toilet
• Fit something firm to hold in the bathroom, and use a chair or stool for washing
• Learn how to help your parent stand and move without pulling on their weak arm. Ask the physiotherapist or nurse to show you
• Support the weak arm when sitting and lying, for example on a pillow, to protect the shoulder
• Use any walking aid the physiotherapist recommends, set to the right height

UK stroke guidance specifically warns families about frequent falls, stiffness in the weak limbs, shoulder pain and incontinence after a stroke, and recommends that carers are trained in safe moving and helping with dressing.

Preventing bed sores

A parent who spends a lot of time in bed or a chair is at risk of pressure sores, also called bed sores. They can start in a few hours on the bony parts of the body, such as the lower back, hips and heels.

• Change their position regularly, at least every few hours, and more often if they cannot move themselves
• Check their skin every day. On dark skin, look and feel for patches that are darker, warm, hard or painful
• Keep skin clean and dry, especially if they have incontinence
• Use a pressure-relieving mattress or cushion if they are in bed or a chair for long periods

Read our guide to caring for a bedridden parent

Physiotherapy and how to recover faster

Families often ask how to help a parent recover from a stroke quickly. The honest answer is regular, repeated practice, starting as soon as it is safe.

UK guidance recommends stroke patients get rehabilitation, which can include physiotherapy, occupational therapy and speech therapy, for up to three hours a day, five days a week, if they can manage it. It also recommends repetitive task training: practising real movements over and over, such as reaching, grasping, standing up from a chair, walking and climbing stairs.

More is not always better in the first day or two. A large trial found that very intensive movement within 24 hours of a stroke led to slightly worse outcomes. Follow the hospital's advice on when and how much.

No supplement, herbal remedy or spiritual treatment has been shown to speed up stroke recovery. Be wary of anyone who promises one, especially if it means stopping prescribed medicine.

In Lagos, physiotherapy is available at the teaching hospitals and at private clinics, and some physiotherapists do home visits. Ask the hospital for a referral before discharge.

Speech and communication

A stroke can affect the ability to speak, understand, read or write. This is called aphasia. It is frustrating for your parent and for you.

• Speak slowly and clearly, in short sentences
• Give them time to answer, and do not finish their sentences unless they want you to
• Use gestures, pictures, writing or yes and no questions
• Reduce background noise, such as the television, when talking
• Remember that difficulty speaking does not mean they do not understand

The NHS says most people with aphasia improve with speech therapy, especially in the first few months, and some keep improving for years.

Mood, tiredness and personality changes

Emotional changes after a stroke are common and are part of the illness, not weakness or ingratitude. Research pooling many studies found that about 31 in 100 stroke survivors have depression, and about 48 in 100 have post-stroke fatigue, a deep tiredness that rest does not fully fix.

• Plan activities and therapy for the times of day your parent has most energy
• Break tasks into small steps with rests in between
• Keep visitors and outings short at first
• Watch for low mood, tearfulness, loss of interest or sudden anger, and tell their doctor

Medicines and preventing another stroke

Nearly one in four strokes happens to someone who has had a stroke before. The most important thing you can do to prevent another is to make sure your parent takes their medicines exactly as prescribed, especially blood pressure tablets.

In Nigeria this is a real problem. Studies estimate that fewer than 3 in 100 people with high blood pressure have it under control. Older people often stop tablets when they feel better, run out, or skip doses to save money.

• Keep an up-to-date list of every medicine and when it is taken
• Use a weekly pill organiser
• Record each dose, and check the record
• Get refills before medicines run out
• Check blood pressure regularly and share the readings with the doctor
• Never stop a medicine without asking the doctor

Looking after the carer

Caring for a stroke survivor is physically and emotionally hard, and in many Nigerian families it falls on one person, often a daughter or the parent's spouse. UK guidance recommends that family carers are trained in moving their relative and that their own needs are reviewed regularly.

Share the load where you can: a sibling who pays for help, a relative who covers weekends, or a trained caregiver for part of the day. Getting enough rest yourself is part of good care, not a luxury.

How Home Care Nigeria helps after a stroke

Our Post-Hospital Care plan is designed for recovery at home after a stroke or hospital stay. A caregiver provides longer daily cover, readings such as blood pressure are checked against tighter limits, and a registered nurse visits every week. The hospital's discharge notes are built into the care plan, every medicine dose is recorded, and the whole family can read the signed report after each visit, wherever they live.

Common questions