After a stroke many people have to work to overcome various problems in order to regain
independence, particularly in the area of “self care”. (Also known as “Activities of Daily
Living”, e.g. eating, bathing, grooming and dressing).
These self care tasks may be difficult for a variety of reasons:
1. PHYSICAL IMPAIRMENT - muscle weakness, loss of movement on one side of the
body, difficulty coordinating movement, poor balance, poor mobility, loss of sensation.
2. VISUAL IMPAIRMENT - loss of vision on one side, blurred vision, double vision,
difficulties understanding visual information.
3. DIFFICULTIES THINKING CLEARLY - difficulty in planning and carrying out
tasks in the correct order, poor problem solving ability, memory problems, difficulty
recognising objects and knowing how to use them appropriately (eg unable to recognise
what a tooth brush is and what it is used for).
4. COMMUNICATION PROBLEMS - unable to clearly communicate needs, or to
understand what others are saying.
STRATEGIES TO AID WITH SELF CARE TASKS
Occupational therapists may assess and plan a rehabilitation programme which may
include using equipment and techniques, which can help make self care tasks easier to
perform. It is important for the Occupational Therapist to assess the individual persons
situation, but the following are general points which may be helpful.
If you have difficulty standing up for long periods or have poor standing balance a
shower chair may be placed in the shower alcove or a bath board may be placed
over the bath and a shower hose used to wash. If such equipment is put in place it
is also beneficial to install grab rails in the shower or near the bath to ensure that
there is something to hold onto for added security.
A non slip bath mat will also increase safety.
Clearly label the hot and cold taps and/or install a temperature gauge (this is
particularly important if you have visual problems, poor sensation or difficulty
Other equipment that may be useful include a soap mitt or soap on a rope to make
soap less difficult to handle if you are bathing yourself one handed. A towelling
dressing gown may be used to aid with drying. (1,2,4,5)
It is important to determine what is the best position to carry out the task (ie lying down,
sitting or standing).
If you have limited mobility it is best to dress lying down. Underpants and trousers
can be pulled up by rolling from side to side or by lifting hips off the bed. (7)
Once sitting and standing balance improves dressing can be carried out sitting down or
It is best to put clothing on the weaker arm and leg first. When undressing take the
stronger limbs out first.
Have clothing arranged in the appropriate order and at easy access.
It is best to use clothing that is easy to put on e.g. use zips instead of buttons, clothes that
fasten at the front instead of the back. Velcro fasteners, and elastic waist bands also make
Appliances to help put on socks, shoes and clothing include - sock aid, dressing stick,
long handled shoe horn, and a button fastener. Elastic sided, buckled or velcro fasteners
make putting on shoes easier. A one handed shoe lace tying technique can also be taught.
Clothing labels may be used as a prompt to help orientate clothing appropriately, if the
person has planning problems.
Make sure that the table is at an appropriate height and that the seat is comfortable and
A two handed activity such as cutting with a knife can be adapted so that it can be
performed one handed. Equipment available to aid with eating includes - built up cutlery,
a rocker knife which helps to cut food one handed, a plate guard to ensure food does not
fall off the plate, non slip mats to ensure that the plate does not slip around the table.
For someone with visual problems it may be best to develop a routine so that you know
where items are located on the table and on your plate. Have someone tell you where
items are located when you sit down to have a meal.
Eating can be complicated by facial muscle weakness or paralysis which may result in
drooling or pocketing of food in the side of the mouth. To compensate for these problems
the person can periodically wipe his or her chin and remove food that has accumulated in
the side of the mouth. (7)
After a stroke, some people experience swallowing problems, and these should be fully
assessed and treated by a Speech Pathologist.
During the early stages of recovery it may be necessary to use a commode (you do not have to
travel a long distance to the toilet and it can be used quickly).
A toilet frame or raised seat can be used to make getting on and off the toilet easier.
If incontinence is experienced it is important to have it be assessed thoroughly by a doctor
or continence nurse.
Various re-training programmes are available and aids including pads, pants, catheters, mattress
protection, and special clothing can be used on a short or long term basis. (6)
Aids that may assist with grooming include:
The use of an electric shaver. This is much safer than using a wet razor.
The use of a suction brush to clean dentures or nails.
The handles of most grooming equipment can be built up, or lengthened to accommodate
people with weak grasp or reduced range of movement.
An electric toothbrush is often easier to use if you have limited movement and strength in
your arms. (3,7)
The information given on this sheet is very general. If equipment is needed, or information as to
how to adapt tasks, it is best to contact an occupational therapist at one of the agencies listed
below to enable further assessment to be made of your specific individual needs.
Independent Living Centre - staff will assess your specific needs and provide
information as to where equipment can be purchased.
11 Blacks Rd., Gilles Plains. S.A.
Phone 8266 5260. Free Call 1800 800 523
Metropolitan Domiciliary Care Services - will assess needs within your home and will loan
equipment. The phone numbers for Metropolitan Domiciliary Care Services is Ph: 8193 1234
Fax: 8193 1201
Neurological Services formerly SEETEC - a service associated with the Guide Dogs Association,
will provide services specifically for people with visual problems following a stroke.
251 Morphett St, ADELAIDE
Phone: 8203 8333 or 8203 8371
1. Australian Brain Foundation. Understanding and coping with Stroke. Victoria: Author
2. Australian Brain Foundation. Understanding stroke: A practical guide for stroke patients and families. Australia: Author
3. Hale, G (Ed). (1983) The new source book for the disabled. Great Britain: Blantyre Printing and Binding Co Ltd.
4. National Heart Foundation. Stroke fight back. Australia: Author
5. Neurological Resource Centre. General information on stroke. South Australia: Author.
6. The Independent Living Centre of South Australia Incorporated. Incontinence. South Australia: Author
7. Tropiano, B & Sielaff, G.E. (1984) Regaining self care ability. In G.P. Bray & G.S. Clark (Ed's), A stroke family guide and
resource (pp 46-69) Illinois: Charles C Thomas.
Researched and written by Jocelyn Wesley. Stroke 1993. Revised June 2004. Copyright Stroke S.A.
copy with acknowledgements.
For further information and support, contact
Stroke S.A. Inc
Postal Address 302 South Road Hilton SA 5033
Phone: (08) 83524644