Caring for Someone After a Stroke
When your loved one comes home from the hospital, you're likely juggling a lot of new information — equipment to set up, therapy visits to schedule, and a home that may need to change overnight. This guide covers everything you need, organized the way caregivers think.
What to Expect When They Come Home
Coming home after a stroke is a big transition — for your loved one and for you. The hospital stay might have lasted only a few days, but recovery at home takes weeks, months, and sometimes longer. That's normal, and it doesn't mean anything is wrong.
Every stroke is different.
A small stroke might cause mild weakness that improves quickly. A larger stroke might affect movement, speech, memory, or swallowing. Your loved one's recovery path is unique to them. The therapists visiting your home will build a plan based on where they're starting from.
🦾 Physical Changes
- →Weakness on one side of the body — arm, leg, or face. This is the hallmark of most strokes.
- →Difficulty walking or unsteady gait. Your loved one may need help with every step at first.
- →Balance problems. Falls are the biggest risk in early recovery — especially in the bathroom.
- →Fatigue. Stroke survivors often sleep 12–16 hours a day. This is the brain healing.
💬 Communication Changes
- →Difficulty speaking or slurred speech — the brain's language center may be affected.
- →Trouble finding words (aphasia) — they know what they mean but can't get the words out.
- →Frustration when they can't communicate. Be patient. Don't finish their sentences unless they ask.
- →Swallowing issues in some cases. Speech therapy addresses both speech and swallowing.
💛 Emotional Changes
- →Mood swings — crying, anger, or sudden laughing. These are neurological, not a choice.
- →Depression affects 1 in 3 stroke survivors. It's treatable — tell the doctor if you notice it.
- →Personality shifts. Your loved one may seem like a different person at times. This can improve.
- →Grief. They may mourn who they were before. That's normal and healthy to acknowledge.
Recovery takes months, not weeks. Progress may be slow, but it's still progress. Celebrate small wins — sitting up longer, moving a finger, a word that came through clearly.
📋 Before discharge, ask the hospital for: a copy of all discharge instructions, a list of medications with dosing schedule, the contact number for the home health agency that's been assigned, and a follow-up appointment date with the neurologist.
Equipment Typically Needed
Not everyone needs all of this. The physical therapist visiting your home will recommend what's right for your loved one. But here's what is commonly needed — and what to know about each item.
Hospital Bed
If mobility is very limitedA hospital bed raises and lowers, making it much safer to get your loved one in and out of bed without straining your back. It also elevates the head, which helps with breathing and reduces the risk of aspiration if swallowing is affected.
Typical cost
$150–$300/mo rental or $600–$2,000 purchase
Medicare Part B
Covers 80% after deductible. Usually rented (capped rental over 13 months).
What to know
Your doctor must write a prescription stating medical necessity. You cannot self-refer.
Wheelchair — Manual or Power
Depending on recovery stageIn early recovery, your loved one may need a wheelchair for all movement outside of bed. As strength returns, they may transition to a walker, then a cane. A manual wheelchair works for most; a power wheelchair may be needed if arm function is significantly limited on both sides.
Typical cost
Manual: $200–$600 | Power: $1,500–$5,000+
Medicare Part B
Covers 80% after deductible. Manual chairs purchased; power chairs rented then owned.
What to know
Power wheelchairs require an in-person evaluation. Ask your PT which type is right.
Walker or Rollator
For those regaining mobilityAs your loved one's strength returns, they'll likely transition from wheelchair to a walker or rollator. A standard walker provides maximum stability. A rollator (a walker with wheels and a seat) is better for people who can bear weight but need help with balance and stamina on longer walks.
Typical cost
Standard walker: $30–$80 | Rollator: $80–$250
Medicare Part B
Covers 80% after deductible when prescribed by a doctor. Usually purchased upfront.
What to know
Your PT will determine the right type and height. Never buy a walker before the therapy evaluation.
Bath Safety: Shower Chair, Grab Bars, Non-Slip Mats
Essential for all stroke survivors returning homeThe bathroom is the most dangerous room in the house after a stroke. Weakness on one side, balance problems, and fatigue make falls much more likely. A shower chair lets your loved one bathe while seated. A handheld showerhead (a flexible hose that detaches from the wall) means they can shower without standing or reaching overhead. Grab bars give a safe handhold near the toilet and in the shower. Non-slip mats prevent sliding on wet floors.
Typical cost
Shower chair: $30–$100 | Grab bars: $20–$80 each | Mats: $10–$30
Medicare Part B
Shower chairs typically covered. Grab bars usually are not (home modification). Check your plan.
What to know
Your OT (occupational therapist) will assess your bathroom and recommend specific equipment during their first visit.
Communication Devices
If speech is affected (aphasia)Aphasia — difficulty finding or understanding words — affects about 1 in 3 stroke survivors. A speech-language pathologist will guide you on what's best. Simple communication boards (printed charts of words and pictures) are often the first step. Tablet apps and dedicated speech-generating devices are options for more significant aphasia.
Typical cost
Communication boards: Free–$50 | Speech-generating devices: $1,000–$8,000
Medicare Part B
Speech-generating devices covered at 80% when prescribed by a doctor and evaluated by a speech therapist.
What to know
Your speech-language pathologist will assess communication needs and write the prescription if a device is needed.
Bedside Commode
If bathroom access is difficultIf your loved one can't safely walk to the bathroom — especially at night — a bedside commode is a simple, important safety tool. It sits next to the bed and eliminates the risk of a fall in a dark hallway. Most people no longer need it once mobility improves.
Typical cost
$40–$150
Medicare Part B
Covered at 80% after deductible when prescribed as medically necessary. Usually purchased, not rented.
What to know
Ask your supplier for a model with padded arms — much more comfortable for daily use.
Find stroke care equipment suppliers near you
Enter your ZIP code to see Medicare-enrolled suppliers for wheelchairs, hospital beds, and bath safety equipment.
Home Health Services
After a stroke, your loved one will likely qualify for home health services — skilled professionals who come to your house so your loved one doesn't have to travel to a clinic. Here's what each type of therapist does:
Physical Therapy (PT)
Your physical therapist focuses on strength, balance, and movement. They'll help your loved one relearn how to walk, get in and out of bed safely, and build back the muscle strength lost from the stroke and hospitalization. PT also teaches you how to safely help with transfers and movement.
Typical: 2–3 visits per week. Expect to work hard — the effort in PT directly affects recovery speed.
Occupational Therapy (OT)
Your occupational therapist helps your loved one relearn daily tasks — dressing, bathing, cooking, and using the bathroom. OT also does a full safety assessment of your home and recommends which equipment to get and where to place grab bars. If your loved one's arm is affected, OT works on hand and arm function.
Typical: 2–3 visits per week, especially in the first 4–6 weeks.
Speech Therapy (SLP)
Despite the name, speech therapy covers both talking and swallowing. If your loved one has trouble finding words (aphasia), understanding speech, or swallowing safely, a speech-language pathologist is essential. Swallowing issues (dysphagia) can be life-threatening if food or liquid goes into the lungs, so this is taken seriously.
Typical: 2–3 visits per week if speech or swallowing is affected.
Skilled Nursing (RN or LPN)
A skilled nurse visits to manage medications, wound care (if there was a fall or procedure), blood pressure monitoring, and IV medications if needed. Nurses also serve as a communication bridge between you and the doctor — if something looks wrong, call them first.
Typical: 1–2 visits per week, or more if wound care or IV medications are needed.
📅 How long do visits last? Home health visits are usually 45–60 minutes. The initial evaluation visit may be longer (up to 90 minutes) as the therapist assesses your loved one and your home. Under Medicare, home health is typically approved for 60-day periods, renewable if still medically necessary. Most people have home health for 60–120 days after a significant stroke.
What Medicare Covers
Medicare covers a lot after a stroke — and understanding the basics can prevent surprise bills and help you advocate for your loved one.
A Equipment (Durable Medical Equipment)
- →Medicare Part B pays 80% of the approved amount after you meet your annual deductible ($257 in 2025).
- →You (or your Medigap policy) pay the remaining 20%.
- →Most equipment is rented first (hospital beds, wheelchairs) — after 13 months of rent, you own it outright with no more payments.
- →Some items (commodes, walkers, shower chairs) are purchased upfront at the Medicare-approved rate.
- →You must use a Medicare-enrolled, accredited supplier. All suppliers on DMEHelper show their enrollment status.
B Home Health Services
✅ Home health is covered at 100% under Medicare Part A — with no copay in most cases.
- →Includes PT, OT, speech therapy, and skilled nursing.
- →Your loved one must be "homebound" (leaving home requires considerable effort).
- →A doctor must order home health and certify the need every 60 days.
- →The home health agency must be Medicare-certified.
C Medicare Advantage Plans
⚠️ If your loved one has a Medicare Advantage plan (like Humana, UHC, Aetna), the rules can be different:
- →You must use in-network suppliers and home health agencies.
- →Some equipment may require prior authorization (pre-approval) before ordering.
- →Copays for equipment may differ from Original Medicare.
- →Call the number on the back of the insurance card before ordering any equipment. Ask: "Does this require prior authorization?" and "Is this supplier in my network?"
D "What if I can't afford my 20%?"
If the 20% cost share for equipment is a hardship, there are options:
- →Medicaid: If your loved one qualifies for both Medicare and Medicaid (dual-eligible), Medicaid often covers the 20% gap, leaving a $0 cost.
- →QMB (Qualified Medicare Beneficiary): A federal program that pays Medicare premiums and cost sharing for people with limited income. Ask your local Social Security office.
- →State pharmaceutical and equipment assistance programs: Many states have programs for low-income seniors. Call 1-800-MEDICARE (1-800-633-4227) to ask what's available in your state.
Week-by-Week Recovery at Home
Here's a realistic picture of what the first months at home often look like. Use this as a general guide — every stroke is different.
Adjusting — Setting Up Equipment & Routines
This week is about getting settled. Equipment should be delivered and set up before your loved one arrives home. The home health agency will call to schedule the first evaluation visit — usually within 24–48 hours of discharge. Expect your loved one to be exhausted. Don't try to do therapy exercises on your own yet — wait for the professionals to guide you.
Therapy in Full Swing — Learning Transfers & Mobility Assists
By week two, therapy visits are happening regularly. Your physical therapist will teach you both how to do safe transfers — moving your loved one from bed to wheelchair, in and out of the shower. These techniques protect their safety and your back. Home exercises between visits become important now; the therapists will show you what to practice each day.
Adjusting Equipment — Seeing Early Progress
By now you may notice what's working and what isn't. The occupational therapist will review the home setup and may recommend changes — a grab bar moved, a different shower chair, a raised toilet seat. Small equipment adjustments make a big difference in daily function. Early progress is often visible by week three: sitting independently longer, taking a few steps, saying a word more clearly. Celebrate each one.
Reassessment with Home Health Team
Around week four, the home health team will informally review progress. They'll check whether the current visit frequency is right, whether additional therapy types should be added, and what goals to set for the next month. This is a good time to voice any concerns — about pain, mood changes, or things you've noticed at home that the therapists haven't seen. You're a key part of this team.
Reassessment — Visit Frequency May Decrease
Around the 60-day mark, the home health agency will do a formal reassessment. If your loved one still needs skilled care, therapy can continue (Medicare renews in 60-day episodes). Some people graduate from home health to outpatient therapy at a clinic. Others continue home health longer. This isn't about failing or succeeding — it's about matching care to where your loved one is in recovery.
Long-Term Adaptations & Ongoing Needs
By six months, your loved one's recovery trajectory is becoming clearer. Some people return to nearly full function. Others adapt to a new baseline that's different from before. Either way, life continues — often in a rich, meaningful way. Ongoing equipment needs (wheelchair, grab bars) become part of the permanent home setup. Stay connected with the neurologist and primary care doctor for long-term monitoring of blood pressure and secondary stroke prevention.
Warning Signs — When to Call for Help
Once your loved one is home, you become the first line of detection. Knowing these warning signs can save their life.
⚠️ Signs of Another Stroke — Call 911 Immediately
Use the FAST acronym to remember what to watch for. Act immediately — don't wait to see if it passes.
F — Face Drooping
Ask them to smile. Is one side of the face drooping or numb? Is the smile uneven?
A — Arm Weakness
Ask them to raise both arms. Does one arm drift downward? Can they hold both arms up?
S — Speech Difficulty
Is their speech slurred, strange, or are they unable to speak or understand you?
T — Time to Call 911
If ANY of these signs are present, call 911 immediately. Time is brain — every minute counts.
Also watch for: sudden severe headache unlike any before, sudden vision changes, sudden numbness or weakness on one side of the body, or sudden confusion or trouble understanding.
Other Signs to Watch For (Call Your Home Health Nurse)
Signs of Post-Stroke Depression
Persistent sadness, loss of interest in recovery, crying spells, or saying "what's the point?" Affects 30–40% of stroke survivors. Very treatable with support and, if needed, medication.
New Pain or Swelling
Shoulder pain (especially on the affected side) is common after stroke. Leg swelling can be a sign of deep vein thrombosis (DVT), which is serious.
Falls or Near-Falls
Report every fall to the home health nurse and therapist, even if there's no injury. Fall patterns help them adjust the home environment and therapy plan.
Increased Confusion or Sudden Behavior Changes
New or sudden confusion — especially with fever — can be a sign of a urinary tract infection (UTI), which stroke survivors are prone to. Call the nurse.
📌 Keep these numbers on your fridge: Your home health nurse's direct line, your loved one's neurologist, and 911. Call the home health nurse for non-emergency concerns — they can assess over the phone and often prevent unnecessary ER trips. Call 911 for anything that looks like FAST symptoms or feels life-threatening.
Taking Care of Yourself
You can't pour from an empty cup.
Caregiver burnout is real, and it affects the quality of care your loved one receives too. Taking breaks isn't abandoning them — it's making sure you can be there for the long haul.
Respite Care Options
Home health aide visits
Some home health agencies can provide a home health aide (HHA) for personal care (bathing, grooming). Medicare may cover this if skilled care is already in place.
Adult day programs
Many communities have adult day programs where your loved one can socialize and receive supervision a few days a week, giving you a break. Check with your local Area Agency on Aging (call 211).
Short-term inpatient respite
If you need a longer break, some skilled nursing facilities accept short-term admissions for respite care. Medicare Advantage plans sometimes cover this.
Caregiver support groups
Talking to others who understand is powerful. The American Stroke Association has a stroke caregiver support group finder at stroke.org.
💛 You're not doing this alone. Ask your social worker (the hospital should have connected you to one) about local caregiver resources, meal delivery programs, and transportation assistance. If you weren't connected to a social worker at discharge, ask your home health agency — most have one on staff.
Caregiver Support Resources & Hotlines
American Stroke Association Helpline
1-888-478-7653 · stroke.org · Caregiver resources, support group finder, local programs
Eldercare Locator (U.S. Dept. of Aging)
1-800-677-1116 · Connects you to local Area Agency on Aging for respite care, meals, transportation
ARCH National Respite Locator
archrespite.org · Find respite care programs in your state
211 — Local Social Services
Dial 2-1-1 from any phone · Free service that connects you to local food, housing, and caregiver support resources
Your "What You'll Need" Checklist
Check off items as you arrange them. Bring this to your discharge meeting.
Equipment
Services & Actions
Your checkboxes save automatically as you check them.
Have Questions About Stroke Recovery at Home?
Dottie can walk you through equipment options, explain what Medicare covers, and help you find providers near you — all in plain English.