Everyday tools to make home life easier.
After a stroke, everyday activities may require a different technique, a change to the environment, temporary assistance, or specialized equipment. The best solution is not always the most expensive product. A well-fitted cane, a strategically placed grab bar, a seated work area, or a change in how a task is organized may make a larger difference than a major remodel.
Begin with the activities the survivor needs and wants to perform: getting to the toilet, entering the home, preparing a simple meal, showering, sleeping safely, communicating in an emergency, or returning to a favorite community activity. Observe the entire task. A person who cannot prepare breakfast may be limited by standing endurance, one-handed package opening, visual neglect, memory for steps, or difficulty reaching—not by cooking itself.
A home assessment by an occupational or physical therapist is especially valuable after falls, unsafe transfers, severe weakness, impulsivity, vision loss, neglect, or a change in caregiver availability. The assessment should consider the person, the caregiver, the equipment, and the actual space. A device that works in a clinic may not fit through the bathroom door or turn beside the bed.
Prioritize safety and essential access before cosmetic or convenience projects. Low-cost changes may include removing loose rugs, widening pathways by moving furniture, improving lighting, adding contrasting tape to steps, relocating frequently used items, and creating seated work areas. Major remodeling should be based on a long-term plan and professional measurements. The financial cost of modifications should also be weighed against the cost of falls, injuries, caregiver strain, hospitalization, or an earlier move from the home.
Resources: ASA: Make Your Home Work for You—Moving Around the House; ASA: The Cost of Not Modifying Your Home; NIA Home Safety Checklist.
A mobility device should match balance, strength, coordination, endurance, cognition, vision, hand function, and the environment. A standard cane provides less support than a quad cane or hemi-walker. A two-wheeled walker behaves differently from a four-wheeled rollator. A device that appears more supportive may be less safe if the person cannot control it, remember the brakes, or position it correctly.
Wheelchair selection involves more than seat width. Cushion, back support, footrests, armrests, pressure relief, one-arm or foot propulsion, transfer setup, and transportation all matter. A transport chair may be appropriate for occasional caregiver-assisted outings but is not a substitute for a properly configured wheelchair when the person needs independent mobility or spends substantial time seated.
An ankle-foot orthosis (AFO) may assist with foot drop, ankle instability, toe clearance, or knee control. Fit and design affect walking, balance, comfort, skin pressure, and footwear. Check the skin after use and report persistent redness, blisters, pain, or worsening walking. Transfers, patient lifts, and gait belts require hands-on training; a caregiver should not improvise lifting techniques that place both people at risk.
Resources: Medicare DME Coverage; Medicare Walkers; Medicare Wheelchairs and Scooters; Medicare Patient Lifts; Medicare Supplier Directory.
Bathrooms combine water, hard surfaces, small spaces, clothing management, and repeated transfers. A person who walks safely in a hallway may still need supervision or equipment in the bathroom. An occupational therapist can assess tub or shower entry, toilet height, one-handed hygiene, balance during clothing management, and whether a caregiver can assist without lifting or twisting.
Common options include a shower chair, tub-transfer bench, handheld showerhead, nonslip surface, raised toilet seat, toilet safety frame, bedside commode, and professionally anchored grab bars. A bedside commode may be placed near the bed or over the toilet to increase height. Use equipment only for purposes approved by the manufacturer. Suction-cup grab bars and towel racks should not be treated as dependable weight-bearing supports.
Preserve privacy and independence by setting out supplies, using pump dispensers or easy-open containers, and allowing the survivor to complete safe parts of the task. Bathing may be easier at the time of day when energy and medication effects are best. If fatigue is significant, separate bathing, hair care, and dressing rather than completing everything at once.
Resources: ASA Bathing Tips; ASA Bathroom Modifications; Medicare Commode Chair Coverage.
The bedroom should provide a clear route to the bed, bathroom, light, and emergency help. Consider which side of the bed is easiest for transfers, whether the mattress height allows the feet to reach the floor, and whether the person can roll or reposition without pulling on the affected arm. Very soft or low beds may make standing difficult; very high beds may make sitting and transfers unsafe.
Possible solutions include repositioning the bed, adding motion-activated lighting, using a firm transfer surface, placing a bedside commode, or considering an adjustable or hospital bed when medically necessary. Bed canes, transfer poles, trapezes, and positioning aids should be selected based on the person’s physical and cognitive abilities and the exact bed and mattress.
Bed rails are not automatically protective. Portable and hospital bed rails can create entrapment, strangulation, and fall risks, especially when the person is confused, impulsive, physically limited, or attempts to climb over them. Seek an individualized assessment and consider lower beds, floor mats, transfer devices, repositioning aids, or increased monitoring when rails are not appropriate.
Resources: ASA Bedroom Modifications; FDA Adult Portable Bed Rail Safety.
Dressing may be affected by one-handed function, weakness, spasticity, balance, neglect, apraxia, pain, or difficulty sequencing steps. Sitting in a stable chair with back support is often safer than standing. Arrange clothing in the order it will be put on and allow enough time to avoid rushing.
A common strategy is to dress the affected arm or leg first and undress it last, but individual recommendations may differ. Helpful items can include button hooks, zipper loops, elastic shoelaces, long-handled shoehorns, dressing sticks, reachers, sock aids, front-opening bras, magnetic closures, hook-and-loop fasteners, and garments with wider openings. Adaptive clothing should remain comfortable, dignified, and easy to wash.
For grooming, consider pump dispensers, electric razors, nonslip mats, built-up handles, one-handed nail brushes, and toothbrushes with larger grips. Protect reduced sensation and the affected shoulder: avoid very hot water, forcing stiff joints, or pulling the weak arm through a sleeve. An occupational therapist can teach one-handed methods and recommend equipment that matches the person’s actual abilities.
Resources: ASA Dressing Tips; ASA Personal Care; ASA Daily Living Videos.
Kitchen tasks may be limited by balance, one-handed use, visual neglect, reduced sensation, fatigue, memory, or difficulty planning a sequence. Start with simple, familiar meals and organize the workspace so frequently used items are reachable. A seated workstation, slide-out shelf, rolling cart, or lightweight cookware may reduce effort and fall risk.
One-handed tools may include nonslip mats, rocker knives, cutting boards with spikes or corner guards, electric can openers, jar openers, lightweight cups with lids, plate guards, and utensils with built-up or angled handles. These devices should support independence without bypassing swallowing or diet recommendations. Ask the speech-language pathologist about safe food textures, liquid consistency, pacing, and adaptive utensils when dysphagia is present.
Shopping can be simplified through written or picture lists, store pickup, delivery, smaller trips, a mobility cart, or going during quiet hours. When cognition or vision is affected, practice locating items, reading labels, comparing prices, paying, and navigating the parking lot with a therapist or trusted helper. Household tasks can be delegated or divided into shorter steps; independence does not require doing every chore without assistance.
Resources: ASA Shopping Tips; ASA Starting a Kitchen Remodel.
Assistive technology includes simple tools and advanced electronic systems. Low-tech options include picture boards, written schedules, pill organizers, large-print labels, contrasting tape, reachers, and adapted utensils. High-tech options include speech-generating devices, smart-home controls, medication dispensers, video doorbells, location reminders, fall alerts, and voice-activated phones or lights.
Technology should be selected around the person’s communication, motor, vision, hearing, and cognitive abilities. A touchscreen may be difficult for someone with poor finger control or visual neglect; voice control may be difficult with dysarthria or aphasia. Trial devices with an occupational therapist or speech-language pathologist and build a backup plan for power failure, internet loss, or inability to operate the system.
Emergency access deserves special attention. The person should be able to summon help from the bedroom, bathroom, and floor. Options may include a wearable alert button, accessible phone, smart speaker, call bell, or caregiver check-in plan. Make sure the survivor can demonstrate how to use the system and that responders can enter the home if necessary.
Resources: ASA Assistive Technology Connects You to the World; Find Your State Assistive Technology Program; Tetra Society of North America.
Driving should not resume automatically because physical mobility has improved. Stroke can affect vision, attention, reaction time, judgment, awareness, seizure risk, and the ability to manage multiple demands. Ask the medical team whether driving is currently restricted and whether a comprehensive driving evaluation is appropriate. A driver rehabilitation specialist may assess both clinical skills and on-road performance and recommend training or vehicle adaptations.
When driving is not safe or possible, build a transportation plan that covers medical appointments, groceries, social activities, and emergencies. Options may include family rides, public transit, ADA paratransit, Medicaid nonemergency medical transportation, volunteer driver programs, taxis or ride services, and accessible transportation organizations. Eligibility, advance scheduling, service boundaries, and whether a caregiver can ride should be confirmed.
Help in the home may include home health, personal-care attendants, homemaker services, meal delivery, adult day programs, respite, or Medicaid home- and community-based services. Equipment and modifications may be covered through Medicare, Medicaid, private insurance, veterans’ benefits, vocational rehabilitation, local nonprofits, or home-repair programs. Coverage rules differ, and many modifications are not covered by standard health insurance. Obtain written estimates and ask about grants, loans, reuse programs, and tax implications before beginning major work.
Resources: ASA Driving After Stroke; ASA Living at Home After Stroke; Eldercare Locator; Rebuilding Together Safe at Home; Rebuilding Together Local Affiliates.
The three activities that are currently most difficult or unsafe are:
The equipment or home changes we want assessed are:
The professional who should evaluate each need is:
The items we will borrow or trial before purchasing are:
The funding, insurance, or nonprofit resources we will contact are:
The date we will review whether the plan is working is:
This guide provides general education and is not a substitute for individualized medical, rehabilitation, equipment, home-safety, driving, legal, or insurance advice. Equipment can create risk when it is poorly fitted, incorrectly installed, or used without training. Consult qualified professionals and verify current coverage, eligibility, product instructions, and local regulations.
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by Jake Sheaffer
“I once threw a canister of my supplement powder at the wall and dented it. That’s something I can’t imagine ever doing before my stroke, but it’s just another part of my recovery to work on.”
______________________________
On an early October weekend in 2019, Alesha Goodman and her longtime boyfriend Drew hiked over 50 miles of rugged desert landscape in the Ochoco National Forest in Central Oregon. They were on a nine-day hunting trip they’d been planning for months. While Drew streaked up the steep slopes of sagebrush and loose rock, Alesha tarried behind breathing heavily, fighting the searing pain radiating from the base of her skull. An active thirty-four-year-old who frequented local gyms, walked her dog daily, and hiked on weekends, Alesha never suspected the severe neck pain and nausea she’d had for the past week and a half were signs of an impending stroke. And not just one stroke, but two. Two potentially fatal strokes that would occur within an hour of each other the day after she returned from the Ochocos.
An only child, Alesha was close to her parents and her grandmother who lived on her parents’ property later in life. As a kid, she delivered newspapers in her Bend, OR neighborhood, and in her spare time, she wrote children’s books for fun and read voraciously, prompting close friends to refer to her as a “living encyclopedia of odd information.”
On the Monday morning after she got home, Alesha sat in traffic at a parkway off -ramp, still in discomfort from the neck pain and the nausea. She had new symptoms, too, dizziness and feeling faint. Regardless of the pain, she readied herself for work, but she had an uneasy feeling about her job.
Over the weekend, Alesha had received multiple text messages from her employer, a jewelry company in Central Oregon, about an issue with her company email and password, but with no cell reception, she couldn’t respond to her manager’s concerns. After searching through Alesha’s desk for her email password and not finding it, but instead finding an important legal document she’d already dealt with but had not yet disclosed to her boss, the company hired a specialist to get around the digital safeguards. That day, Alesha was let go from her position.
Purchase the Book to Learn More About Alesha’s Journey!