As a result of these observations the team decides that Joan needs a more organised timetable which addresses the timing, intensity and nature of the interventions. The team get together and discuss how best to manage her fatigue and also enhance her activity levels.
Select the crosses next to the headings below to find out how you could maximise the benefits of early mobilisation for Joan.
CHSS: Positioning for People Affected by Stroke [.pdf]
Joan now has an organised timetable and is better able to actively participate in therapy. What does her therapy involve?
Select the crosses next to the headings below to find out how you could maximise the benefits of early mobilisation for Joan.
Toilet – Regular toileting is important in the management of stroke. Joan could stand with support, from staff or a weight-bearing hoist, to carry out the transfer from wheelchair to toilet. Nurses and therapists, and possibly relatives with appropriate guidance, could assist her in this function.
Meals – Adequate nutrition is vital and positioning to aid digestion and to facilitate use of her arms during feeding is important. She should be positioned in a well-fitting chair and encouraged to eat normally. Therapists and nurses could guide Joan in the use of her affected arm during the activity of feeding, but it is also important that Joan has protected time to eat and socialise. She may wish to join other patients in this activity.
Visiting – Visiting by family and friends should be encouraged in order to stimulate and motivate Joan throughout her rehabilitation journey. However, it should be timed appropriately so as not to add to her fatigue. She should be well positioned in a chair to enable normal interaction. A wheelchair could be used to take Joan off the ward to socialise in a more natural way.
Sessions with therapists – Joan has daily sessions with speech and language therapists, occupational and physiotherapists, supported by the stroke unit nurses. The timing, content and duration of therapies should be well managed so as to maximise the benefits of early mobilisation whilst avoiding the detrimental effects of excess fatigue. Therapists and nurses should consider joint therapy/care sessions to achieve this. See next page for more details about the delivery of specific interventions.
Rest – Protected rest times need to be discussed and agreed with the patient and the team so that all know why and when they are occurring, this needs to be reviewed regularly as the patient improves to increase stamina.
Page last reviewed: 27 Mar 2021
