Tips & Tools Care Planning Template

STROKE CARE PLAN: ACTIVITIES OF DAILY LIVING All interventions must be monitored, evaluated and documented as per Home policy Any changes (improvements or deterioration) must be reported to the RN/RPN

FOCUS GOAL(S) TIMELINES INTERVENTIONS ACCOUNTABILITY

Toileting Resident will actively participate in toileting Assess resident’s readiness prior PSW/HCA Resident has difficulty using the toilet/commode/bedpan with to toileting. with toileting (using supervision/encouragement/cueing or toilet / commode/ assistance of __staff. Check that all assistive devices PSW/HCA bedpan) (transferring, and equipment are in place and bridging) related to Resident will be able to toilet self safely and secure before toileting (specify impaired mobility due appropriately with/without assistance the assistive devices required) to stroke. (specify). Provide positive feedback Resident score will improve from ___ to ___ throughout the process and PSW/HCA on the (specify ADL form) provide cueing / assistance as required.

Place toilet paper or wipes within PSW/HCA reach on non-affected side.

Use ___ staff to provide PSW/HCA assistance with toileting.

Support the affected arm with an PSW/HCA armrest or sling.

Position the resident with their feet flat on the floor when seated PSW/HCA on toilet/commode.

Educate resident/family on PSW/HCA/Registered toileting interventions. Staff

December 2011 Developed by the Ontario Stroke System in collaboration with Long Term Care Stakeholders and based on the best practice resource: Tips and Tools for Everyday Living (Heart and Stroke Foundation of Ontario, 2010) Page 1 of 4 STROKE CARE PLAN: ACTIVITIES OF DAILY LIVING All interventions must be monitored, evaluated and documented as per Home policy Any changes (improvements or deterioration) must be reported to the RN/RPN

Bathing

Resident has difficulty Resident will bathe at least one limb/body Confirm resident’s readiness PSW/HCA self-bathing related to prior to bathing. paralysis of right/left Bathing self-performance will improve or be side due to stroke maintained Provide positive feedback PSW/HCA throughout the process and provide cueing / assistance as required.

Put bathing items within reach PSW/HCA (i.e. cleansers, cloths, towels, lotions)

Check that all assistive devices PSW/HCA and equipment are in place and secure before bathing (specify the assistive devices required)

Resident will participate in PSW/HCA bathing restorative program.

Educate resident/family on PSW/HCA/Registered bathing interventions. Staff

Grooming / Personal Hygiene

Resident has difficulty Resident will actively participate in grooming Confirm resident’s readiness PSW/HCA, with grooming/ / personal hygiene with the assistance of prior grooming/personal hygiene Restorative Care personal hygiene/ face ___ staff with supervision or encouragement washing/ brushing or cueing and using the most appropriate Check that all of the resident’s PSW/HCA, teeth/ shaving/ equipment. grooming materials are within Restorative Care makeup/ combing hair/ his/her reach nail care related to paralysis of affected Resident score will improve from ___ to ___ Position the resident on a chair PSW/HCA,

FOCUS GOAL(S) TIMELINES INTERVENTIONS ACCOUNTABILITY limb due to stroke. on the (specify ADL form) or wheelchair with their feet flat Restorative Care on the floor.

Use a grab bar for safety and PSW/HCA, Grooming and personal hygiene self- support when resident standing. Restorative Care performance will improve or be maintained, Specify the support required.

Alternate rest periods with PSW/HCA, grooming activities as required. Restorative Care

Support the resident’s affected PSW/HCA, arm. Restorative Care

Provide positive feedback PSW/HCA, throughout the process and Restorative Care provide cueing/assistance as required.

Use assistive devices as PSW/HCA, required. Specify the devices. Restorative Care

Educate resident/family on PSW/HCA/Registered grooming & personal hygiene Staff interventions.

Dressing

Resident has difficulty Resident will actively participate in dressing Ask resident to select their PSW/ HCA, dressing related to of upper and lower body with the assistance clothing and accessories. Restorative Care paralysis of affected of ___ staff with supervision or limb due to stroke encouragement or cueing Position the resident in a sitting PSW/HCA, position in a firm chair with back Restorative Care Resident score will improve from ___ to ___ support, with feet flat on the on the ADL Long Form floor.

Dressing self-performance will improve or If required, help with dressing PSW/HCA,

be maintained and undressing the affected limb Restorative Care first. You may find it easier to slide your arm through the : garment from the wrist or ankle end, gently grasp the resident’s arm or leg, and draw garment up the limb.

Provide positive feedback PSW/HCA, throughout the process and Restorative Care provide cueing / assistance as required.

Use adaptive clothing and/or PSW/HCA, devices to allow resident to Restorative Care dress more independently. Specify the adaptive clothing and devices.

Educate resident/family on PSW/HCA/Registered dressing interventions. Staff

December 2011 Developed by the Ontario Stroke System in collaboration with Long Term Care Stakeholders and based on the best practice resource: Tips and Tools for Everyday Living (Heart and Stroke Foundation of Ontario, 2010) Page 4 of 4