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Mary Free Bed's Rehabilitation Experts Help You Regain Self Care Skills Following Stroke

Self care skills include:

  • Eating
  • Oral hygiene
  • Hair and facial care
  • Dressing
  • Bathing or showering
  • Toileting

How Stroke Affects Self Care

Physical problems resulting from a stroke, may mean that you aren't able to perform self-care activities. Problems may include:

Sensory and Motor

  • Lack of strength and sensation preventing movement of the affected side
  • Balance and/or coordination problems interfering with positioning and smooth movements or fine motor control


  • Lack of initiation and follow through
  • Poor judgment and safety awareness
  • Difficulty sequencing
  • Poor memory
  • Short attention span

Visual and Perceptual

  • Difficulty judging distance
  • Difficulty seeing in all directions, especially toward the affected side of the body
  • Difficulty locating objects
  • Difficulty recognizing objects

When physical, cognitive, visual, or perceptual impairments are present, you may not be able to complete basic care needs and may need verbal and/or physical assistance. For example, to think through a task completely, you may need reminding to dress the affected side of an extremity first.



Following a stroke, dressing can be one of the most challenging, but also the most rewarding, activities of the day. Dressing involves vision, motor skills, balance, perceptual skills, and cognitive skills. Clothing for therapies should be comfortable and casual with minimal fasteners. Many find jogging or sweat outfits to be the easiest and most comfortable during the therapy workday. Having your own clothing and shoes available is essential for the morning therapy program.

A Mary Free Bed occupational therapist teaches you methods and strategies to increase independence. Every morning, you'll work to learn one-handed techniques, compensatory strategies, and safe positioning. When physically possible, dressing is done out of bed and in the same place each day. Dressing in the same manner and in the same place helps maintain good habits and make the most of learned skills. You're encouraged to do as much of the task as safely possible to help facilitate independence.

Some common problems related to gathering clothing and putting on clothes following a stroke include: 

  • Locating clothing in closet or dresser
  • Selecting appropriate or desired items
  • Maintaining sitting balance and/or standing balance during activity 
  • Planning the dressing process
  • Finding sleeve and pant leg holes
  • Determining front from back
  • Dressing the affected arm and leg
  • Pulling garments over head and affected shoulder 
  • Tying shoes


Performing grooming and hygiene activities require motor, cognitive, and perceptual skills. Grooming and hygiene items used during therapy are usually kept where you can easily reach or retrieve them. Your occupational therapist helps maximize independence with hair care, face washing, teeth cleaning, make-up application, and shaving. Instructions for using one-handed techniques and adaptive equipment, as well as repeated practice, provide training needed to increase independence. Since you may be on blood-thinning medications, using an electric shaver is recommended for your safety.

Common problems related to grooming: 

  • Identifying hygiene items appropriately
  • Seeing and locating items on counter top, especially on affected side
  • Using one extremity to brush teeth/clean dentures, wash face, shave
  • Using non-dominant hand if dominant hand was affected by stroke
  • Shaving or applying make-up/creams to both sides of face


Another essential activity of daily living is toileting. Mary Free Bed's therapists take great care to protect your dignity and privacy during this activity as well as with other personal self-care tasks. Safe toileting requires the use of sensory-motor skills, balance, and cognitive skills. 

Common problems related to toileting:  

  • Managing clothes and fasteners 
  • Safely transferring on and off a toilet or commode chair 
  • Safely maintaining sitting or standing balance 
  • Cleansing 
  • Caring for continence needs


Bathing the entire body in the shower, tub, or at the sink, from a seated or standing position, is difficult if vision, strength, endurance, balance, sensation, or body awareness are impaired. Therapists work with you and your family to address equipment needs for safety and increasing independence. Having equipment within reach and easily accessible during bathing minimizes the need for help. However, because wet surfaces increase the risk of falling, you may need help.

Common problems related to bathing: 

  • Determining a safe and appropriate water temperature
  • Transferring on and off wet shower/tub bench safely 
  • Managing soap, washcloth, shampoo with one extremity 
  • Washing back and below knees

Home Management

The amount of emphasis and training in home management activities varies based on:

  • Your needs
  • Your physical and cognitive abilities
  • Intended discharge site
  • Amount of support available to you after discharge

Activities addressed during your stroke rehabilitation therapy may include:

  • Meal prep and clean up
  • Laundry
  • Cleaning
  • Shopping
  • Money management
  • Household maintenance
  • Safety
© 2015 Mary Free Bed Rehabilitation Hospital., Grand Rapids, MI | 1.855.MFB.REHAB
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