Epilepsy Care at Home

Types of Seizure

There are many types of seizure — not all involve convulsions:

• Tonic-clonic seizures — what most people think of as a "grand mal": loss of consciousness, stiffening and jerking. The most recognisable type.
• Absence seizures — brief episodes of staring and unawareness, lasting a few seconds. May look like the person is simply distracted.
• Focal seizures — begin in one part of the brain. May cause unusual sensations, automatic movements, confusion or temporary changes in awareness.
• Atonic seizures — sudden loss of muscle tone, causing collapse or "drop attacks". Significant injury risk.
• Myoclonic seizures — sudden brief muscle jerks, often in the morning.

Each person's epilepsy is unique. The care team will provide a Seizure Action Plan specific to the individual — carers must read and follow this.

Seizure First Aid

For a tonic-clonic (convulsive) seizure:

1. Stay calm and time the seizure
2. Protect from injury — clear hard or sharp objects away. Cushion the head with something soft.
3. Do NOT restrain the person or put anything in their mouth
4. After convulsions stop, turn into the recovery position (onto their side)
5. Stay with them until fully recovered. Speak calmly and reassuringly.
6. The person may be confused or tired after a seizure (the "postictal" phase) — this is normal and can last minutes to hours
7. Record duration and type of seizure in the seizure diary

Home Safety

The home environment should be adapted to reduce seizure-related injury risk:

• Bathroom — shower rather than bath where possible. If a bath is used, it should not be locked; keep water shallow. A carer should be accessible.
• Kitchen — use the back hobs where possible; use a microwave rather than the hob; protect against hot surfaces
• Stair safety — stair gates, carpeted stairs, a handrail on both sides
• Furniture — padding on sharp corners in areas the person frequently uses
• Seizure alert devices — bed monitors, movement sensors, and wearable devices that detect seizures and alert carers or family

Medication — Critical Importance

Anti-epileptic drugs (AEDs) must be taken at the same time every day without exception. Missing a dose or taking it late can trigger a seizure even in people whose epilepsy is otherwise well controlled.

Key points for carers:

• Medication must be prompted at the exact prescribed time every day
• Different brands of AEDs should not be interchanged without GP advice — this can affect seizure control
• Many AEDs interact with other medications and with grapefruit juice — be aware of this
• If a dose is missed, follow the instructions in the Seizure Action Plan — do not simply double the next dose
• Some AEDs require regular blood tests to monitor levels — carers can assist by ensuring appointments are kept

How Home Care Helps

A home carer provides both practical support and a safety presence:

• Medication prompts — the most important thing a carer does for someone with epilepsy. Consistent medication timing is the most effective way to reduce seizure frequency.
• Seizure response — trained in the individual's Seizure Action Plan; able to respond calmly and correctly to a seizure
• Seizure diary — recording seizure frequency, duration and type. This information is vital for the neurologist to optimise treatment.
• Safety monitoring — being present during higher-risk activities (bathing, cooking) where a seizure could be dangerous
• General practical support — meals, housekeeping, shopping
• Companionship — epilepsy can be socially isolating due to unpredictability. Consistent company and social engagement support mental wellbeing.

Common Seizure Triggers

Avoiding known triggers reduces seizure risk:

• Missed medication
• Sleep deprivation
• Stress and anxiety
• Alcohol
• Flickering lights (photosensitive epilepsy)
• Illness and fever
• Hormonal changes (in women)