Stroke Recovery: What Can I Do Now?

A stroke is a brain injury that occurs when the blood supply to the brain stops. The brain is the central organ of the human nervous system, controlling motor and sensory functions throughout the body. As such, a stroke can affect a person's cognitive and physical abilities. The effects of a stroke depend on which part of the brain was damaged and how much damage occurred. A stroke can cause permanent loss of function, and early treatment and rehabilitation are key to improving recovery. Most people will need stroke rehabilitation to help them regain their independence and recover their ability to care for themselves.

Can I live at home after a stroke?

The goal for all stroke survivors is to return home and resume their daily routines. However, leaving the hospital can be daunting, as you may have concerns about your changed abilities and new challenges. Here are some factors to consider and adjustments to make that can help you live at home safely and comfortably after a stroke:

Ability to Care for Yourself

One of the key considerations is your ability to perform daily tasks independently. Rehabilitation should focus on helping you regain skills in areas such as eating, dressing, and bathing. It is important to work on your ability to care for yourself to determine if you can safely live at home.

Ability to Follow Medical Advice

Adhering to medical advice is vital for your recovery and preventing another stroke or complications. Make sure you take any prescribed medication and follow the recommendations provided by your healthcare team. This includes making recommended lifestyle changes, such as improving your diet and incorporating gentle exercises into your routine.

Caregiver Availability

It is essential to have a caregiver or support system in place to assist you when needed. Ask family members or friends to help you with tasks around the house or accompany you to medical appointments. If you don't have a dedicated caregiver, discuss alternative options with your medical team.

Ability to Move Around and Communicate

Your ability to move around and communicate effectively is crucial for your safety and independence. If you struggle with mobility or communication after your stroke, you may require additional support or adaptations to your living environment.

Home Adjustments for Safety and Accessibility

To live safely at home after a stroke, you may need to make some adjustments. First, conduct a thorough inspection of your home and remove any potential hazards. This can include picking up throw rugs, testing bathwater temperature, and wearing rubber-soled shoes to prevent slips and falls. You may also need to install handrails in the bathroom and other areas to enhance your safety and independence. Additionally, rearranging furniture or building ramps can improve your accessibility and ease of movement within your home.

Independence Aids

To maximize your independence, consider adding special equipment to your home, such as grab bars or transfer benches. These aids can make a significant difference in your daily life and help you perform tasks with greater ease.

Alternative Accommodation Options

If your needs cannot be adequately met at home, even with adjustments, alternative accommodation options are available. These include supported living, sheltered housing, or a nursing home. Your healthcare team and social services can guide you in choosing the most suitable option based on your specific needs and circumstances.

Can I work after a stroke?

Returning to work after a stroke is a big decision and a significant change. It can be challenging, but with the right care, support, and advice, many people do return to work. Planning ahead and setting realistic goals can help you through the process. Here are some important things to consider:

Timing and Recovery:

The time it takes to return to work depends on the severity of your stroke and your individual side effects. Every stroke is unique, and recovery varies for each person. Some people may return to work within a few weeks, while others may take months or even years. It's important to follow your treatment plan and focus on your rehabilitation. Talk to your doctors, nurses, and therapists about what to expect and when you might be able to return to work.

Workplace Accommodations:

Before returning to work, discuss your needs and limitations with your employer. They are legally required to provide reasonable accommodations for employees with disabilities under the Americans with Disabilities Act (ADA). Be open about your condition and the adjustments you may require. Your employer should work with you to identify what adjustments can be made, such as changing work times, transferring to another position, or providing specialist equipment.

Support and Resources:

There are various resources available to help you plan your return to work and navigate any challenges. These include vocational rehabilitation services, job coaches, and government schemes like "Access to Work," which provides funding and support for disabled people in the workplace. You can also seek advice from occupational therapists, speech and language therapists, and support groups specifically for stroke survivors.

Communication with Employer:

Stay in touch with your employer during your recovery. Let them know about your rehabilitation progress and when you plan to return to work. Ask about their policy on returning to work after sick leave and request a copy of your current job description or any alternative roles you may be considering. Be open about your needs and work together to develop a return-to-work plan that accommodates your recovery.

Financial Support and Benefits:

It's important to understand your financial situation and any benefits you may be entitled to during your recovery. These could include disability benefits, income protection insurance, or government schemes like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Remember that returning to work doesn't necessarily mean going back to the same job with the same responsibilities. You may need to explore other options, such as retraining or changing careers.

Remember that your recovery and return to work are unique to your situation. Take the time you need, seek support, and make informed decisions about your return to work after a stroke.

Can I drive after a stroke?

Driving after a stroke is a complex issue as the effects of a stroke vary from person to person. The severity of the stroke and the secondary effects that follow will determine whether or not survivors can safely resume driving. Many people who have had mild strokes are able to drive soon after, but those with more severe secondary effects, such as impaired mobility, vision, or cognition, may need rehabilitation.

If you have had a stroke, it is important to discuss with your doctor or healthcare professional whether it is safe for you to drive, and if so, whether you need to modify your car. You should also check with your state or country's Department of Motor Vehicles to see if your physician must report your health status before you can drive again.

If you are in the UK, you must stop driving for at least one month after a stroke or transient ischaemic attack (TIA). You can restart only when your doctor tells you it is safe. If you still have weakness in your arms or legs, problems with your eyesight, or problems with balance, memory or understanding after this period, you must inform the DVLA.

In the US, the National Mobility Equipment Dealers Association can help you explore mobility equipment options, locate dealers and funding sources.

If you are unable to drive after a stroke, there are still many resources available to help you get around. For example, if your community has public transportation, it may also offer free paratransit services for those with disabilities.

Can I walk after a stroke?

Walking is a complex task that requires the integration of multiple systems in the body. After a stroke, you may realise just how intricate the process of walking is, as moving your body can become more challenging.

Strokes can damage parts of your brain that coordinate your movements, causing brain signals to become scrambled. Your mind and muscles may not work together as well as they did before. Specific issues that can occur include:

• Weakness: Many people experience weak muscles after a stroke, which can affect a small area or one side of the whole body.
• Spasticity: This occurs when muscles stay tight and are difficult to stretch. For example, you may have a clenched fist or an arm pressed against your chest.
• Foot drop: This happens when the muscles in your feet are weak or cannot be moved, causing you to drag your toes on the ground and making it easier to trip.
• Changes in feeling: You may experience a loss of feeling or get pins and needles in your legs or feet. Some parts of your body may also become very sensitive and painful.
• Tiredness: Basic activities may now require a lot of energy and concentration, causing you to get worn out more easily.
• Coordination problems: Damage to your brain can affect how your body controls movement, resulting in ataxia, which can make you feel awkward or clumsy.
• Balance problems: You may experience dizziness or feel unsteady on your feet.

Rehabilitation and Recovery

After a stroke, your healthcare team will start helping you regain your abilities, including walking. Rehabilitation nurses, physical therapists, and occupational therapists will play a crucial role in your recovery. They will create a specific plan tailored to your unique needs and abilities to help you relearn basic tasks and improve your strength and balance.

Physical therapy will involve a combination of passive stretches, active exercises, and therapeutic modalities. Some recommended exercises include:

• Seated marches: Raising one leg at a time towards the chest while sitting, then relaxing the leg back down.
• Toe taps: Raising the toes and then lowering them back down while starting with the feet flat on the floor.
• Sit-to-stands: Beginning in a seated position and pushing up to a standing position, using support if needed, before returning to a seated position.

Gait training and balance training are also essential components of post-stroke rehabilitation. These techniques help improve your walking pattern, balance, coordination, and increase the strength of your hips, knees, and ankles for better support during movement.

Aids and Devices

During your recovery, you may need to use walking aids or devices such as canes, walkers, or wheelchairs. There are various types of walkers available, including front-wheeled and four-wheeled walkers. As your strength, balance, and coordination improve, you may be able to transition to less stable walking devices or walk without a mobility aid.

Recovery Timeline

The majority (up to 85%) of stroke survivors can walk independently by six months after their stroke. However, recovery timelines can vary, and some individuals may require more time and effort to regain their walking ability. The first 3-6 months after a stroke are crucial for neuroplasticity, which is when the greatest improvements tend to occur. Even if independent walking is not achieved during this initial period, it is still possible to make improvements years after a stroke.

Can I talk after a stroke?

Yes, you may be able to talk after a stroke, but it is common to experience difficulties with communication. This is known as aphasia, which is a language disorder that affects your ability to communicate, including both written and oral speech skills. Aphasia can result in difficulty speaking, reading, writing, and comprehending, among other things. It happens when you're no longer able to understand or use language.

A stroke occurs when the supply of oxygen-rich blood to the brain is interrupted. When brain cells are deprived of oxygen, they begin to die, and blood flow must be restored as soon as possible to preserve brain tissue. The most common cause of a stroke is impaired blood supply to the brain, known as an ischemic stroke, which can occur due to a partial or complete blockage of a blood vessel. Less often, strokes are caused when a vessel in the brain leaks or bursts, known as a hemorrhagic stroke.

A stroke can affect your ability to talk because it damages parts of your brain that control speech and language. Speech is a complex task that involves many different skills, such as sentence production and word retrieval, and different areas of the brain contribute to these various speech-related skills. So, depending on which areas of the brain are affected by the stroke, different types of speech difficulties may occur, including the inability to talk.

Types of Speech Disorders

If you can't talk after a stroke, you may be diagnosed with one of the following speech disorders:

• Aphasia: As mentioned, aphasia is a language disorder that affects your ability to communicate through written or oral speech. People with aphasia may be able to understand language but can't speak, or they may be able to talk but don't make sense, with their sentences jumbled or made up of random words. Aphasia can also affect one's ability to read or write.
• Dysarthria: This is a motor speech disorder that causes difficulty controlling the muscles used for speech, such as the tongue, lips, and other parts. People with dysarthria may speak too softly or slowly, or their speech may become slurred or difficult for others to understand.
• Apraxia of speech: This is also a motor speech disorder that causes difficulty coordinating the oral muscles to form words. This can result in inconsistent and unpredictable errors in speech.

Treatment for Speech Disorders After a Stroke

If you are experiencing difficulties with speech after a stroke, it is important to work with a speech-language pathologist or speech therapist. They can help assess your cognitive communication skills, motor speech skills, and other areas involved with communication. They will also develop a rehabilitation program tailored to your specific needs and goals.

Treatment options may include:

• Programmed stimulation: This therapy technique uses sensory aids such as music and pictures to help build verbal communication skills.
• Cognitive linguistic therapy: This technique uses emotional responses to language to strengthen language comprehension.
• Promoting Aphasic’s Communicative Effectiveness (PACE): PACE is a conversation-based model that uses pictures as prompts to build communication skills.
• Stimulation-facilitation therapy: This technique helps individuals relearn word meanings and grammar.
• Group therapy: Individuals with speech difficulties can come together to practice their skills and support one another.
• Family therapy: This allows individuals and their family members to build communication skills under the guidance of a speech therapist.

In addition to these therapies, it is important to practice, practice, practice. The more you work on your communication skills, the better they will become. This can include practicing with writing pads, cue cards, pictures, gestures, computer programs, and other tools.

While most recovery takes place in the first few months after a stroke, it is possible to continue improving for years.

Frequently asked questions