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A stroke happens when blood flow to any part of the brain stops.
Each person has a different recovery time and need for long-term care. Problems with moving, thinking, and talking often improve in the first weeks or months after a stroke. Some people will keep improving months or years after a stroke.
Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery
WHERE TO LIVE AFTER A STROKE
Most patients will need stroke rehabilitation (rehab) to help them recover after they leave the hospital. Stroke rehab will help you regain the ability to care for yourself.
Most types of therapy can be done where you live, including in the home.
Whether you can go back home after a stroke depends on:
You may need to go to a boarding home or convalescent home to have a safe environment.
For people who are cared for at home:
SPEAKING AND COMMUNICATING
After a stroke, some people may have problems finding a word or being able to speak more than one word or phrase at a time. Or, they may have trouble speaking at all. This is called aphasia.
A stroke can also damage the muscles that help you speak. As a result, these muscles do not move the right way when you try to speak.
A speech and language therapist can work with you and your family or caregivers. You can learn new ways to communicate.
THINKING AND MEMORY
After a stroke, people may have:
These problems increase the need for safety precautions.
Depression after a stroke is common. Depression can start soon after a stroke, but symptoms may not begin for up to 2 years after the stroke. Treatments for depression include:
MUSCLE, JOINT, AND NERVE PROBLEMS
Moving around and doing normal daily tasks such as dressing and feeding may be harder after a stroke.
Muscles on one side of the body may be weaker or may not move at all. This may involve only part of the arm or leg, or the whole side of the body.
Many of these problems can cause pain after a stroke. Pain may also occur from changes in the brain itself. You may use pain medicines, but check with your health care provider first. People who have pain due to tight muscles may get medicines that help with muscle spasms.
Physical therapists, occupational therapists, and rehabilitation doctors will help you relearn how to:
BLADDER AND BOWEL CARE
A stroke can lead to problems with bladder or bowel control. These problems may be caused by:
Symptoms may include:
Certain medicines your doctor may prescribe may help with bladder control. You may need a referral to a bladder or bowel specialist.
Sometimes, a bladder or bowel schedule will help. It can also help to place a commode chair close to where you sit most of the day. Some people need a permanent urinary catheter to drain urine from their body.
To prevent skin or pressure sores:
See also: Preventing pressure sores
SWALLOWING AND EATING AFTER A STROKE
Swallowing problems may be due to a lack of attention when eating or damage to the nerves that help you swallow.
Symptoms of swallowing problems are:
A speech therapist can help with swallowing and eating problems after a stroke. Diet changes, such as thickening liquids or eating pureed foods, may be needed. Some people will need a permanent feeding tube, called a gastrostomy.
Some people do not take in enough calories after a stroke. High-calorie foods or food supplements that also contain vitamins or minerals can prevent weight loss and keep you healthy.
OTHER IMPORTANT ISSUES
Both men and women may have problems with sexual function after a stroke. Medications called phosphodiesterase type 5 inhibitors (Viagra or Cialis) may be helpful. Ask your health care provider whether these drugs are right for you. Talking with a therapist or counselor may also help.
Treatment and lifestyle changes to prevent another stroke are important. This includes healthy eating, controlling illnesses such as diabetes and high blood pressure, and sometimes taking medicine to help prevent stroke.
Dobkin BH. Principles and practice of neurological rehabilitation. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 52.
Stein J. Stroke. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 149.