Recovering after stroke
Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recoveryA stroke happens when blood flow to any part of the brain stops.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleEach 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.
Information
WHERE TO LIVE AFTER A STROKE
Most people 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 your home.
- People who are not able to care for themselves at home after a stroke may have therapy in a special part of a hospital or in a nursing or rehabilitation center.
Nursing or rehabilitation center
When you no longer need the amount or type of care provided in a hospital, the hospital will begin the process to discharge you. Most people hope to ...
Read Article Now Book Mark Article - Those who are able to go back home might go to a special clinic or have someone come to their home.
Whether you can go back home after a stroke depends on:
- Whether you can take care of yourself
- How much help there will be at home
- Whether the home is a safe place (for example, stairs in the home might not be safe for a stroke patient who has trouble walking)
You may need to go to a boarding home, adult family home, or convalescent home to have a safe environment.
For people who are cared for at home:
- Changes may be needed to stay safe from falls in the home and bathroom, prevent wandering, and make the home easier to use. The bed and bathroom should be easy to reach. Items (such as throw rugs) that may cause a fall should be removed.
Safe from falls in the home
Older adults and people with medical problems are at risk of falling or tripping. This can result in broken bones or more serious injuries. Use the ...
Read Article Now Book Mark ArticleBathroom
Older adults and people with medical problems are at risk of falling or tripping. This can result in broken bones or more serious injuries. The bat...
Read Article Now Book Mark ArticleWandering
It is important to make sure the homes of people who have dementia are safe for them.
Read Article Now Book Mark Article - A number of devices can help with activities such as cooking or eating, bathing or showering, moving around the home or elsewhere, dressing and grooming, writing and using a computer, and many more activities.
- Family counseling may help you cope with the changes needed for home care. Visiting nurses or aides, volunteer services, homemakers, adult protective services, adult day care, and other community resources (such as a local Department of Aging) may be helpful.
- Legal advice may be needed. Advance directives, power of attorney, and other legal actions may make it easier to make decisions about care.
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.
- People who have had a stroke may be able to put many words together, but they may not make sense. Many people do not know that what they are saying is not easy to understand. They may get frustrated when they realize other people cannot understand. Family and caregivers should learn how best to help communicate.
How best to help communicate
Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs after strokes or traumatic brain injuries. I...
Read Article Now Book Mark Article - It can take up to 2 years to recover speech. Not everyone will fully recover.
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. This is called dysarthria.
A speech and language therapist can work with you and your family or caregivers, and you may be able to learn new ways to communicate.
Learn new ways to communicate
Dysarthria is a condition that occurs when there are problems with the part of the brain, nerves, or muscles that help you talk. Most times, dysarth...
Read Article Now Book Mark ArticleTHINKING AND MEMORY
After a stroke, people may have:
- Changes in their ability to think or reason
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Changes in behavior and sleep patterns
Changes in behavior and sleep patterns
People with dementia often have certain problems when it gets dark at the end of the day and into the night. This problem is called sundowning. The...
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- Poor judgment
These changes may lead to:
- An increase in the need for safety measures
Need for safety measures
It is important to make sure the homes of people who have dementia are safe for them.
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Changes in ability to drive
Changes in ability to drive
If your loved one has dementia, deciding when they can no longer drive may be difficult. They may react in different ways. They may be aware they ar...
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Other changes or precautions
Other changes or precautions
People who have dementia may have trouble with: Language and communicationEatingHandling their own personal care
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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:
- Increased social activity, including potentially more visits in the home or going to an adult day care center for activities.
- Medicines for depression.
- Visits to a therapist or counselor.
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.
- Muscles on the weak side of the body may be very tight.
- Different joints and muscles in the body may become hard to move. The shoulder and other joints may dislocate.
Joints and muscles in the body may beco...
Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, deep tendon reflexes, like a knee-jerk re...
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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 (sometimes called physiatrists) can help you relearn how to:
- Dress, groom, and eat
- Bathe, shower, and use the toilet
- Use canes, walkers, wheelchairs, and other devices to stay as mobile as possible
- Possibly return to work
- Keep all of the muscles as strong as possible and stay as physically active as possible, even if you cannot walk
- Manage muscle spasms or tightness with stretching exercises and braces that fit around the ankle, elbow, shoulder, and other joints
BLADDER AND BOWEL CARE
A stroke can lead to problems with bladder or bowel control. These problems may be caused by:
- Damage to part of the brain that helps the bowels and bladder work smoothly
- Not noticing the need to go to the bathroom
- Problems getting to the toilet in time
Symptoms may include:
- Loss of bowel control, diarrhea (loose bowel movements), or constipation (hard bowel movements)
- Loss of bladder control, feeling the need to urinate often, or problems emptying the bladder
Your provider may prescribe medicines to 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.
Urinary catheter
You have an indwelling catheter (tube) in your bladder. "Indwelling" means inside your body. This catheter drains urine from your bladder into a ba...
Read Article Now Book Mark ArticleTo prevent skin or pressure sores:
Pressure sores
A pressure sore is an area of the skin that breaks down when something keeps rubbing or pressing against the skin.
Read Article Now Book Mark Article- Clean up after incontinence.
- Change position often and know how to move in a bed, chair, or wheelchair.
- If you have a wheelchair, make sure it fits correctly.
- Use cushioning of parts of your body, especially ones that have thinner skin or may have prolonged pressure on them.
- Have family members or other caregivers learn how to watch out for skin 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:
Swallowing problems
Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This proble...
Read Article Now Book Mark Article- Coughing or choking, either during or after eating
- Gurgling sounds from the throat during or after eating
- Throat clearing after drinking or swallowing
- Slow chewing or eating
- Coughing food back up after eating
- Hiccups after swallowing
- Chest discomfort during or after swallowing
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
People may have problems with sexual function after a stroke. Medicines called phosphodiesterase type 5 inhibitors (such as Viagra, Levitra, or Cialis) may be helpful. Ask your 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 another stroke.
References
Centers for Disease Control and Prevention website. Treatment and intervention for stroke. www.cdc.gov/stroke/treatment/?CDC_AAref_Val=https://www.cdc.gov/stroke/treatments.htm. Updated May 14, 2024. Accessed June 19, 2024.
Del Brutto VJ, Rundek T, Sacco RL. Prognosis after stroke. In: Grotta JC, Albers GW, Broderick JP, et al, eds. Stroke: Pathophysiology, Diagnosis, and Management. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 17.
Dobkin BH. Neurological rehabilitation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 55.
Stein J. Stroke. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 159.
Review Date: 8/20/2023
Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.