Stroke Care: How to Help Stroke Survivors Regain Skills
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The medical emergency of having a stroke can change every aspect of an individual’s life. The physical effects are the most obvious, they can include difficulty walking, speaking, moving, sleeping, and involve profound changes in strength and motor functionality. Daily activities that we tend to take for granted like cooking, cleaning, bathing, driving, and taking the dog for a walk can be brought to a sudden halt with the onslaught of a stroke. The emotional toll that a stroke has on the stroke survivor and his/her family can be life-changing and profound. While the effects of stroke vary for everyone, for many, the stroke survivor requires extensive care from family and friends in supporting their recovery.

Perspective on Stroke Treatment

About 800,000 people have a stroke each year in the United States. For those who survive, the overwhelming majority require rehabilitation therapies. Stroke care at rehabilitation centers provide treatments that share the goal to optimize how the person functions after a stroke and to achieve the best possible quality of life.

Thanks to amazing advances in emergency stroke treatment, damage to the brain can be limited and reduced in ways that were not possible only a few years ago. The disability that a person who has a stroke experiences and the rehabilitation that is needed depends on the size of the brain injury and the particular portion of the brain that has been damaged. But, can the brain heal itself after a stroke? The good news is that research shows that the brain has the ability to rewire its circuits after a stroke. This can lead to some degree of improved function over months to years. In cases when rehabilitation can’t reverse brain damage, it can and often does help a stroke patient achieve the best long-term outcome.

Although generalizing on a person’s chances of recovery is not the best idea, the National Stroke Association compiled the following overall statistics on stroke recovery:

  • 10% of stroke survivors recover almost completely
  • 25% recover with minor impairments
  • 40% experience moderate to severe impairments requiring special care
  • 10% require care in a nursing home or other long-term care facility
  • 15% die shortly after the stroke

There are so many nuances and variations of how a stroke affects a person, so each person’s post-stroke care plan can vary. Physical and mental abilities can be compromised or permanently damaged. The emotional impact also requires care and attention when one is in recovery.

Once the initial days and weeks of a stroke have been addressed, the rehabilitation process takes over. The main thing to be aware of is that the brain is a marvel and that it can heal and recover. Recovery after a stroke is an individual process. For recovery to be as successful as possible, rehabilitation therapies need to take into account the whole individual. Consistent support is vital in the recovery process. Whatever therapies are used, across the board, physical and mental exercise is a major component in stroke care.

Exercises for Stroke Rehabilitation

Let’s look at a brief overview that covers the physical, speech, and mental exercises that have been used to support people in their recovery. Exercise is vital in stroke care. Of course, exercise needs to be worked on with a physical therapist. The spectrum of disability is wide. It can run from being generally able to move but experiencing fatigue to being paralyzed.

Many people experience paralysis or profound weakness on one side of the body. There are physical therapists who can help with figuring out what sort of exercise one can do to function and help gain strength.

Physical exercises: Post-stroke, arm, finger, and leg exercises can help to regain movement and motor skills, especially those needed to drive. Your rehabilitation center, physical therapist or occupational therapist probably practiced these exercises with your loved one while in rehab. It is important to continue these exercises regularly at home and to be patient. Your loved one is bound to get discouraged. Remind him or her of the goals that have been set and provide encouragement to continue with the exercises. Remember to meet your loved one where they are and build on their abilities while gently encouraging them through the more difficult aspects of their recovery.

  • Exercises in bed. For those who are in early days of recovery, lying in bed and stretching can be a good start.
  • Balancing exercises. Many people experience difficulty with their balance. Moving slowly, developing strength, regaining confidence on stairs or walking in the park can be a long process. The use of a cane or walker might be needed for a period of time.
  • Resting and taking it slowly. Frequent resting while exercising is important. Recovery is not a race. Being gently consistent with exercise is best. Slow and steady wins this race.

Speech exercises: If the stroke affected your loved one’s speech, he or she will continue to work with a speech and language therapist. You can support this work at home by helping your loved one continue the exercises.

If speech has been significantly interrupted, you will need to find new ways to communicate. Some words may be easy for your loved one to say while others may be impossible for him or her to recall or articulate. Develop sign language and other cues so that you can communicate. Avoid situations where your loved one feels distraught or discouraged because you cannot speak to one another.

A stroke may cause aphasia which is difficulty expressing oneself verbally, trouble understanding speech, or difficulty with reading and writing. There are different types of aphasia that will require different therapies to regain speech:

  • Expressive aphasia. Knowing what you want to say but not finding the words you need to share the thoughts.
  • Receptive aphasia. Hearing someone talking or see the printed page but not making sense of the words.
  • Anomic or amnesia aphasia. People that have the least severe form of aphasia have difficulty in using the right names for objects, people, places, or events.
  • Global aphasia. This is the most severe, caused by widespread damage to the language areas of the brain. Stroke survivors with global aphasia cannot speak or understand speech, nor can they read or write.

When caring for someone with aphasia, be sure to get some coaching on how to communicate with someone who is experiencing difficulty expressing themselves.

Mental exercises. A stroke may also affect memory. It is possible to recover from memory loss over time. The most important reason to engage your loved one in mental exercises is to regain memory and prevent another stroke. According to the new Center for BrainHealth research at The University of Texas at Dallas, cognitive brain training improves executive function while aerobic activity improves memory. Some of the most effective ways to work the brain include:

  • Learn a new skill or hobby. Help them learn to knit, paint, color or do yoga. Hobbies that exercise both the body and the mind are most beneficial for stroke survivors.
  • Listen to music. Turn on some music and enjoy it together. Studies have shown that stroke survivors who listen to music show lower rates of depression and increased functionality in a shorter period of time than the control groups that didn’t.
  • Exercise. Believe it or not, one of the most beneficial mental exercises is physical exercise. Something as simple as walking can increase the flow of blood and oxygen to the brain, improving memory and cognition.
  • Spend time with your pet. If there is a pet in the house, spend time with your fine furry (or feathered) friend. Pets calm us with their unconditional love and when we are recovering from any illness they are there for us.
  • Spend time in nature. Go outside and be with trees, walk or sit in a garden with your loved one.

Stroke home care and recovery is not an easy road but there is a lot of support available to you and your loved one. Rely on the therapists you met in rehab for ongoing support and call your loved one’s primary care physician if you need help. Also, for caregivers, given that during these days many medical offices are limited in the services that they can provide due to Coronavirus concerns, research online for experts who can provide many ideas and viable exercises that can support the physical, mental, and emotional recovery for your loved one.

Recovery can be a lifelong process. Support groups are important to your loved one as he or she takes on a life of rehabilitation. Talking to others and sharing experiences will bolster your loved one’s courage and help to avoid feelings of isolation. Stroke survivors are resilient and communicating with each other is a key part of recovery. Your loved one may be angry, anxious or depressed after suffering a stroke. Fellow survivors can help your loved one to walk through those stages of recovery.

Resources

Post-Stroke Rehabilitation Fact Sheet

How Walking Can Promote Stroke Recovery

Recovery After Stroke

Rehabilitation After Stroke: Current State of the Science

Mental, physical exercises produce distinct brain benefits

Active Music Therapy Approach for Stroke Patients in the Post-Acute Rehabilitation

Exercises that can be done in bed

About the Author(s)

As a Volunteer Caregiver to the Zen Hospice Project and a Course Manager at the CareGivers Project, Audrey Meinertzhagen is passionate about improving the standards of care for older adults and educating caregivers on the principles of mindfulness and self-care.

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