More than 7 million Americans are survivors of a stroke, the “brain attack” that occurs when an area of the brain is cut off from normal blood flow. Every year in the United States, 800,000 people experience a new or recurrent stroke, and while some people recover completely from a stroke, nearly 70 percent of stroke survivors undergo rehabilitation to help recover from post-stroke disabilities such as limb weakness, paralysis, cognitive deficits or inability to speak.
Starting in the early 1950s, the American Heart Association pioneered stroke research and in 1998 founded its American Stroke Association (ASA) division to work with volunteers, researchers and other partners to prevent stroke, improve patient outcomes and maximize recovery from a stroke. The ASA and stroke associations in several other countries support World Stroke Day, Oct. 29, and its 2018 theme, “Support for Life After Stroke.” This year’s campaign focuses on support and advocacy for stroke survivors and their caregivers.
“The American Stroke Association is the leading voice in the United Sates for stroke awareness and is devoted to saving people from a stroke,” said Dr. Mitchell Elkind, professor of neurology and epidemiology at Columbia University in New York City. “Stroke is the fifth-leading cause of death in the country … and the leading cause of serious long-term disability in the U.S.”
Dr. Elkind is chair of the ASA advisory committee and a board member of the American Heart Association. A vascular neurologist, Dr. Elkind specializes in brain disease, particularly strokes and other conditions that affect blood vessels that deliver blood the brain.
“We first learned a lot about how to prevent strokes, and more recently we learned how to treat them when they are occurring acutely, but the rehabilitation and recovery is a bit of a black box still,” Dr. Elkind notes. “We are really just beginning to understand how to help the brain recover after a stroke.”
Key Challenges for Stroke Survivors
Recovery after a stroke is often a mix of hope and anxiety. Once stabilized, the stroke patient may be transferred to inpatient or acute rehabilitation or discharged to a skilled nursing facility. The patient’s hospital medical team or personal physician can help with a referral to an accredited, reputable rehabilitation facility or home care therapist who can assist with further stroke care. Whenever possible, the goal for the patient to return to their own safe, home environment.
Dr. Elkind divides the challenges of stroke survivors into four areas: physical, communication, emotional and family/financial/social. “Physical challenges, like weakness, the inability to walk, a tendency to fall or trouble swallowing, affect daily activities,” Dr. Elkind said. Pain can also be a problem following a stroke, caused a deformity or an injury to the brain itself. Fatigue is also a common physical challenge after a stroke.
Slurred speech and aphasia, a language disorder that impairs one’s ability to speak or understand others, can cause difficulty. Cognitive changes, such as shortened attention span, memory loss, or distractibility, can affect social interactions. Some stroke survivors cannot control inappropriate behaviors, or they repeatedly stay with one topic in conversation.
Emotional challenges, such as depression, are extremely common, Dr. Elkind notes. Anxiety and symptoms like PTSD often appear. Some people experience episodes of laughter or crying that they cannot control. “All those things take their toll.”
Dealing with medical costs and loss of income certainly affects stroke survivors. Learning new roles within the family and other relationships can be difficult. One’s sense of self can be challenged, especially if the body doesn’t function as before.
Help for Life After a Stroke
Recovery from a stroke depends on many factors including what part of the brain was affected, overall health and determination, and caregiver support. Patients may need ongoing rehabilitation either at an outpatient rehab facility or in the home.
Because stroke recovery takes time, family caregivers are at risk for compromising their own health and family responsibilities. “After a stroke, it is paramount that family caregivers develop a strong support system of medical staff, other family and friends, professional caregivers and community resources,” said Cathy Queen, R.N., owner of Right at Home of the Rivercities.
“One of the greatest needs outside post-stroke care and help with everyday activities is ensuring family members get much-needed respite care for themselves and have time to take care of their own needs, such as going to a movie or out to lunch with friends,” she noted.
Queen recommends family caregivers stay in touch with the hospital case manager or social worker to learn about rehabilitation services and community resources. She shares these stroke care tips:
• A change in condition can spur a change in treatment. A decline in a stroke survivor’s physical function may mean the loved one is eligible for more services.
• Consider a rehabilitation tune-up. “After initial rehabilitation, many stroke patients can use a bit of a tune-up, periodically doing more therapy or trying another course of therapy,” Dr. Elkind advises. “A good ongoing relationship with either a neurologist, physiatrist or rehabilitation specialist can be helpful.”
• Stay updated on insurance coverage. Clarify what inpatient and outpatient services are covered, for how long, and expected out-of-pocket costs.
About Right at Home of the Rivercities
Right at Home of the Rivercities has been serving the needs of people in the Tri-State nearly 10 years. Right at Home of the Rivercities directly employs and supervises all caregiving staff, each of whom is thoroughly screened, trained, and bonded/insured prior to entering a client’s home. Right at Home offers in-home companionship and personal care and assistance to seniors and adults with a disability who want to continue to live independently.
For more information, visit rahrivercities.com, call 1-866-453-2128 or email at firstname.lastname@example.org. Subscribe to Right at Home’s free adult caregiving e-newsletter, Caring Right at Home, by visiting caringnews.com.