Information for Patients:
What to Expect After Stroke: Recovery and the Role of Stroke Rehabilitation
Stroke can affect patients in a wide variety of ways. Some patients may not even recognize they are having a stroke, while others may become disabled and no longer be able to live without the help of a breathing machine and a feeding tube. Most individuals who experience a stroke will be discharged with some degree of impaired motor function, language skills, physical/mental coordination, or vision. While each patient’s experience may be different to some degree, these points may give you an idea of what to expect after a stroke.
- Disability after stroke: Stroke patients typically have their worst degree of disability shortly after a stroke, and they will generally improve in the following weeks and months. The degree to which a patient recovers depends on many factors: the age of the patient, their baseline functional status, whether the patient was eligible for thrombolysis or thrombectomy, and the type of stroke they’ve experienced, to name a few. It is difficult to predict if symptoms will completely resolve, allowing a patient to return to their normal level of function, or if they will have to live with a permanent disability.
- Stroke rehabilitation: Regardless of how disabled the individual has become after a stroke, stroke rehabilitation will be beneficial. Physical therapy, occupational therapy, and speech therapy help to accelerate the process of normal brain tissue taking over (some of) the functions previously performed by the affected parts of the brain. In addition, stroke rehabilitation will teach patients how to find new ways to perform some of those same functions, using new tools or altering prior ones to remain functional.
- Coping with stroke: Stroke happens suddenly. Unlike some medical conditions, patients or their loved ones do not expect such a sudden and potentially disabling and life-changing occurrence. This means the patient and their family need a great deal of counseling and support. Depression and “post-stroke” fatigue are also commonly experienced by individuals after stroke, which necessitates psychiatric and neurological attention and treatment.
- Personal hygiene: Stroke affects mobility and grooming dexterity. Incontinence and constipation are not uncommon after a stroke. These lead to unpleasant appearances and increased risk of infections that may shorten patients’ lives. Therefore, a multi-faceted and patient-centered approach needs to be crafted by primary care physicians and rehabilitation doctors to minimize soiling and promote regular washing and grooming.
- Driving after a stroke: Patients with moderate to severe disability due to a stroke should not drive. Those with milder symptoms or seemingly no symptoms may check with their doctor if they can drive again to determine whether it will be safe for themselves and others. Individuals should refer to New York state’s regulations about drivers with medical conditions. For the state of New York, an approved physician must approve one’s ability to drive after stroke. Individuals should consider taking a driving test before deciding to return to driving. For those who cannot drive, alternative means of transportation, particularly when necessary for therapies and medical needs, should be sought.