e-book Rehabilitation of Stroke

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Rehabilitation nurse — helps people with disabilities and helps survivors manage health problems like diabetes and high blood pressure and adjust to life after stroke. Physical therapist — helps with problems in moving and balance, suggesting exercises to strengthen muscles for walking, standing and other activities.

Occupational therapist — helps with strategies to manage daily activities such as eating, bathing, dressing, writing and cooking. Speech-language pathologist — helps with talking, reading and writing, and shares strategies to help with swallowing problems.

Stroke rehabilitation

Dietician — teaches survivors about healthy eating and special diets low in sodium, fat and calories. Social worker — helps survivors make decisions about rehab programs, living arrangements, insurance and home support services. Neuropsychologist — diagnoses and treats survivors who face changes in thinking, memory and behavior. Case manager — helps survivors facilitate follow-up to acute care, coordinate care from multiple providers and link to local services. Recreation Therapist. Helps with strategies to improve the thinking and movement skills needed to join in recreational activities.

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Stroke's Impact More than four million Americans live with the effects of stroke. Rehabilitation is an ongoing process. How successful rehabilitation is will depend on the amount of brain damage as well as the skill of your rehabilitation team, support of family and friends and how soon you begin rehabilitation after a stroke. How a person is affected by a stroke will depend on the type of stroke, where in the brain the damage occurred and its severity. You may have an x-ray of your throat to see what your swallowing difficulties are and what types of food and drink are safe for you to eat.


The Speech and Language Therapist SLT will also provide special swallowing therapy and advice to help you eat and drink safely. The SLT will teach you how to sit correctly and proper eating methods to prevent food and drink from getting into your windpipe. In severe cases, a feeding tube will have to remain in order for you to get a nutritious diet. After a stroke you may have problems communicating with others because you do not understand the words that they are saying, or because you cannot find the right words to express yourself fully.

Some people may completely lose the ability to speak, but can still understand what is being said to them. The ability to read and spell and write may also be affected. For others speech may become slurred and difficult to understand because the nerves and muscles of speech have been damaged. Sometimes one side of the face and tongue is paralysed or weak and can affect speech. This problem is called dysarthria. Speech and language therapy can help you to recognise words or find other ways to communicate, like using gestures, word-and-picture charts, symbols and computers.

The SLT will also show your family and friends ways of communicating with you which make it easier to get your message across. These may be caused by the change in your life from the stroke or by the damage caused to your brain by the stroke itself. Feelings of anger, despair, frustration and grief are all normal for people who have had a stroke. Life changes that follow a stroke such as changes to relationships, work, finances and dealing with the loss of abilities and confidence can lead to anxiety and depression.

If you are experiencing these problems, do not suffer alone. Both depression and anxiety can be treated using psychological therapies where you can learn to cope with and understand these feelings. Contact your GP or medical social worker to get a referral to a clinical psychologist or psychiatrist for expert advice. A dietitian will advise you to make sure you are getting the best nutrition to help you recover.

The Center for Stroke Rehabilitation - Kessler Institute for Rehabilitation

The nutritionist or dietitian will make sure that your dietary needs are met by assessing your nutritional requirements, monitoring what food you eat and educating you on the type of food and drink more appropriate for your needs. She will monitor your nutritional status and adjust the plan as you improve. Weight changes can happen after a stroke so it is important that you look after your diet when you leave hospital. A healthy balanced diet may help you prevent another stroke. If you have diabetes, high cholesterol or high blood pressure, remember to follow your diet plan.

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  5. If you need more advice on your diet, ask your GP or hospital consultant to refer you to a dietitian. Stroke may causedouble vision, blurred vision or partial blindness. Some people cannot see to the left or right and this causes difficulty with balance, co-ordination or recognising familiar things or people. It is common for people to have difficulty controlling their bladder or bowel after a stroke. This is known as incontinence. For many people this control will come back over time.

    Occasionally, a tube catheter may need to be inserted to help drain the bladder. If this is needed, it should be done every now and then rather than inserted for long periods of time.

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    The problems with movement, coordination and perception following a stroke can make it difficult to perform everyday tasks like washing, dressing, eating and going up stairs. The occupational therapist OT and physiotherapist work to help you become as independent as possible in your activities of daily life, leisure activities, working, driving and socialising to the best level possible.

    If you have cognitive problems following your stroke such as, problems thinking, remembering and concentrating, the OT will work with you to improve these things. This may involve:. You may find that you have difficulty with some day-to-day activities. By talking to your care team, you can find ways to make them easier. Standing and walking — can be made easier with shoes which offer good support and rearranging the furniture in your home. Walking up and down stairs can be difficult, but fitting handrails or a stair lift can make it easier.

    Some may also need to use a stick, a walking frame or a wheelchair. If needed, an OT can advise you about the use of a wheelchair. OTs can advise on the best types of chairs and mattresses. Your physiotherapist can show you the best transfer technique to help you move about. Dressing — putting on and taking off clothes may be difficult. Simple procedures can make dressing easier, such as putting your weak arm or leg into clothes first and using shoehorns. Feeding — sometimes using a knife and fork may be clumsy or awkward. Using utensils with thick handles can help, as can non-slip mats which prevent the plate from moving around the table.

    Washing and grooming — again there are many simple tips an OT can give you which will may make it easier, such as using a free standing shower. Going to the toilet — if your toilet is upstairs and you find it difficult to walk, you might use a commode or move your toilet downstairs. You might also need to have rails fitted in the bathroom. Talk to your public health nurse and your OT about what you could do.

    Applying for a grant — Many of the adaptations to your home or the equipment you require can be purchased using a Housing Adaptation Grant. These grants are provided by your Local Authority.

    Ask your Social Worker about how you could apply for a grant. After your stroke, you might need to get extra help around the house or with your personal care.

    There are different services in different areas, but may include:. Sometimes a person may need more care than they can receive at home. If this is the case, your social worker can help you to think about the type of care which would be suitable for you, from sheltered accommodation, to residential care in a nursing home to hour nursing care. There are organisations in the community which can help you as you settle in to your life after stroke.

    Day hospitals are generally in the grounds of a larger hospital.

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    They care for mainly older people who are well enough to live at home but who need regular medical care or the services of the hospital therapists. When you leave hospital arrangements may be made for you to go to the day hospital if this is necessary. Day centres do not provide medical care and generally do not have therapists providing rehabilitation. They provide an important social outlet — the opportunity to meet other people who have had a stroke or other illnesses, and may offer activities such as painting, swimming, and outings.

    Support groups help people who have had a stroke to meet up and discuss common issues. Groups often meet once a week and many also organise social activities and outings. Many people who have had a stroke will be entitled to receive social welfare payments. You can qualify for certain payments if you are sick for just a short time. For other payments you need to show that you have an illness or disability that will last longer than one year. You should discuss your entitlements with your Social Worker.

    You can also receive information on the different types of payments and grants available from the Citizens Information Service. It is natural that you feel concerned about whether you will be able to have sex after a stroke. You may be worried about whether you will be physically able to have sex or you may be concerned about changes to your appearance which make you feel less attractive.

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    Low mood and depression may also affect your desire for sex. The good news is that the ability to have sex is rarely damaged by a stroke and sex is unlikely to cause another stroke. At the same time it might take a while to get back to a satisfying sexual relationship and you might have to make some changes, depending on how your stroke has affected your physical movement. It is very normal to have questions about sex and you should discuss any concerns you have with a member of your care team.

    Once you have begun to recover and have developed ways of managing the difficulties caused by your stroke, you might start to think about going back to work. It may be possible for you to return to work part or full time, or maybe to a different job with your previous employer, or even a new job with a new employer. You should talk to the relevant members of your care team about the best way to approach your employer about going back to work.

    The law says that employers must make reasonable adjustments to help you to return to work after your stroke. They may need to make some adaptations to your workplace, such as getting a new type of office chair or a computer.