Life After Stroke

What is a Stroke?

A stroke occurs when the blood supply to the brain is disrupted. Blood is transported to the brain by blood vessels called arteries. Blood carries important nutrients and oxygen to your brain. Blood may stop moving through an artery because the artery bursts (hemorrhagic stroke) or the artery is blocked (ischemic stroke). When the brain cells are not getting enough nutrients or oxygen, they die. The area where the brain has been damaged is called a cerebral infarct.

What is a stroke?

Common Challenges After a Stroke

After an individual has a stroke they can be affected in a number of different ways including physically, cognitively and emotionally.

 

Common challenges can include:

  • Loss of strength on one side of the body
  • Weakness or drooping of the face
  • Changes in sensation, for example, numbness and pins and needles
  • Balance problems
  • Fatigue
  • Loss of field of vision
  • Coordination difficulties
  • Difficulties knowing right from left or judging depth and distance
  • Speech, communication, attention deficits

Rehabilitation Process

What can I expect in terms of recovery?

Stroke affects people differently. While some recover completely, others may have or experience lasting disability or difficulties in certain areas.

The first year after having a stroke is crucial for recovery, meaning that during this time rehabilitation should be made a priority. After a year, the ability of the body to adapt and regain function decreases meaning that recovery will slow down.

However, the brain takes time to heal and recovery can continue for years. More severe strokes tend to take longer to recover from. Remaining active and exercising regularly can boost recovery for most people

Exercise and How It Can Help

Exercise is proven to help stroke survivors regain lost body function. Through exercise therapy, the brain rebuilds connections to the body that may have been damaged by the stroke. This “rewiring” of our brain improves our ability to move, balance and complete activities of daily living which in turn helps to keep us independent.

Other reasons to exercise include:

  • Help you to stay healthy and feel good
  • Reduce the chance of another stroke
  • Improve your balance and muscle strength
  • Reduce fatigue and lessen pain
  • Improve your mood
  • Maintain endurance for everyday activities

What Type of Exercise Should I Do?

The World Health Organisation mentions two main categories of exercise for people to focus on – exercise which works the heart (cardiovascular training) and exercise which works our muscles (strength training). Cardiovascular and strength exercises make your heart beat faster and will make you feel warmer. If you are doing something for a longer period of time at a high intensity, or a lot of physical effort, you may feel a little out of breath but you should still be able to speak. It is important to include both types of exercise within your week.

 

The good news is that many movement based tasks that people do every day can be seen as exercise. Walking stairs in your home, lifting groceries and gardening are all good examples. We should all aim for approximately 150 minutes of cardio activity like walking/cycling and 2-3 strength workouts per week. It’s important to find activities and exercises you enjoy doing, sometimes involving others can help to boost the fun!

 

Setting goals can be a great way to build routine, track progress and stay motivated. Starting small with realistic and attainable goals is important. Discussing goals with a health professional can also help. A good example of an attainable goal may be to spend 20 minutes per day doing something that elevates your heart rate. To begin you may need to build up this time meaning that you could start with 10 minutes a day or 10 minutes twice a day before exercising for a full 20 minute duration.

Here Are Some Home Exercise Workouts You Can Try to Get Started

  • Reflect on activities that you enjoy doing which are challenging or raise your heart rate
  • Plan how exercise fits into your day
  • Start slowly
  • Involve other people where possible

 

 

Understanding Emotional Changes After a Stroke

Recovery from a stroke can be an emotional challenge as well as a physical one. Feeling many different emotions is a completely normal response to a stroke, which can be a life-changing event. Experiencing strong emotions after a stroke can also be caused by changes in the brain as a result of the stroke itself. 

Emotional Symptoms

  • Feeling sad, anxious, irritable, nervous, guilty, worthless, or hopeless.
  • Loss of interest in previously enjoyable activities.
  • Difficulty focusing, remembering, or making decisions.
  • Changes in work style or enthusiasm.
  • Thoughts of death and/or suicide.

Physical Symptoms

  • Changes in sleep patterns.
  • Changes in appetite.
  • Fatigue or decreased energy.
  • Restlessness and physical discomfort.

Depression

Feelings of depression are common after a stroke and can be experienced both physically and emotionally.

Some common emotions which can be experienced are listed below:

Shock: Feeling like, “I can’t believe this is happening to me.”

Anger: Asking, “Why is this happening to me? What did I do to deserve this?”

Anxiety: Worrying about what might happen in the future or how much recovery is possible.

Denial: Refusing to accept the truth that you have been affected by the stroke

Embarrassment: Feeling awkward and ashamed because things don’t work the way they used to.

Fear: Worrying a lot about the chance of having another stroke.

Frustration: Getting annoyed with yourself because you can’t do things the way you used to or getting frustrated with others because they don’t understand.

Grief and Sadness: Feeling sad about losing abilities or having a different future.

Guilt: Feeling bad about how this affects your family or feeling guilty for needing more help and support.

Emotional Challenges Are Part of Your Recovery Journey

Feeling strong and sometimes difficult emotions is perfectly normal, and acknowledging and working with these feelings is part of your recovery. Seeking support is recommended as nobody should need to make this journey alone. Family, friends, other stroke survivors and healthcare professionals can all be part of your support system but if feelings become overwhelming, please consult a healthcare professional who is trained in working with individuals who have experienced after a stroke.

Where to Get Support:

  • Speak with a trusted member of your healthcare team such as a stroke nurse or your GP. 
  • Consider making an appointment with a therapist.
  • Engage in conversations with close and trusted individuals in your life.
  • Explore support groups 
  • Remember, your emotional well-being is an integral part of your recovery journey. Don’t hesitate to reach out for the support you need.

Caregiver Guide for Supporting Stroke Survivors

Caring for a loved one who has experienced a stroke can be challenging. With the right support and information, you can make a significant difference in their recovery journey. Here’s a short guide to help you understand the elements of care a stroke survivor may need. 

  1. Mobility and Transfers:
    • Assistance with walking, mobility aids, and transferring in and out of bed. These can be sourced
    • Ensuring the home environment is safe and accessible, removing obstacles and installing handrails if necessary. As a carer, you may be able to qualify for a grant for a stairlift. Visit Mobility Aids Grant Scheme (citizensinformation.ie) for more information.

List of mobility aid websites:  

  1. Activities of Daily Living:
    • Assistance with personal hygiene, dressing, and grooming. 
    • Support meal preparation and feeding if needed. 
  1. Communication:
    • Communication may be difficult for someone who has had a stroke. Be patient and use clear, simple language as cognition can sometimes be affected. 
    • Encourage communication through gestures or assistive devices as required. 
    • Foster an open and supportive environment for expressing needs and emotions. 
    • Speech and language therapy can help with communication difficulties. Call Croí at 091 544310 to find out about our speech and language therapist.
    • Visit our Stroke Carers Information page for additional information and advice.

Examples of Assistive Devices:  

  1. Home Environment:
    • Create a safe and accessible living space, considering the specific needs and limitations of an individual with stroke 
    • Install necessary home modifications such as grab bars, ramps, and adaptive equipment for ease of access. 
    • Speak to your local city council for support with installation of modifications.  

List of home modification websites:  

  1. Medication Management:
    • Ensure your stroke survivor takes medications as prescribed. 
    • Keep track of appointments and follow-up visits, maintaining a medication schedule. 

6.  Emotional Support: 

    • Stay attuned to the emotional well-being of both yourself and the individual you are caring for. 
    • Encourage open communication and provide reassurance during moments of frustration or fear. 
    • Revert back to a verbal or non-verbal communication style to help with emotions as much as possible.  

There are services in place to help aid you with the above-listed activities. Please see the support section below. 

Caregiver Guide for Supporting Themselves

Caring for yourself is just as important as caring for your loved one. It is important to monitor how you are feeling, recognise the areas you may need assistance with and take moments to yourself to relax. Below is a short list of how you can create the best environment for yourself in order for you to be able to care for others. 

  1. Self-Care for the Caregiver: 
    • Seek support through Croí caregiver support groups or counselling services. 
    • We offer two free counselling sessions with our psychotherapist. Contact healthteam@croi.ie or call 091 544310 to book.
    • Schedule time for yourself to prevent burnout.

Self-Care Strategies:  

    • Spa day/pamper session  
    • Spend a day in nature  
    • Adult colouring book  
    • Coffee/tea break with a friend or loved one  
    • Music therapy  
    • Cold water swimming  
    • Meditation/Mindfulness practices  

2. Stay informed about the stroke survivor’s condition:

Taking care of a loved one can be intimidating and stressful at first and there may be some elements of care that you may need to learn. A caregiver training course may be helpful to support yourself with the knowledge you need to ensure your loved one is well taken care of and also reduce the burden for yourself.

Training courses:  

Our website is a great safe space for carers to seek advice from others in relatable situations, visit Stroke Carers Information page for more information.

3. Taking Breaks:

    • Prioritise your well-being by taking regular breaks to recharge. 
    • Arrange for backup assistance when needed, ensuring you have a support system in place. 

4.  Monitoring Signs of Burnout:

    • Be vigilant for signs of burnout, such as increased tension, anger, or feelings of being overwhelmed. 
    • Watch for changes in physical and emotional health, and seek help if needed.

5.  Prioritising Your Health:

    • Eat well, stay physically active, and ensure you get a good night’s sleep. Information and tips on how to improve your diet and physical activity levels can be found here.  
    • Engage in enjoyable activities and hobbies to maintain a healthy balance in your life. 

A Personal Message to Caregivers:

Remember that caregiving is a collaborative effort, and you are not alone. Prioritise your own health, both physically and emotionally. Recognise signs of burnout and don’t hesitate to seek support from friends, family, support groups, or healthcare professionals. Taking care of yourself enables you to provide the best care and support for your loved one’s recovery. Your well-being is crucial, and your dedication is commendable.

Support & Additional Resources

There are a number of additional services available nationwide which can help support you to get the help you may require.

HSE

Citizen’s Information

I am a person with a disability

I am a carer

Family Carers Ireland

Headway

  • Website: www.headway.ie
  • Contact Details: Tel 1800 400 478
  • Useful Direct Links:

I have a brain injury

I am a family member

For those interested, the source material for this page can be accessed via the below links:

Quinn, 2023: https://jmp.sh/wa3qAQPd

McCausland, 2023: https://jmp.sh/s/9PCpItLlJ2PKZ4dfRZpg

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