This booklet is about stroke rehabilitation. Its goal
is to help the person who has had a stroke achieve the
best possible recovery. Its purpose is to help people
who have had strokes and their families get the most
out of rehabilitation.
Note that this booklet sometimes uses the terms "stroke
survivor" and "person" instead of "patient"
to refer to someone who has had a stroke. This is because
people who have had a stroke are patients for only a
short time, first in the acute care hospital and then
perhaps in a rehabilitation program. For the rest of
their lives, they are people who happen to have had
a stroke. The booklet also uses the word "family"
to include those people who are closest to the stroke
survivor, whether or not they are relatives.
Rehabilitation works best when stroke survivors and
their families work together as a team. For this reason,
both stroke survivors and family members are encouraged
to read all parts of the booklet.
A stroke is a type of brain injury. Symptoms depend
on the part of the brain that is affected. People who
survive a stroke often have weakness on one side of
the body or trouble with moving, talking, or thinking.
Most strokes are ischemic (is-KEE-mic) strokes. These
are caused by reduced blood flow to the brain when blood
vessels are blocked by a clot or become too narrow for
blood to get through. Brain cells in the area die from
lack of oxygen. In another type of stroke, called hemorrhagic
(hem-or-AJ-ic) stroke, the blood vessel isn't blocked;
it bursts, and blood leaks into the brain, causing damage.
Strokes are more common in older people. Almost three-fourths
of all strokes occur in people 65 years of age or over.
However, a person of any age can have a stroke.
A person may also have a transient ischemic attack
(TIA). This has the same symptoms as a stroke, but only
lasts for a few hours or a day and does not cause permanent
brain damage. A TIA is not a stroke but it is an important
warning signal. The person needs treatment to help prevent
an actual stroke in the future.
A stroke may be frightening to both the patient
and family. It helps to remember that stroke survivors
usually have at least some spontaneous recovery or natural
healing and often recover further with rehabilitation.
The process of recovering from a stroke usually includes
treatment, spontaneous recovery, rehabilitation, and
the return to community living. Because stroke survivors
often have complex rehabilitation needs, progress and
recovery are different for each person.
Treatment for stroke begins in a hospital with
"acute care." This first step includes helping
the patient survive, preventing another stroke, and
taking care of any other medical problems.
Spontaneous recovery happens naturally to most
people. Soon after the stroke, some abilities that have
been lost usually start to come back. This process is
quickest during the first few weeks, but it sometimes
continues for a long time.
Rehabilitation is another part of treatment.
It helps the person keep abilities and gain back lost
abilities to become more independent. It usually begins
while the patient is still in acute care. For many patients,
it continues afterward, either as a formal rehabilitation
program or as individual rehabilitation services.
Many decisions about rehabilitation are made by the
patient, family, and hospital staff before discharge
from acute care.
The last stage in stroke recovery begins with the person's
return to community living after acute care or
rehabilitation. This stage can last for a lifetime as
the stroke survivor and family learn to live with the
effects of the stroke. This may include doing common
tasks in new ways or making up for damage to or limits
of one part of the body by greater activity of another.
For example, a stroke survivor can wear shoes with velcro
closures instead of laces or may learn to write with
the opposite hand.
Make sure the patient's condition is caused by a
stroke and not by some other medical problem.
Determine the type and location of the stroke and
how serious it is.
Prevent or treat complications such as bowel or
bladder problems or pressure ulcers (bed sores).
Prevent another stroke.
Encourage the patient to move and perform self-care
tasks, such as eating and getting out of bed, as early
as medically possible. This is the first step in rehabilitation.
Stroke survivors and family members may find the
hospital experience confusing. Hospital staff are there
to help, and it is important to ask questions and talk
about concerns.
Before acute care ends, the patient and family with
the hospital staff decide what the next step will be.
For many patients, the next step will be to continue
rehabilitation.
People who have had a stroke have an increased risk
of another stroke, especially during the first year
after the original stroke. The risk of another stroke
goes up with older age, high blood pressure (hypertension),
high cholesterol, diabetes, obesity, having had a transient
ischemic attack (TIA), heart disease, cigarette smoking,
heavy alcohol use, and drug abuse. While some risk factors
for stroke (such as age) cannot be changed, the risk
factors for the others can be reduced through use of
medicines or changes in lifestyle.
Patients and families should ask for guidance from
their doctor or nurse about preventing another stroke.
They need to work together to make healthy changes in
the patient's lifestyle. Patients and families should
also learn the warning signs of a TIA (such as weakness
on one side of the body and slurred speech) and see
a doctor immediately if these happen.
The information contained in this
web site is not a substitute for medical advice or treatment.
Consultation with your doctor or health care professional is recommended.
About Stroke
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