WHEN STROKE RECOVERY SLOWS DOWN
“Am I going to get better? How long will it take for me to recover?"
The question is usually asked with much hope. Honestly speaking no health professional worth his or her salt can ever give a definite reply to this. Every stroke survivor is different and lives in a different environment, therefore, the journey of recovery for each stroke survivor and their respective families will differ.
If you don’t use your faculties continuously your progress will be affected :
- Age
- Severity of the stroke
- Location of the stroke
- Other health related issues
- Access to rehabilitation
- Intensity of rehabilitation and how soon after the stroke it began
- The appropriateness of the rehabilitation
It is normal that there may come a time when recovery and progress slows down (or grinds to a complete halt).
What happens then? Do we accept this or do we keep pursuing recovery?
It is time to re-assess the strokee’s programme
After the initial intensive rehabilitation (which may be three to six months after a stroke) the gains are small despite intensive input; the goals of therapy have been achieved; or there is no longer any improvement.
A new programme
Should consider if more input or increased intensity is required, perhaps by reviewing therapeutic goals/or the need to move on and cut back on ‘rehabilitation’ and get on with other pursuits.
At NASAM, when the strokee reaches this stage, therapy and rehabilitation is re-evaluated. The strokee may join the group sessions (if they are not already doing so). They are encouraged to socialise, spend time trying out leisure activities and re-establish a new life after stroke. Regular exercise sessions will help maintain the level of function and endurance of the strokee.
There is always hope for further improvement if we keep trying. New exercises and different therapies may bring on some gains.
The termination or transition from intensive post stroke rehab to the less intensive, more casual community management styles of therapy, can bring about a decline in the strokee’s performance and function. It is not uncommon for strokees to complain that when they did not attend a few sessions at NASAM, their walking changed or they felt stiffer.
Maintaining the level of function achieved at the end of the intensive post stroke rehab is hard work. Long term issues such as age and other health concerns could influence progress. The level of input may also change because of lack of:
- Resources – transport, finance, time
- Motivation to maintain current level of training/exercise
Many strokees, after the intensive period, may feel they are happy at their current level of recovery (although their families may not think so). This is a choice that the strokee and his/her family make together. Attending NASAM group sessions regularly can help maintain that level of function and continue to improve participation and socialisation.
For those who suffered a severe stroke this may be the only source of outing and regular supervised exercise.
Looking Ahead
Strokees who are more mobile and independent can, at this time, start looking at what else they can usefully participate in. It could be a time to indulge in hobbies that they previously did not have time for. Or they may even be attracted to join gyms or clubs to maintain their fitness and functional levels. Whatever it is, they should go and experience and cultivate interests that will bring them much joy as well as healing in the process.
Some strokees return to NASAM as volunteers for speech therapy or offer their service to drive strokees to therapy or keep hospital appointments, etc. They also have the option to get involved in NASAM’s fund-raising efforts or use NASAM as a social centre. Some may join other volunteer groups. Others may go back to their family duties, such as looking after the children/grandchildren and running a
household.
The younger generation may return to work or find a new path.
Whatever they choose, most strokees will find a comfortable spot in life to settle into after some adjustments. They will still need to maintain a healthy lifestyle to prevent another stroke. Hence there is a need to stay healthy and active, physically and mentally.
If you don’t use your faculties continuously your progress will be affected …
Stay healthy by practising the following:
- Keep up with your medical issues such as diabetes, cholesterol and hypertension
- Stay healthy mentally – treat depression and think positive. Don’t be afraid to explore new activities
- Be physically active – keep up with your exercise and stretches to improve and maintain what you have regained. Physical inactivity is associated with poorer outcomes and attracts more illness
A word of advice to all strokees – keep mentally and physically active at all times. If you don’t use your faculties continuously your progress will be affected and you will lose the independence you worked so hard to gain.
A stroke affects not only the survivor but the whole family. I have seen families torn apart, bonds broken and strokees placed in nursing homes because families cannot cope with them at home. Thankfully, there are families that come together stronger than before.
