Stroke is a life-changing event It affects everyone differently.
Your healthcare team will:
You may also wish to take some time to re-evaluate what’s important to you.
You CAN learn to live well after stroke with the help of rehabilitation. You may even develop new skills.
Your healthcare team will begin your rehab as soon you are well enough.
Your rehab will usually start in hospital, for example, on the ward, in the physiotherapy gym or in other healthcare team departments.
You may have an early supported discharge to a rehab hospital, or you may continue your rehab at home or in a local rehab centre.
Some people also need specialist rehabilitation in the National Rehabilitation Hospital in Dun Laoghaire, Dublin.
In areas where there is no access to early supported discharge teams, you should be looked after by the health services in your community.
Your healthcare team will advise you on what the best pathway is for you. Get information about what services are available for you.
Stroke can happen very suddenly, and your recovery can be slow. Whether your rehabilitation happens in a hospital setting or at home, you will have a multidisciplinary healthcare team looking after different aspects of your recovery. A typical stroke rehabilitation healthcare team looks like this:
This is the doctor who will oversee your care. They may be:
They will have a team of junior doctors helping them.
A team of nurses will care for you in hospital.
They are the link between you, your consultant and the rest of your healthcare team.
They help to plan your care, encourage you to practise your exercises and help you with your daily activities.
Nurses will also help to plan your discharge with you, your family, carers and your healthcare team.
The Clinical Nurse Manager (CNM) is responsible for supervising nursing staff on your ward.
A stroke care clinical nurse specialist will help match your needs with members of the stroke team while you are in hospital.
They will explain to you about the type of stroke you’ve had.
They will identify your risk factors for stroke and give you advice on how to prevent another stroke.
Like stroke care clinical nurse specialists, advanced nurse practitioners have lots of experience and have undergone extensive training.
The public health nurse looks after your needs when you leave hospital.
They will visit you at home and make sure you have the right care and support.
The physiotherapist will help you with your physical recovery after stroke – the way you sit, stand, walk and exercise.
They will help you with your movement and muscle strength, sensation, coordination and fitness.
An occupational therapist (OT) will work with you to help you become as independent as possible in your daily life.
The OT may also visit your home to see what alterations or equipment you might need.
The SLT will assess, diagnose and treat any difficulties you may have with speech, language, voice and swallowing.
If you are at risk of losing too much weight or you are having trouble swallowing, a dietitian will develop a nutrition care plan to help you meet your nutrition and hydration needs.
This is important if you need a feeding tube or the thickness or texture of your foods and fluids need to be changed to make them easier and safer to swallow.
A medical social worker will give you and your family useful information about benefits, entitlements, employment, housing and HSE and voluntary services that are available.
They will organise meetings with you and your family to discuss any anxieties you or your family may have.
They will also plan your discharge with your team and provide advice and support to your carer.
A psychologist will work with you to help you make sense of the changes a stroke can bring to your life.
They may conduct tests to work out your needs and make a plan to support you.
You and your family and friends are also very important members of the team
In rehab, you’ll do a lot of exercises. You’ll practise tasks over and over with guidance from your team.
Your team will make sure you’re aiming for the right number of repetitions and that the task is at the right level of difficulty for you. This repetition process will help your brain adapt and build new pathways.
Your team will also tell you how much time you need to spend on each exercise without getting fatigued. Many people spend about 45 minutes on each exercise 5 days a week, but this may vary from person to person based on their needs.
It’s difficult to say, but the majority of people show some improvement.
Your recovery will depend on:
Not knowing how much you will improve can be frustrating, but every stroke is different and your recovery will be unique to you.
Focus on your rehabilitation as soon as possible. The fastest recovery takes place in the days and weeks after stroke but can continue for years.
It’s important to work on overall recovery. This means working on your:
Call Irish Heart Foundation Nurse Support Line on 01 668 5001 or Email referrals@irishheart.ie to connect with other stroke survivors.
Don’t give up. We all have down days and when you have a stroke, these down days are even worse. If you can’t do your rehabilitation today, you WILL be able to do it tomorrow. Set goals. Let the professionals guide you. They aren’t pushing you for their own benefit, they are pushing you so you get better. People tend to forget that.
When you are ready, your healthcare team will talk to you about leaving hospital. Together you can put together a discharge plan for yourself. A discharge plan relies on good communication between you, your family and your team. Talk to your team about your needs.
Your discharge plan will make sure:
Your occupational therapist will advise you on what changes and equipment you may need in your home. For example, you may need to install shower chairs or raised toilet seats in your bathroom. And you may need to add handrails or ramps in your house.
You may be allowed to leave hospital early and be under the care of a team who will help you with your rehabilitation at home. This is called Early Supported Discharge (ESD). However, this service is only available in a handful of hospitals and areas.
When I left the hospital, it emotionally hit me. I’m not sure that I’m fully back to where I was before my stroke with certain things like my vocabulary but other than that I feel I have made a full recovery.
Organisations in the community can help you settle into your life after stroke. Talk to your healthcare team to work out what community supports are available in your area.
The Irish Heart Foundation run stroke support groups, which often meet once a month. It’s a good place to come together to meet other stroke survivors and discuss common issues.
Contact our Nurse Support Line on 01 668 5001 for information on stroke groups in your area.
You might need to get extra help around the house or with your personal care. You may be eligible for HSE’s home support service. Talk to your healthcare team about it.
Your GP or public health nurse can give you information on services available in your area, such as home help, care assistants or Meals on Wheels.
If you need more care, your medical social worker can help you consider other types of caring arrangements such as sheltered accommodation, residential care in a nursing home or 24-hour nursing care.
I really encourage people to attend the free talks – from learning about rehabilitation to speech and language therapy, there are lots of really helpful topics that can make a difference to your recovery.
