Life After a Stroke: Who Should Be On Your Team?

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The effect of  a stroke varies depending on the part of the brain that was damaged, so the type of treatment will also vary for each stroke survivor. You or your loved one will need an individualized team of specialists to help with rehabilitation and long-term care. This guide will help you start thinking about what they need.

Doctors and other health care professionals

Below are some of the people you may find on your care team:

  • A neurologist will monitor your loved one’s brain and help prevent or diagnose future stroke or other neurological complications. It’s important to have regular check-ups with a neurologist because of the increased risk for a second stroke. Health complications related to stroke may also emerge months or even years after the initial event.
  • A cardiologist can serve a similar purpose by monitoring your loved one’s heart for any worrying irregularities, keeping an eye on any existing heart disease, or prescribing necessary medication.
  • All stroke survivors in rehabilitation will have a physician to oversee and coordinate their care. Depending on your loved ones needs, this could be a primary care physician, a geriatrician (specialist in working with older patients), or a physiatrist (specialist in physical medicine and rehabilitation).
  • A social worker can be an invaluable resource. They can help find community and financial resources, and are able to assist with decisions about rehabilitation, insurance, or living arrangements.
  • Rehabilitation nurses are an invaluable part of medical care after a stroke. They assist with managing health problems related to stroke and help survivors adjust to life after a stroke. They may be a part of your loved one’s rehabilitation program or a visiting nurse service if your loved one stays at home during the rehabilitation process.
  • Eating healthy after a stroke drastically reduces the risk for a second stroke or additional heart problems. Enlisting the help of a dietitian can help stroke survivors plan a diet tailored to their individual needs.
  • To help with mobility and balance, a physical therapist will work with your loved one to help them gain muscular strength and help with walking and other physical activities.
  • An occupational therapist helps stroke survivors learn to manage day-to-day activities such as cooking, bathing and dressing. While some stroke survivors will regain complete or nearly complete motor functions, others may have a disability. An occupational therapist will help them learn to function in ways that accommodate their new disability so they can return to living life as normally as possible.
  • A speech pathologist will work with stroke survivors to relearn speech and language skills that have been impacted by the stroke. They may also help with difficulty swallowing.
  • Consider adding a psychologist or psychiatrist to your loved one’s care team. Stroke survivors often find the experience of recovery affects their mental health— it can be difficult to learn how to live with new mobility restrictions, or frustrating to relearn basic tasks such as speaking or walking. Clinical depression is one of the most common health complications after a stroke. If your loved one seems to be struggling with their mental health, it’s important to find a professional that can assist her or him.

Stroke rehabilitation programs and facilities

Choosing a facility for rehabilitation after a stroke can be overwhelming. But with many options to choose from, you will likely find a program that’s a good fit for your family’s needs. Asking the right questions of your doctor, such as what services your loved one needs and what programs are covered by insurance, will help put you on the right path. Once you have an idea of the program you want, check to see if it’s been accredited by the Commission on the Accreditation of Rehabilitation Facilities.

Here’s an overview of the different kinds of facilities and programs:

  • Hospital or inpatient programs involve a team of specialists in the hospital or a special attached unit. This team will work together to set appropriate rehabilitation goals for your loved one and help him or her meet them. These programs may be more intensive than others, typically requiring three hours of therapy a day. A stroke survivor who has many lingering issues and might need consistent monitoring for medical problems may be a good candidate for this kind of program.
  • Rehab centers or skilled nursing facility (short-term) or nursing home (long-term) programs. These programs are less intensive than a hospital or inpatient program, but may last for a longer time. Survivors will generally remain in these facilities while they are being treated, so they are a good option for someone who needs medical monitoring or constant care but can’t undertake an intensive rehab program. Depending on the type of program, there may be a different range of services available, so it’s important to ask your loved one’s doctors lots of questions about what kind of rehabilitation is needed, to make sure the program can meet those needs.
  • Outpatient programs are a good option for stroke survivors whose medical issues are under control, and who are able to travel two to three times a week. These programs take place in a doctor’s office or outpatient center.
  • Home-based programs will send rehabilitation professionals to a stroke survivor’s home to provide services. An advantage with home-based programs is that your loved one will be able to learn and practice skills such as dressing and cooking in the same setting where he or she will use them. If your loved one is able to live at home but has difficulty traveling, this may be an appropriate program to explore.

Palliative care

Palliative care takes a holistic view of all aspects of care to enhance quality of life. This can happen at any stage of stroke recovery, and can involve medical care to relieve pain as well as finding ways to meet a person’s psychological, social, emotional and spiritual needs.

Hospice

If your loved one has been severely incapacitated by a stroke or a health complication related to a stroke, it may be time to consider if hospice care is right for your family.  The goal of hospice is not to prolong life, but to provide dignity and comfort to someone nearing the end of life.

Hospice care can be given at a hospital, long-term care facility or even at home. Your primary physician can give you the best options for hospice care in your community.

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