As the treatment technology progresses, more than 7 million Americans have survived strokes today. If you are or have a stroke survivor in your family, please be positive, because the hope of getting better is never gone. Please be patient, since the recovery is a life long process. Please be informed, since there are a lot of changes brought by the stroke you should acknowledge. Today we talk about life after stroke. The information is crucial because it matters to the survivors’ recovery, rehabilitation, and next stroke attack prevention.

Be Prepared: Changes by stroke
Surviving a stroke, we first should admit that stroke changes life, both physically and emotionally. Stroke causes brain injury that may affect how people move, communicate, think and act. Here are some common general changes survivors might experience after a stroke:

• Weakness or paralysis on one side of the body
• Difficulty speaking or swallowing
• Tire easily
• Change in personality, performing improper language or behaviors
• Difficulty with memory, judgment, and problem solving
• Difficulty with peripheral vision and problems with visual cognition

Other changes are dependent on whether it is left- or right-brain injury. Generally, one side of the brain controls the opposite side of the body. For example, right-brain injury may result in weakness or paralysis on left side of the body. The survivor also tends to lack awareness of the left side.
At the same time, stroke survivors also go through a series of changes emotionally. Many of them experience frequent emotional instability. Other changes include:

• Depression
• Lack of motivation and indifferent
• Unexpected feeling of anger, anxiety and frustration

The above are common changes that stroke survivors would go through during the recovery process. It’s best for family members and patients to be prepared and recognize these changes in time.

Returning Home
When the patient is medically stabilized, the physician may recommend returning home. Some stroke patients are afraid of this process for the fear of having another stroke attack. There are a lot of other fears due to this change of setting that we also need to understand. For instance, some may feel that their friends and family will abandon them. Or they fear that their loved ones are not competent in proper caretaking. Being surrounded by other people at home may also make them realize their disability, which can be hard to accept. Therefore, family members and hospital staff need to work together to prepare for the transition.

When is the right time?
There are four major factors to consider when assessing whether getting back to home is a good decision. Stroke survivors at home need to have ability of self-care, meaning one should be able to accomplish some basic daily activities. Also since the medical care still continues, the patient needs to have the ability to follow medical advice as well. It is also highly recommended that a caregiver, either family member or hired professional staff, assist the patient when needed. In addition, the survivor needs to have the ability to move around and communicate, so that they can ask for help in an emergency.

Adapt your home
Before welcoming your loved one home, family members should work with professional staff to change the home setting, making it safe, accessible, and comfortable for the stroke survivor to live.
First, you need to check every corner of your home and be diligent about hidden hazards that may cause falls and other accidents. Measures like taking up the throw rugs, having more lighting, using a non-skid mat, and fixing your floor or staircase are highly recommended. Further action, like installing a raised toilet seat, safety grab bars or handrails can also be helpful. You may also want to build a ramp so that patient can move around as much as possible.

Caregiver
Caregivers are often the spouse, adult child, or parent who provide most of the care for stroke patient at home. Since the recovery process is a challenge for both patient and caregiver, we suggest the two sides to share decision-making and feelings as much as possible. The caregiver’s responsibilities range from providing physical assistance, taking care of the survivor’s everyday life, to managing financial affairs, and providing emotional support. In other words, the caregiver needs to cover almost every part of the stroke survivor’s life.
However, we should not neglect that caregivers also need care themselves. Try to encourage the survivor to be as independent as possible. This will not only relieve your pressure but also help the survivor’s recovery progress. While you encourage your loved one to participate in leisure activities, you can also try to have fun. It’s totally fine to take a break, which would be beneficial for both you and your patient. A paid professional caregiver is also a choice many people turn to. While you try to take good care of people in you life, remember to take care yourself as well.

Resources
http://www.stroke.org/site/PageServer?pagename=surv
http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/documents/downloadable/ucm_309716.pdf
http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/documents/downloadable/ucm_309720.pdf
http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/documents/downloadable/ucm_309723.pdf