Anya’s Story (symptoms on right side of the body)

Anya is nearing discharge from hospital. She has been treated for right arm weakness and right leg weakness (hemiparesis) and for a right facial droop. Anya's speech is improving and she understands when you talk to her, but she still has difficulty speaking in full sentences and often searches for the right word (aphasia).

Anya's balance is improving, but she is slow and cautious when walking. She has been told to walk with help from another person or to use a quad cane. Anya is starting to use her arm for functional activities and is washing and dressing herself. She often finds it difficult to get to the bathroom on time.Anya has been instructed to purchase various assistive devices for use at home. She will be returning to the home she shares with her spouse.

Anya retired from work two years ago, and before the stroke she enjoyed gardening, golf and driving the family car on daily outings. The couple has 2 children, a daughter and a son. The daughter lives close by and visits regularly, while the son lives out of town.

Anya is feeling depressed, especially about going home when she is not back to her old self. Anya's therapist is encouraging her to socialize with friends and family. She would like Anya to start some of her old leisure activities or to think of new ones to try.

As a family member you are feeling concerned about how to do all the things that are needed and you have lots of questions. You are also feeling exhausted from the weeks of hospital visits and trying to balance the other parts of your life. This is a time when many family members wonder how things will work once their family member returns home and how everyone will cope with all of these changes.

Can I have a refresher on what causes a stroke?

A stroke is caused by uncontrolled bleeding in the brain, or by a blood clot that interrupts the blood flow to the brain. This limits oxygen to the affected part of the brain, causing injury or death to the cells in that area. The effect of the stroke depends on what part of the brain was injured and how much injury to the brain occurred.

Click here to visit the Heart and Stroke Foundation website for more information on stroke including causes, types, symptoms and effects of stroke.

Is there anything new in the treatment of my arm at this stage of stroke recovery?

Many patients who have had a stroke experience muscle weakness (hemiparesis) or loss of movement (hemiplegia) on one side of their body. Muscle weakness
or loss of movement can make it difficult to return to everyday activities.

Rehabilitation may focus on improving the patient's use of his/her affected arm and hand. This will enable the patient to resume daily activities such as dressing, bathing and grooming, using cutlery during meals, participating in work or leisure
activities, etc.

Some of the therapies that may be effective in improving arm function at this stage of stroke recovery include:

Modified constraint-induced movement therapy (mCIMT)

Functional electrical stimulation (FES)

Mirror therapy

Motor imagery

Music therapy

Repetitive Transcranial Magnetic Stimulation (rTMS)

Virtual reality

Is there anything new in the treatment of my leg at this stage of stroke recovery?

Many patients who have had a stroke experience muscle weakness (hemiparesis) or loss of movement (hemiplegia) on one side of their body. This can affect the patient's use of the affected leg for movement and everyday activities.

Some of the therapies to improve leg weakness at this stage of stroke recovery include:

Functional electrical stimulation (FES)

Mirror therapy

Strength training

Rehabilitation may also include activities to improve walking. Some of the therapies that have been shown to improve walking skills at this stage of stroke recovery include:

Functional electrical stimulation (FES)

Gait trainer

Task-oriented training

A health care professional may also prescribe an assistive device. Mobility aides such as a quad walker, walking stick, roller walker or wheelchair can help regain walking skills and independence.

video

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Is there anything new in the treatment of balance at this stage of stroke recovery?

Side effects of stroke (e.g. hemiparesis, perceptual problems, spatial neglect) and side effects of medication can impact on balance. Even weeks or months after a stroke, patients may feel unsteady when they are moving from one position to another (e.g. getting out of bed or up from a chair), walking on uneven ground (e.g. in the garden), or walking up stairs.

A health professional may recommend the following interventions or strategies to improve balance during stroke rehabilitation:

Aerobic exercise

Functional electrical stimulation (FES)

Body-weight supported treadmill training

Balance training using activities such as aquatic therapy, balance platform exercises and tai chi

Positioning for safety

Assistive devices when moving and transferring from one position to another.

Why do health professionals prescribe assistive devices after stroke?

Why do health professionals prescribe assistive devices after stroke?

Assistive devices are pieces of equipment that make daily activities easier to perform. Health professionals may recommend assistive devices for a patient when he/she is leaving hospital and returning home, as they can help the patient regain independence in everyday activities.

Is there anything new in the treatment of aphasia at this stage of stroke recovery?

Language and communication difficulties (aphasia) are common among patients who have had a stroke on the left side of the brain. Difficulties with reading and writing, finding the right word to say, or understanding what others are saying, can persist long after a stroke.

There is evidence that interventions such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are effective in treating aphasia at this stage of stroke recovery.

Click here for more information on Aphasia

For more information on aphasia including symptoms, diagnosis, treatment and tips, visit the Aphasia Institute of Canada.

Why is urinary incontinence associated with stroke?

Urinary incontinence can result directly from stroke, side effects of stroke (e.g. movement, language, cognitive or sensory difficulties), and side effects of some medication. In most cases urinary incontinence can be treated or managed.

For more information on urinary incontinence, click here.

Is depression common after a stroke?

Depression is very common after a stroke. Depression can be caused by injury to the areas of the brain that control our emotions. Also, stroke is a serious
condition that causes big changes to the patient's life. Everyday activities become very difficult and require a lot of effort. People may not be able to do
the activities they used to enjoy. These changes can cause feelings of sadness, depression and mood swings.

Click here for more information on depression

What leisure activities can people do after a stroke?

The side effects of stroke can make it difficult to return to hobbies, sports and activities that the patient enjoyed before the stroke. However, leisure activities
are very important to our well-being and quality of life. Leisure and social activities are good for maintaining and improving physical health and mental
health, which in turn helps the recovery process. Health professionals can help patients return to leisure activities, by helping to regain skills, adapt activities, or
find new activities. Assistive devices can be used to make leisure activities more manageable.

Click here for more information on leisure & participation

Can I drive after a stroke?

Some people may have difficulty driving after a stroke. The effects of stroke can impact on driving skills. Health professionals can provide rehabilitation to assist with return to driving.

Click here for more information on driving after stroke

What about the family?

A stroke can be a very stressful event for the patient and his/her family members. Knowledge of stroke can help family members cope during this difficult time, and support the patient. Resources such as written information, group education programs and family support clinicians may be helpful for supporting patients and family members.