What is involved in stroke recovery?

A specialist, such as a neurologist, rehabilitation physician or geriatrician, will be in charge of managing patient care. They will oversee progress and coordinate healthcare staff throughout the acute phase of hospitalisation and ongoing healthcare. The specialist doctors will often be involved in decision making and planning for rehabilitation and advise patients on further stroke prevention.

Nurses provide day-to-day patient health care in the acute phase of hospitalisation and rehabilitation. Nurses make regular observations of the patient’s condition to report information back to the healthcare team. Nurses provide vital assistance with daily care, including:

• showering
• toileting
• dressing
• eating
• taking medication.

Ongoing nursing assistance can be arranged when patients are discharged from hospital. Community nurses can help with everyday activities such as:

• showering
• self-care
• administering medication
• monitoring recovery.

Dieticians ensure patients are getting adequate nutrition throughout the acute phase of hospitalisation and ongoing healthcare issues with eating, swallowing, or poor appetite. They also provide education and advice to patients about diet to reduce the risk on another stroke.

Neuropsychologists may work with patients who are having trouble with:

• thinking
• memory
• personality
• behavioural changes.

The neuropsychologist can also advise and provide counselling to patients and families about changes that may occur in daily living as a result of the stroke. They can help with issues that may impact the ability to return to the workforce and advise on strategies to help this process.

Occupational Therapists are involved in helping patients with daily living activities and independence that could be impacted by the stroke. Therapy involves relearning skills needed to return home safely and using adapted methods to get back to completing daily tasks like dressing and showering. Occupational Therapists often visit patient’s homes to look at access and things that will assist the patient to manage in the home. They may recommend home modifications and home aids, such as stair handrails and shower chairs. They can also help with return to work planning and driving.

Physiotherapists work with patients to help with movements after a stroke.

This includes:

• sitting
• standing
• walking
• prevention of falls.

A physiotherapist is usually involved in rehabilitation and design individualised programs that considers a patient’s general health and previous level of activity. Appropriate goals are made and readjusted as patient’s progress through their recovery. Early goals may involve movements like sitting up in bed safely or maintaining balance while standing. Longer-term goals may involve more complex movements and activities. In addition, Physiotherapists are involved in selection of mobility aids, such as walking frames and wheelchairs. They can also advise on exercise and activities to reduce the risk of further stroke.

Psychologists assists with the life changes and mental health issues that can occur after stroke. Psychologists provide support to patients and family about getting used to life after stroke, and mental health concerns including depression and anxiety.

Social Workers help patients and their families deal with the possible impacts of stroke. These changes can include:

• emotional
• financial
• social
• family changes.

Social workers provide counselling and support to patients and family members. Social Workers can assist when making decisions on:

• care
• discharge planning
• finding suitable accommodation for discharge
• giving information on costs.

Social Workers can advise on assistance programs and arrange services such as community nursing care, meals on wheels, respite care and home help.

Speech Pathologists help patients who have trouble with:

• speech
• understanding spoken or written information
• reading
• writing.

Speech Pathologists assess what difficulties the patient is having and decide on the best therapy. Therapy for patients with aphasia may involve:

• relearning names of people and objects
• relearning to speak clearly
• learning to use alternative ways to communicate and understand language.

Difficulties might also occur in speech production (dysarthria, dyspraxia) and Speech Pathologists design therapy to maximise recovery. Speech Pathologists also help patients who are having difficulty swallowing and can recommend ways to eat and drink safely. They can also work alongside the dietician and advise on the most optimal diet.