What happens after a stroke?
When brain cells are
damaged or die, the body parts controlled by those cells lose their ability to
function. The loss of function may be mild or severe, temporary or permanent.
This depends on where and how much of the brain is damaged and how fast the
blood supply can be returned to the affected cells.
Life-threatening complications may occur after a stroke. Stroke is the most
common nervous system–related cause of physical disability. Of the people who
survive a stroke, 15% to 30% will have a permanent disability, and 20% will
need institutional care within 3 months of having a stroke.1
Your ability to care for a loved one at home
will depend on his or her level of disability, your health, and the amount of
support you have from family members or outside help.
from stroke can be related to:
- Movement. Your loved
one may not be able to use his or her arms or to walk. This is usually because
of weakness or paralysis on one side of the body
- Speech and language. Your
loved one may not be able to speak, read, or write. Also, he or she may not be
able to understand what someone else is saying.
- Thinking and reasoning. Your loved one may not be able to
think clearly. The stroke may cause changes in behavior.
- Senses. Your loved one may not be able to feel when something
or someone touches his or her affected body parts, such as the arms or legs.
Sight or hearing (rare) may be affected.
Regaining some abilities, such as speech, comes slowly,
if at all. Many people who have a stroke will have some long-term problems with
talking, understanding, and decision-making. They also may have behavior
problems that affect their relationships with family and friends.
Long-term complications of a stroke may develop right away or within
months to years after a stroke. They include:
- Weight loss, if the person has difficulty
swallowing and does not eat well.
- Skin sores
(pressure sores) or blood clots within deep veins if the person sits or lies in
one position for a long period of time.
- A stiff joint that cannot be straightened (a contracture) if
the person holds the affected arm or leg in the same position over
- Infection, especially
pneumonia or a
urinary tract infection.
- Tight muscles and
muscle spasms in the affected arm or leg.
People who have had a stroke tend to be slow, cautious,
and disorganized when they are doing unfamiliar activities. They appear anxious
and hesitant, which is often quite different from the way they were before the
There may be problems with memory or behavior. The person
may need help learning how to analyze behavior and respond appropriately to
The level of care and assistance your loved one
requires may increase if his or her condition gets worse. Basic activities like
eating, dressing, bathing, using the bathroom, and simply moving around may
become more difficult or impossible for the person to do alone. Taking care of
your loved one at home often becomes more difficult or even impossible, both
physically and emotionally.
What kinds of long-term care facilities are available?
"Nursing home" is commonly used when referring to any long-term care
facility, but there are several kinds of long-term care facilities. Each
provides different levels of medical care, personal assistance, and programs
and support services. The quality and costs of care and services at long-term
care facilities vary widely, and options vary from community to
- Assisted-living facilities usually provide private, apartment-style housing and offer a
range of services. These services may include meals, cleaning and laundry
services, and help with personal needs such as bathing, grooming, and dressing.
However, assisted-living facilities do not provide medical care. An
assisted-living facility may be appropriate for people who cannot live alone
but can still function fairly well on their own.
- Residential care facilities, which include board-and-care
homes, retirement homes, and foster care homes, typically provide a greater
level of supervision than assisted-living facilities. They offer
community-style housing, meals, laundry and cleaning services, and help with
other personal needs. They do not provide daily medical care. A residential
care facility may be appropriate for a person who needs daily assistance and
supervision but does not require daily nursing care. Residential care
facilities are less expensive than nursing homes.
- Nursing homes can provide skilled nursing care up to 24 hours
per day. All aspects of care are provided, including medical attention,
medicine, housing, meals, laundry, help with personal needs (such as dressing,
bathing, and using the toilet), and other support services. A nursing home is
the most expensive type of long-term care facility, but it also may be the most
appropriate choice for someone with extensive disabilities.
- Continuing-care communities offer different levels of care,
from assisted living to full nursing care, within the same facility. These
facilities are an expensive but appealing option for caregivers who are looking
at long-term care because these facilities are well-equipped to meet the
person's changing needs.
What are the options for part-time care?
people find that part-time help allows them to keep their loved one at home for
a longer time. Part-time care may take place either at home or in an adult day
care facility. As in long-term care facilities, home care can provide different
levels of assistance. A home health aide, for instance, can help with tasks
like bathing, cleaning, and washing clothes and linens, while a nurse may
provide medical care and help with behavior issues. Adult day care and respite
services assume temporary responsibility for the person and allow the regular
caregiver to take a break. This may relieve some of the stress of caregiving
and allow time for other responsibilities and activities.
health professionals or other caregivers to provide around-the-clock care in
the home is another option. This option is very expensive-more than a nursing
home-and also requires time to hire, supervise, and coordinate the team of