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Surviving Strokes: Rehabilitation Helps Nearly Everyone

June 03, 2014

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In addition to being the fourth leading cause of death, strokes also are the leading cause of serious, long-term disability in stroke survivors, according to Dr. Ash Jain, a cardiologist and medical director of the Washington Hospital Stroke Program.

Statistics like these are the reason why the Stroke Program at Washington Hospital continues to dedicate significant resources and energy to educating the public and working to help individuals in the community prevent stroke and recognize strokes when they occur, Dr. Jain said.

Unfortunately, strokes — the vast majority of which are caused when a blood clot travels to the brain and cuts off oxygen to the affected areas — are still one of the most common causes of patients arriving in the emergency room, Dr. Jain said.

For stroke victims, cutting-edge care at a certified Primary Stroke Center like that at Washington Hospital, is critical to mitigating the damage from a stroke.

“Our primary goal is to treat a stroke as quickly as possible once a patient reaches our Emergency Room, because time is everything when it comes to effective management of a stroke,” according to Dr. Jain. “Even small delays can have heavy costs, and research has shown that outcomes are better when people can properly identify signs of stroke and then seek help immediately.”

The more community members understand about stroke, the more likely they will be to recognize it and take action, Dr. Jain said.  Most often it is a family member — not the stroke victim — who recognizes stroke and calls 9-1-1.  Most importantly, many of the acute management techniques for stroke are only viable for a limited time, which means a patient must reach the ER as quickly as possible.

According to the American Heart Association, an estimated 6.8 million Americans over the age of 20 have had a stroke of some kind and most survivors have had to overcome some level of stroke-induced disability, added Washington Hospital Stroke Program Coordinator Doug Van Houten, R.N.

After experiencing a stroke, participation in an ongoing rehabilitation program under the direction of specialized therapists offers stroke victims some measure of improvement. 

“Amazingly, if one survives a stroke, the stroke victim almost always gets at least somewhat better with appropriate rehabilitation therapy,” Van Houten said.  While nearly every stroke patient can measure some improvement, stroke recovery is quite complicated because of the stroke’s impact on the whole patient, Van Houten noted.

Rehabilitation activities typically focus on three main areas of disability:
   
Physical:  Recovering motor function such as learning to walk again, becoming independent with activities of daily living, being able to swallow safely.  It also means recovering from cognitive impairment:  adapting to brain damage that keeps the stroke survivor from processing information and communicating normally.

Psychological:  This means focusing on “recovery of the self.”  Before a stroke, a person thinks of one’s self as independent, competent — just like everyone else.  Suddenly there may be a loss of independence, a loss of the “normal” self, of other similar identities.  A patient’s health perception also is impaired as now the patient suffers from a chronic condition.

Social:  A stroke survivor may be confronted with the loss of his/her identity as a worker, provider, head-of-family, advisor, other functions or activities.  Suddenly the stroke survivor may now find him/herself in the role of a care-receiver, of being dependent on others and no longer able to work.  This change can seriously affect a patient’s social environment.  For example, a marriage partnership may change to a caregiver/care-receiver relationship.

Thus recovery from a stroke can be a challenge from many different vantage points, Van Houten said.  “These issues are part of the reason a stroke can be so disabling.

Rehabilitation is the key to stroke recovery, Van Houten emphasized.  Stroke patients and their caregivers must take advantage of rehabilitation experts who include physical, occupational and speech therapists. 

Rehabilitation therapy specialists are a primary reason in stroke recovery but equally important is the will of the stroke survivor to get better, he added.

Studies indicate that recovery from a stroke requires several factors in addition to good rehabilitation:

  1. A willingness on the part of the stroke survivor to work hard with the rehabilitation therapist.
  2. A sense of optimism and hope that life will get better with time.
  3. The assistance of a home caregiver, most often a spouse, who will help, nurture and encourage the stroke survivor to get better.

Some level of recovery from a stroke is likely with the assistance of rehabilitation therapists, personal commitment to the recovery program and the help and support of family and friends, Van Houten added.

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