Learning to adapt after a stroke

Carter Holm, RN
Prairie Doc Perspective

Working as an RN in inpatient rehab, I am often called upon to care for patients who have had a cerebrovascular accident, or more commonly called a stroke. I have observed that every stroke patient experiences a unique combination of symptoms but the one of the most important tasks they accomplish in rehab is learning how to be adaptable.
According to the American Stroke Association, left sided strokes (which affect the right side of the body) cause patients to experience more difficulty with language, both in speech and understanding. Right sided strokes, can cause more behavioral changes that may lead to uncharacteristic impulsivity, and may affect the patient’s vision. Based upon the type of stroke, each patient’s experience is different and they will have their own set of challenges to overcome as they work towards recovery.
Identifying the challenges is a crucial aspect of stroke rehabilitation. A main focus of the rehab team, for example, is balance and gait. Physical therapy is crucial in recovering strength and coordination in the affected side. If a patient is experiencing weakness to the left or right side of their body, they may require the use of a walker to allow for safe ambulation. Some patients may instead require the use of a cane, quad cane, or hemi-walker. Finding the correct assistive devices is one way stroke patients work to return to some normalcy.
Stroke patients may regain their freedom of movement with the help of an adaptive foot brace, or the use of a specialized cane. They may adapt to using their non-dominant hand for eating or writing. They may learn tools to adapt their speech patterns, or use electrical stimulation of the facial muscles to increase strength, and improve oral function. What all of these things have in common is learning how to change, how to adapt. And while each stroke is different, and symptoms vary from patient to patient, one common thread is that all stroke patients, their families, and friends must learn to adapt. And it isn’t just the physical recovery, people must adapt to the emotional and psychological changes as well.
Depression, anxiety, altered moods or sudden mood changes are all common symptoms following a stroke. Often, I have had patients who are so frustrated that they feel like giving up on therapy, even giving up on life. Patients and family members may experience grief: mourning the loss of the person that they were, or that they once knew. Author Delanie Stephenson wrote of her stroke, “While my body and mind were healing, I was learning to be a new person”. Just as the body needs time and practice to adapt to the physical changes, the brain also needs time and practice.
Neuroplasticity does not return overnight, and may take months to return to normal. Regaining function requires setting goals, hard work, patience, and most important an acceptance of the need to adapt!
(Carter Holm, RN is a Registered Nurse at Avera McKennan in Sioux Falls Specializing in inpatient rehabilitation.)