When a loved one has a stroke, attention shifts to the ER and hospital. The faster they’re seen, the more IV clot busting medicine, maybe even a surgical procedure, all of this is what every person understands is crucial to success. But here’s what no one tells families, which subsequently catches most by surprise: the recovery portion of the process does not happen within the four walls of the hospital – but instead at home, for months or years to come – and the challenges do not stem from what everyone worried about in the medical arena.

The Hospital Takes Care of Part of The Problem

Hospitals are there to stabilize and provide partial medical needs. For example, one can expect to be in a hospital for a few days to a week post-stroke to gain some physical therapy, speech pathology, assessed medications, and adjusted needs. After about a week to two, discharge comes – and suddenly, the family is expected to uphold all recovery needs. However, “all needs” are far more complicated than anyone previously anticipated.

Physical therapy might occur twice weekly. What about the other five days? Someone still needs to learn to walk again safely or learn arm motions or reintegrate how to use utensils. Professionals can teach but are not present at 2 PM when someone wants to take a shower or at dinnertime when someone cannot effectively use utensils. Many stroke survivors benefit from non-medical stroke recovery support at home in Philadelphia for these reasons, as non-medical support is rooted in these daily living adjustments that do not occur in typical rehabilitation.

Communication Problems Extend Beyond Speech

Everyone knows that strokes impact speech. What they don’t know is how many more factors exist in the realm of communication. Some survivors know what they want to say but cannot find the words; others can talk just fine but cannot understand what someone else is saying. Even more, some can do both and now can’t read or write.

Further, some people who had very strong verbal channels of communication can no longer pick up on social communication factors, they don’t understand humor or sarcasm, nor do they pick up on someone’s tone. These conversations become exhausting because they’re working really hard to process all external channels, while family members take this as rudeness or a lack of caring when, in reality, their brains are no longer functioning the same.

And this feeds into everything. Relationships suffer. The stroke survivor feels discouraged from attempting communication because it’s too much work. Depression sets in – further complicating the idea of physical recovery.

Cognitive Changes No One Informed You About

Memory problems and concentration failings plague survivors post-stroke, but this is not where it ends. Many survivors and their families face something called executive function – essentially, brain plans for organization and task completion fail. Someone might remember each step of getting dressed but fail to remember how to put them in a proper order. Someone might be halfway through making lunch and forget why they started at all.

Further, reasoning and judgment can be impaired. For example, a life-long saver may make impulse purchases; someone who never forgot medications now requires daily reminders. This is not a product of stubbornness but instead a failure of part of the brain that no longer gets used as intended.

This becomes troubling when safety is involved – intruding on thoughts about someone’s perception of reality. For example, a survivor who thinks they can navigate walking without assistance actually cannot or believes they don’t need help turning on the stove and sitting down might need assistance. Families find themselves needing to monitor people who were once entirely independent.

The Emotional Rollercoaster Loses Focus

Depression after-stroke is relatively common – but unfortunately, it does not look like what everyone expects. Some stroke survivors are not sad; instead, they rant and rave with anger over all circumstances. Others are emotionally flat over everything. Finally, there’s a phenomenon called emotional lability where individuals cry or laugh at inappropriate times when they can actually not control themselves. For example, they may break down crying when discussing the weather, an inappropriate time without sad context.

Anxiety plagues many survivors who fear having a second stroke above anything else. They refuse to be left alone or constantly ask companions to assess any pains. Some panic for the first time in their lives.

Family members often feel guilty for being mad at what’s going on. They know their loved ones can’t help it, but it’s exhausting to live with someone who drastically changes personality-wise; and simultaneously, the stroke survivor often realizes they’re different, which complicates the entire distressing phenomenon.

Daily Living Becomes a Somewhat Complicated Puzzle

Dressing occurs multiple times a day; however, it’s not as easy as putting on pants. It’s balancing standing on one foot while getting pants up; it’s buttoning with fingers that don’t fully work; it’s putting a shirt over one’s head when an arm doesn’t lift fully (or at all). What once took two minutes stretches into twenty – and exhausts people immediately.

Bathing creates a challenge as most households are not built for aesthetic bathing – but safe bathing. It’s hard to get into a tub without falling over; standing up for ten minutes in a shower is too difficult – and this is one part of life that people absolutely refuse assistance – they want privacy (and humble respect) to do their business even if they cannot physically help.

Meals require cognitive functioning with physical coordination with safety awareness – all at once – readjusting recipes, weighing options, managing stovetop requirements at different temperatures and keeping cleared surfaces safe around heat – this is all too much post-stroke. Many survivors find themselves with terrible diets because it’s too complicated to prepare healthy meals instead of lack of willpower.

Recovery Timelines Don’t Meet Expectations

Most people assume recovery will happen steadily over a couple of months and plateau thereafter; however, that recovery happens messily with unpredictable bursts of success at all levels (or fails). For instance, someone might work on something for three weeks without resolution until miraculously it’s figured out. Someone might grasp everything well for one week and then flatline for three months without progression.

The medical community states that most recovery occurs within the first six months, which is only partially true as some people recover years into their journey, but insurance companies and rehabilitation facilities subscribe to the six-month timeline for treatment perpetuation, leaving families afterward on their own to grasp how this might play out.

Additionally, physical rehabilitation and re-entry into daily life are disjointed efforts – someone might regain most physical therapy functions but fail to return back to work due to cognitive or emotional changes, or someone might regain status quo mentally but find challenging physical issues become disallowed.

The Takeaway

Much more than medical needs and therapy sessions everyone initially worries about perform an integral role in the recovery process after stroke. Daily living challenges along with communication issues, cognitive changes and emotional development may require outside support facilitated far longer than occurs in doctor’s offices or hospitals, and understanding less tangible recovery elements helps families prepare what’s truly on deck for them and when additional help will be required if their loved one no longer meets expectations. The hospital is only the beginning of a longer journey process that transforms daily life in ways no one ever tells you about upfront.