Offering Support After a Stroke

When someone you know has a stroke, it can be hard to know how to support them. A stroke (sometimes called a brain attack) happens when part of the brain’s blood supply is blocked, or when a blood vessel within the brain bursts. Both occurrences can damage parts of the brain, or even cause its tissue to die. Strokes can kill. Both can also cause long-term disability or permanent brain damage.

Our brains are our bodies’ command centers. They store memories, control body functions like breathing, heartbeat and digestion, and are where thoughts and emotions come from. Same with our ability to speak and read. All of these activities and functions requires oxygen, which is delivered via the arteries, in the form of oxygen rich blood. Brain cells, when deprived of oxygen, start to die within minutes. 

What is the most common type of stroke?

The most common type of stroke, an ischemic stroke, occurs when a blood clot, or other object, blocks a blood vessel, thus stopping the delivery of oxygen to that region of the brain. The less common hemorrhagic stroke occurs when an artery in the brain bursts or leaks blood. The blood flow into the brain puts pressure on brain cells, damaging them. Hemorrhagic strokes are cased by bulges in arteries that stretch until they pop (aneurysms) or high blood pressure. A loved one or friend who has had a stroke has experienced a life-changing event. The exact type of support each person needs is as unique as each individual, however there are some commonalities.

How can I care for myself when caring for someone who had a stroke?

If you are a caregiver, you’ve got to take care of yourself in order to care for someone else. Maintaining your own good physical and mental health is crucial. You’re going to need endurance and a positive attitude, and that means you’ve got to take good care of yourself. Here are some ways to do that:   

• Try not to dwell on what came before, or other things you cannot change
• Go easy on the caffeine
• Start a gratitude practice, either in a journal or by taking the time to focus on things you’re grateful for every day
• Learn as much as you can about stroke. This will feel (and be) empowering
• Create (and stick to) a routine
• Eat a healthy diet and get regular exercise
• Talk about your feelings with trusted friends or family
• Rest

As a caregiver, you may find yourself feeling hopeless and helpless. When this happens, allow yourself to process your feelings. Allow yourself to grieve your losses. Allow yourself to feel angry, but remember – you’re angry at the situation, not the person who had a stroke. Accept that you now have new responsibilities, and that life is different than it was before.

When friend or loved one has had a stroke, it’s be helpful to try to understand what they may be going through physically and emotionally. Each person’s recovery will be unique, and there is not set timeframe by which milestones may be met. To make matters even more complex, stroke recovery can sometimes be a ‘one step forward, two steps back’ proposition, which can add to the stress levels of patients and the people who care about them.

• Physical rehabilitation after a stroke starts in the hospital, sometimes as soon as the day after the stroke occurs. Some effects of a stroke can include:
• Trouble with memory, judgement, attention, thinking, awareness and learning.
• Painful hands and feet, with pain that increases with activity and temperature changes.
• Difficulty with, or loss of, bladder and bowel control.
• Problems speaking
• A decreased ability to express or control emotions
• Depression
• Weakness, paralysis (or both) on one side of the body

These challenges may be improved by use of multiple rehabilitative therapies. Speech therapy can help people regain the ability to produce or understand speech; physical therapy can use targeted exercises to help relearn movement and coordination skills; occupational therapy can help make daily activities like bathing, dressing, eating and drinking easier to accomplish.

How else can I be supportive?

Listening and learning are two terrific ways to help. Of course, offering to help with day-to-day tasks or errands can be immensely helpful to someone who’s had a stroke and their immediate caregivers, but it’s the emotional fallout from a catastrophic health event like a stroke that may be tougher for the patient to navigate. This is where you can shine. Be aware, though, that you won’t always know what to say. And that’s perfectly okay. You also certainly won’t be able to address or manage every situation. Also perfectly fine. Some tips from Psychology Today: 

• Be patient and listen. There are going to be difficult moments.  
• Hear the words they speak, yet be mindful of their body language and actions. A very valuable tool is to learn how to assess a situation and decide when it is best to let them resolve the task or challenge on their own versus immediately stepping in. 
• Be as supportive as possible without making them feel incapable.
• Recognize this has affected both of you and work together as a team to learn how to adapt and cope with this new normal.

Learn all you can about strokes in general, and your friend or loved one’s stroke specifically. The location, size, and duration of the stroke may predict the potential for recovery.
When you spend time with someone recovering from a stroke, don’t do everything for them. This can be a tough one to remember but swooping in and doing everything for them can slow their recovery process. During stroke recovery, people must work on rebuilding neural pathways in their brain, through a process called neuroplasticity. To activate neuroplasticity, a person needs to do the same tasks over and over. For example, to relearn how to hold a spoon, the person needs to practice holding a spoon many times.

Remember, the side effects of stroke are not all physical. Perhaps a patient is making great physical progress – their speech is nice and clear, walking is getting easier, and they’ve regained the ability to eat and bathe. Cause for celebration, right? Well yes, BUT…resist the impulse to assume the person is fine. When in doubt, ask. Invisible side effects of a stroke can include anxiety, fatigue, fear, depression and attention deficits.

Communicate anyway. Overcome barriers. People who lose their ability to speak after a stroke have not also lost their intellect. Be patient, it may take longer for a stroke survivor to find the right words or understand yours. It can be tempting to simply speak louder. Don’t. Just repeat what you said normally, and don’t rush the person to reply or try to guess what they plan to say.

Offer emotional support. More than half of stroke survivors experience depression within a year of the stroke. Emotions like frustration, anger, sadness and irritability are a normal part of the healing process. Sometimes the best thing you can do is to simply be there. 

To learn more about caring for someone after a stroke, visit our stroke medicine page.