What happens after a stroke?

Feelings of anger, despair, frustration and grief are all normal for people who have had a stroke – and their families. Worries about work, money, close relationships and loss of confidence can lead to anxiety and depression. The tiredness that usually follows a stroke can also make depression worse.

The person may find it hard to control their emotions. Dramatic mood swings and sudden outbursts – such as crying or laughing at the wrong time – can be due to the damage the stroke has caused to their brain.

Helping to understand, and cope with, these symptoms and feelings is an important part of rehabilitation. If symptoms are severe or last a long time, a GP may refer the person to a clinical psychologist or psychiatrist for expert advice.

Mental processes

It is common for a stroke to cause problems with mental processes such as thinking, concentrating, remembering, making decisions, reasoning, planning and learning. A clinical psychologist can help assess these difficulties and find ways of overcoming them. For example, people who have memory loss might need to keep notes to remind themselves to do routine things. Someone with concentration problems may need to learn to take things more slowly and avoid distraction

Physiotherapy

A stroke can cause weakness or paralysis in one side of the body and problems with balance or co-ordination. Physiotherapy helps to regain as much mobility and muscle control as possible.

Physiotherapy begins very soon after a stroke, at home or in hospital. If the person cannot move, the therapist first makes sure they are correctly positioned in their bed and changes their position regularly to stop their muscles and joints from getting stiff.

If the person who has had a stroke finds it difficult to stay upright in bed or in a chair, the physiotherapist will work with them to regain balance. When they are ready, they might move on to standing with the support of equipment or other people, and then to moving around safely.

Treatment for weak or paralysed limbs starts with small guided movements and practising simple tasks. As the person begins to improve and build up strength, they will be shown larger movements and more complicated exercises that encourage both sides of the body to work together. This will help them to stop overusing the side of their body that is unaffected by the stroke.