Your parent had a stroke: What’s next?

“You’ve had a stroke.” When your parent hears these words, their reaction – and yours – might include shock, denial and fear.

First? Take a deep breath – literally and figuratively. Acknowledge the uncertainty and anxious thoughts, and then steady yourself and know that many have traveled this road before. Modern protocols – based on decades of experience with millions of stroke survivors – inform us on best practices for treating a stroke and up the odds for successful rehabilitation.

What to ask if your parent is still in the hospital

Be proactive. Ask your parent’s medical team to share important information, such as:

• What type of stroke did your parent have? If it was an ischemic stroke, ask if clot-reducing medications have been used.
• If your parent wound up in intensive or acute care, ask about the stroke’s severity and how that might impact recovery.
• Before being discharged, be sure to ask the medical staff about the suggested rehabilitation plan. Make sure you understand their assessment of the likely long-term effects the stroke has caused. Major symptoms include:
  • Cognitive issues (memory challenges, having trouble speaking)
  • Physical issues (weakness, paralysis, trouble swallowing, trouble sleeping, extreme fatigue)
  • Emotional issues (depression, anxiety)

What happens after your parent returns home?

Once Mom or Dad gets home, make sure you are aware of the lingering problems that may persist following a stroke. The hospital team will share everything they’ve observed before discharging your parent. Some symptoms, however, might become noticeable as your parent settles in at home. Keep a watchful eye out for conditions such as:

• Muscle weakness, paralysis or balance problems
• Physical sensations including numbness, tingling and burning
• Pain
• Unusual tiredness
• Incontinence
• Speech issues
• Trouble swallowing
• Memory or attention problems
• Eyesight complaints
• Denial relating to the severity of the stroke

If you see any of the above, or your parent says they don’t feel right – which could range from any of the symptoms listed above to feelings of loneliness – don’t wait. Alert your parent’s care providers immediately. Just as time is of the essence when a stroke first happens, rapidly addressing any emergent issues will enhance the prospects for optimal recovery.

What factors impact recovery?

According to the American Stroke Association, stroke recovery happens on multiple fronts. The degree of recovery depends on:

• The location of the stroke in the brain
• The percentage of the brain impacted by the stroke
• How motivated the person is to get better
• How committed and skilled the caregivers are
• How healthy the person was before the stroke

When does recovery peak? The period of fastest recovery is typically in the first three to six months following the stroke. However, this isn’t a hard and fast rule. Some people continue to get better one or even two years later.

Special considerations for elderly stroke patients

The older we get, the greater our risk of experiencing a stroke. About half of all strokes happen to people older than 75. Older adults often stay in the hospital longer and find recovery more difficult. Ask your parent’s medical team to identify any age-related challenges and how they might affect rehabilitation, and what the plan is to maximize recovery. You will also want to discuss any physical conditions that might change the course of rehabilitation, including cognitive impairment and incontinence.

While strokes may cause great harm to the body, research indicates that the brain can bounce back. Neurons may begin to regenerate just a few days after a stroke – even in the brains of older adults.

Make sure to compare notes with your parent’s healthcare team about the impact of their age on their recovery and quality of life.

Create the conditions for recovery while reducing the risk of another stroke

There’s a lot you can do to keep your parent safer and healthier as recovery continues. Follow these tips:

• Review your parent’s prescriptions. Learn about possible side effects, some of which might increase due to the stroke. Make sure they take the correct doses of each medication at the appropriate times.
• Assess whether their home should be “stroke proofed.” Consider your parent’s symptoms and whether any inconveniences or hazards need adjusting.
• Stroke-related falls are quite common, and your parent might be at an increased risk. Be sure to address potential tripping hazards. Should your parent experience a serious fall with significant pain, bleeding or bruising, get them to a hospital immediately. If your parent falls repeatedly, consult with a doctor or physical therapist.
• To lower the chances of another stroke, be mindful about your parent’s diet. If your parent is healthy enough to exercise, support them in committing to a regular program.

The role of physical therapy

A plan for physical therapy, if recommended, is established before your parent leaves the hospital. The discharge papers will outline a physical therapy protocol. The hospital staff may also share resources for physical therapy.

Look for a physical therapist who is experienced with stroke rehabilitation – ideally, a stroke recovery specialist who is skilled in helping people with coordination issues, balance problems and other conditions that impact quality of life.

Ask questions about the program and its goals, along with a therapy timetable. Make sure you and your parent understand the plan and are clear on how to follow it.

What about occupational therapy?

Occupational therapy might help your parent rebuild life skills following a stroke. When the connection between the brain, nerves and muscles is compromised, occupational therapy can teach alternative methods for completing daily activities. This might include speaking and communication, walking and getting dressed, eating, writing, bathing, and toileting. The overriding goal will be to help your parent regain as much independence as possible.

How to promote positive outcomes for stroke rehabilitation

Here are the main factors that contribute to a successful stroke rehabilitation program:

• How badly did the stroke damage the brain?
• How old is your parent?
• What is their level of alertness?
• How intense can the rehab program be?
• Does your parent have other medical conditions? If so, how serious are they?
• Can the home be outfitted for safety and independence, with additions like stair railings and grab bars?
• Are family and friends on board and ready to be supportive?
• How soon can rehabilitation begin?

How to keep the lines of communication open with your parent

A stroke can be stressful, even for the best parent-child relationship. A decline in your mother or father’s physical abilities, changes to the way they live their life, and challenges to their independence may cause significant emotional turmoil.

The best way to address the situation is straight on. Regularly ask your parent how they are feeling. Involve them in their recovery and care decisions. Be respectful of their feelings – but always speak the truth.

If your parent is experiencing communication problems due to the stroke, follow these guidelines:

• Practice patience
• Create a quiet zone with a minimum of distractions (e.g., lower the volume on the TV or turn it off)
• When possible, ask questions that can be answered with “yes” or “no”
• Don’t raise your voice or speak too softly
• Slow down and give your parent time to process what you are saying
• Listen to what your parent has to say and make sure they know you understand
• Don’t answer questions for your parent; give them time to respond 

The value of a strong social network 

The demands of a hospital stay and the initial weeks of a rehabilitation program may find you, your family and your parent stretched to the limit. That’s why it’s important to assemble a “home team” of family, friends and neighbors who are committed to your parent’s recovery.

The home team can also help your parent avoid social isolation. Even a short in-person visit or a phone call from a friend keeps your parent engaged and can help them maintain a positive mental outlook to strengthen recovery.

Don’t go at it alone

Your parent suffered the stroke, but you are going through this, too. It can be emotionally draining, and many children of older adults who’ve had strokes often shove their emotions to the side and power through the situation. Yes, develop your courage muscles as part of being a good partner for your parent. However, being strong doesn’t mean treating your emotions like a doormat. Acknowledge uncomfortable feelings, but don’t say “I’m fine” when you’re not. Keep in mind what flight crews always say: “Should we experience a drop in pressure, secure the oxygen mask over your nose and mouth before helping others.” Meaning: Taking care of your parent requires looking after yourself, too.

The long and winding road to recovery: Six months and beyond

From here on out, further recovery is a possibility, but progress will likely be slower. Is full recovery possible? For some, the answer is yes. Others learn to adjust to their limitations and live happy, fulfilling lives.

While recovery might be more or less complete, staying in contact with your parent’s healthcare team is an essential part of remaining healthy and lowering the chance of another stroke. Team members might include:

• Your parent’s primary care doctor
• A rehabilitation physician (also known as a physiatrist)
• Physical and occupational therapists
• A neurologist
• A rehabilitation psychologist

Speak with your parent’s doctor’s office to identify the right team of professionals for your situation.

When your parent needs more help

We all value our independence. If all goes well, your parent might bounce back to resume most or all of the activities they enjoyed prior to the stroke. On the other hand, the time may come when Mom or Dad needs more help than can be provided by you, family members or friends.

If your parent is no longer engaged socially, eating well or staying active, it might be time for professional assistance. Some people who have had strokes do well with in-home care; others get exactly what they need in an assisted living community.

Is assisted living the right choice for your parent? Try a short-term stay at Atria. This might make a perfect transition following a hospitalization or rehab stay.  Locate an Atria community near you.

Atria Senior Living is here to help

With more than 25 years of experience serving families like yours, we specialize in a well-rounded approach to healthy living – providing discreet, professional care. We are happy to share our expertise and offer any support we can to help your parent live a fulfilling life after a stroke.

Let us call on our relationships with trusted senior living professionals to put you in touch with the best solution for you and your parent.

Feel free to reach out to your local Atria community director today.

Stroke recovery checklist for seniors (PDF)