Quality of Life After Stroke

By Chris DeWald


Recently The Stroke Network sent out a mass email asking what topics readers would most like to read about in this newsletter. One of the topics which was at the top of many survivors and caregivers lists was Quality of Life After Stroke.


I have researched this and tried to re-look at myself and quality of life. Most sites were very confusing with percentages and abstracts. I think for now, we shall forgo all the numbers and just explain the pros and cons of “Quality of Life”….


Depression is a common consequence of stroke and it is known to be associated with deterioration of quality of life. According to the Department of Neurology, University of Oulu Department of Rehabilitation, the quality of life of patients was low at three months after the stroke, and it did not improve during the follow-up of a year. The test domains most often impaired were physical functioning, physical role limitations, vitality and general health.


One interesting website is  www.stroke-information.com. The most difficult aspect of having a stroke is living with the disability caused by the condition. Stroke is associated with high morbidity rates, meaning that many patients experience both physical and mental disability following the event. In fact, stroke morbidity is the leading cause of decreased independence and lowered quality of life among adults.

Stroke rehabilitation, however, offers a chance to restore quality of life after a stroke. While damaged brain tissue cannot be healed, stroke recovery techniques can offset some degree of disability. Ideally, rehabilitation helps a patient maintain existing abilities and provides strategies for handling stroke-related disabilities.


While the specific rehabilitation needs depend on the stroke patient's particular condition, a team approach can be used successfully for most people. A rehabilitation team may include physical therapists, speech therapists, rehabilitation nurses, and psychologists, as well as the stroke patient's doctor. Family members may also be part of the stroke recovery team. Even more important than the team, however, is the stroke patient's attitude. A positive attitude is vital to successful rehabilitation and the team of caregivers can work together to help the patient maintain an optimistic outlook


Having said this, stroke recovery begins as early as possible. If the patient's medical condition permits, rehabilitation may begin as early as one or two days after the stroke. Rehabilitation usually begins in the hospital. Once the patient is discharged, rehabilitation centers, inpatient facilities, and at-home programs continue to serve the patient's rehabilitation needs.


How Quickly Will Quality of Life Improve?


The effectiveness of stroke rehabilitation on improving quality of life depends on many factors: access to rehabilitation specialists, the extent of patient morbidity, the individual's commitment to recovery, and the patient's ongoing medical conditions. Generally speaking, the most significant improvements in quality of life occur within eighteen months of the stroke. However, further improvement in quality of life after this time frame remains possible and stroke rehabilitation should be continued until it becomes apparent that no further progress will occur.



From my own experience…


Almost everyone has heard the 18 months analogy. For those under the 18 months, that is a number…It is just a number used by most bean counters, insurance rehab payers……


I was told this and I continued to improve each day and still improve. It may be a minor improvement, but hey, it is like finding a hair on your bald head…it’s a hair!!!


There are many who will tell you on the message board that they continued to improve after 18 months. A lot of quality of life depends on your deficits, but a positive mental attitude and the fortitude to not give in to this “attack” assisted me.


Those like me with one side in “the twilight zone” and the other normal seem to present themselves quite well with those that I have seen writing on our chat support System. Now In the later part of August 2008, I had another stroke resulting from my not following the advise of three doctors. I tried to be Superman, but now I am just the Boy Wonder. But you know, we all must revisit the Therapy Departments or Brain Injury Wards and see what’s there.


Note. this was the hardest article I have ever written, because it has many limbs to the tree of our lives.



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The Stroke Network, Inc.

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