Reviving Rehabilitation: Helping Stroke Survivors Overcome Setbacks

My mother has had a stroke for many years?

Hello Doctor: My mother is 63 years old and had a stroke 8 years ago, which has left her with mobility issues on her left side.
After the stroke, her rehabilitation and follow-up visits were neglected due to her emotional problems (depression) and poor experiences with medical visits.
She has also been afraid to use the stairs in our apartment and has not left the house for many years.
We have prepared a simple pedal exerciser for her to use at home, and she occasionally does some basic hand exercises.
After the stroke, my mother has been able to take care of herself to some extent, but this year her physical condition has rapidly declined.
She no longer enjoys cooking and has completely stopped rehabilitation exercises.
This year, she has even fallen at home twice.
We hope to encourage her to be more proactive in her rehabilitation, at least to regain her strength.
I am wondering if the neglect of rehabilitation over the years is the main reason for her rapid decline in physical condition.
Do you have any recommendations for rehabilitation after so many years? Thank you.

kehan, 30~39 year old female. Ask Date: 2016/02/02

Dr. Yin Xinbei reply Rehabilitation

If there is a rapid decline in physical strength, other possibilities should be considered, such as a recurrent minor stroke, exacerbation of depression leading to decreased mobility, or even dementia.
It is recommended to first consult a neurologist to rule out potential causes.
The most important factors in rehabilitation are the patient's willingness and cooperation.
If the patient refuses rehabilitation, the effectiveness of passive rehabilitation activities performed by machines or caregivers is very limited.
Therefore, it is advised to actively address emotional issues by seeking help from a psychiatrist.
In principle, rehabilitation years after a stroke should focus on maintaining the patient's existing functions and cardiovascular endurance.

Reply Date: 2016/02/02

More Info

Reviving rehabilitation for stroke survivors is a critical and multifaceted process that requires a comprehensive approach, especially when dealing with setbacks such as emotional challenges and physical decline. Your mother’s situation, having suffered a stroke eight years ago, highlights the importance of consistent rehabilitation and the impact of neglecting it over time.

Firstly, it is essential to understand that stroke can lead to significant physical and cognitive impairments, and the recovery process can be prolonged and complex. The decline in your mother’s physical condition, particularly her reluctance to engage in rehabilitation activities, is not uncommon among stroke survivors. Emotional issues, such as depression, can significantly hinder motivation and participation in rehabilitation. This is often exacerbated by negative experiences in healthcare settings, leading to a cycle of avoidance and further decline.

The fact that your mother has been inactive and has experienced falls indicates that her muscle strength and balance may have deteriorated, which is a common consequence of prolonged inactivity. The body requires regular movement and exercise to maintain strength, flexibility, and coordination. When rehabilitation is neglected, as in your mother’s case, it can lead to a rapid decline in physical capabilities, making it increasingly difficult to regain lost functions.

To address these challenges, here are several recommendations for reviving your mother’s rehabilitation journey:
1. Emotional Support and Counseling: It is crucial to address the emotional aspects of recovery. Consider seeking the help of a mental health professional who specializes in working with stroke survivors. Therapy can help your mother cope with feelings of depression and anxiety, which may be contributing to her reluctance to engage in rehabilitation.

2. Gradual Reintroduction to Rehabilitation: Start slowly by reintroducing rehabilitation activities. The simple pedal machine you have at home is a great start. Encourage her to use it for short periods, gradually increasing the duration as she becomes more comfortable. Celebrate small achievements to boost her confidence.

3. Structured Physical Therapy: If possible, consult with a physical therapist who can create a tailored rehabilitation program for your mother. A therapist can provide guidance on safe exercises that focus on strength, balance, and mobility. They can also help monitor her progress and adjust the program as needed.

4. Incorporate Daily Activities: Encourage your mother to engage in daily activities that promote movement. Cooking, gardening, or even simple household chores can be beneficial. These activities can help her regain confidence in her abilities while also providing a sense of purpose.

5. Social Engagement: Isolation can worsen feelings of depression and lead to further physical decline. Encourage your mother to participate in social activities, whether it’s joining a support group for stroke survivors or engaging with family and friends. Social interaction can provide emotional support and motivation.

6. Safety Measures: Given her history of falls, ensure that her living environment is safe. Remove any tripping hazards, and consider using assistive devices such as grab bars in the bathroom or a walker for added stability.

7. Regular Check-ups: Schedule regular follow-ups with her healthcare provider to monitor her overall health and adjust her rehabilitation plan as necessary. This can also help address any medical issues that may arise, such as pain or fatigue, which can impact her ability to participate in rehabilitation.

8. Set Realistic Goals: Work with her to set achievable goals for her rehabilitation. These goals should be specific, measurable, and time-bound. For example, aim for a certain number of steps per day or a specific duration on the pedal machine.

In conclusion, while the years following a stroke can present significant challenges, it is never too late to re-engage in rehabilitation. With the right support, encouragement, and a structured approach, your mother can work towards regaining her strength and improving her quality of life. Remember, recovery is a journey that requires patience, persistence, and a supportive environment.

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