If you or someone you love recently had a stroke, you may be feeling overwhelmed with emotion and questions about what lies ahead. But chances are, recovery is at the center of your focus.
No two strokes are the same. Some people may feel more like themselves within just a few days, without any lasting physical or cognitive issues. But for others, it may take several months to heal or adjust to any long-term effects.
So, how do you know what comes next?
Things like the type and severity of the stroke, when stroke symptoms were first noticed and when treatment began, preexisting conditions and overall health can all have an impact on treatment and how long it can take to recover from a stroke.
Below, we walk you through some of the physical and cognitive challenges that can come with strokes, as well as a general stroke recovery timeline to help you know what may be coming in the days and months ahead.
What to expect after a stroke: Possible physical and cognitive effects
When someone has a stroke their brain’s blood supply is either interrupted or reduced. When this happens, brain tissues can’t get all the oxygen or nutrients they need, which can cause damage.
Not everyone will experience the same effects of a stroke. But some of the most common physical and cognitive challenges that stroke patients face after a stroke include:
- Reduced gait and motor function
- Impaired coordination and balance, or in more serious cases ataxia – which is a degenerative condition of the nervous system
- Weakness or paralysis
- Difficulty speaking or understanding language
- Difficulty swallowing (also called dysphagia)
- Emotional and behavioral changes such as depression, anger or frustration
- Impaired cognitive ability
- Sensory changes such as vision problems, and reduced or lack of sensation in parts of the body
Stroke recovery timeline: Day 1 to one year later (and beyond)
How long it takes for someone to recover from a stroke depends on several factors. As we mentioned earlier, the type and severity of the stroke, how quickly treatment began, preexisting conditions and overall health can all have a big impact.
Other things like how quickly you or your loved one may be able to begin rehab, living and working environments, and the level of support you can count on from family and friends can affect the stroke recovery timeline, too.
So, while we can’t tell you exactly what recovery may look like or how long it will take, we can give you a general idea of what you can expect and the milestones you or your loved one will be working toward.
Day 1: Confirming a stroke diagnosis and beginning treatment
Step 1: Get an accurate stroke diagnosis
The first minutes and hours after stroke symptoms begin is the time when certain treatments can be most successful in reversing damage and improving outcomes. That means accurately diagnosing a stroke so treatment can begin as soon as possible is the vital first step.
When a patient arrives at the hospital, a stroke team immediately takes them to a nearby imaging room for a CT scan, which helps identify a stroke. Inside the imaging room, the patient’s weight is taken, blood is drawn, lab tests are completed and more. Once a stroke (and the type of stroke) is identified, treatment can begin almost immediately.
Step 2: Begin treatment
The type of stroke helps determine the course of treatment. According to Centers for Disease Control and Prevention (CDC) data, about 87% of strokes are ischemic strokes, which happen when a blood clot blocks blood flow in the brain. The remaining 13% of strokes are typically hemorrhagic strokes, which are caused by a blood vessel rupture in the brain.
For ischemic strokes, a clot-busting medication called tissue plasminogen activator (tPA) is often the first step. This medication can be extremely effective at reversing damage if given within a certain time period. For hemorrhagic strokes, medications can help control bleeding, but surgery may also be needed.
A mechanical thrombectomy – which is also called endovascular therapy – may also be performed. During this procedure, a special device is threaded through the blood vessels to the site of the stroke-causing blood clot in the brain. The device grabs the clot and removes it, restoring blood flow and dramatically improving patient outcomes.
Step 3: Start the stroke recovery process
The stroke recovery process begins as soon as the patient is stable. Based on the patient’s condition, you or your loved one’s stroke care team will recommend an initial therapy and rehabilitation plan.
The plan will be guided by a multi-disciplinary team, which may include neurologists who specialize in treating strokes, physical therapists, occupational therapists, speech-language pathologists and other experts.
The first week after a stroke
In many cases, stroke patients are discharged from the hospital to either a rehabilitation facility or their home within four to seven days. It depends on the severity of the stroke and how recovery is progressing.
Within the first week after a stroke, care teams are focused on bringing a patient’s initial recovery plan to life. Depending on their needs, a patient may begin one or more of the following therapies:
- Physical therapy – Physical therapy can include motor-skill exercises, mobility training, range-of-motion therapy and other activities to help a patient regain motor skills and prepare for life after a stroke.
- Occupational therapy – In addition to guided motor-skill exercises, an occupational therapist can work with patients on vision and cognition (or thinking) skills.
- Speech therapy – Speech therapy focuses on helping patients regain their ability to speak, communicate or swallow after a stroke.
- Cognitive and emotional activities – Stroke rehabilitation should focus on treating the whole patient, mind, body and spirit. Cognitive and emotional activities with a mental health specialist can help patients understand and deal with the range of emotions they may be experiencing.
The first three months of recovery after a stroke
Leaving the hospital is a major milestone in the stroke recovery process. But before you or your loved one is discharged, your care team members will work together to recommend the best next steps in treatment and recovery. And you’ll likely meet with a social worker at the hospital to go over immediate next steps, including where to continue stroke rehabilitation.
Many patients will return home and continue their recovery with either home-based care – where therapists come to you or your loved one – or outpatient therapy through a stroke rehabilitation center like our own Regions Hospital Stroke Center and Methodist Stroke Center.
But some may benefit from specialized short-term or long-term care. Some options can include:
- Inpatient stroke rehabilitation – Inpatient rehabilitation is an intensive acute care program, with most patients spending somewhere between two and three weeks in a rehabilitation unit. With this type of therapy program, patients have therapy at least five days a week for three or more hours per day. An inpatient stroke rehabilitation program may be recommended when around-the-clock access to medical care is still in the patient’s best interest, but the patient can handle the rigor of daily, intensive therapies. Our own Regions Hospital provides inpatient stroke rehabilitation and is certified by the Commission on Accreditation of Rehabilitation Facilities (CARF).
- Skilled nursing care – A skilled nursing facility that specializes in rehabilitation is usually recommended when a patient requires intensive care but may not be able to participate in daily intensive therapies. This means that patients may be dealing with more serious or longer-lasting stroke issues. That said, a skilled nursing facility can also be recommended after a patient completes an inpatient program but still needs therapy to regain full functionality. At skilled nursing facilities, therapy sessions last for two hours or less each day, and the average stay is about a month.
- Nursing home care – Nursing home care is long-term, custodial care. While a patient can still receive certain therapies at a nursing home, nursing home care is an option when they need daily non-medical help with things like bathing, grooming, eating, medication monitoring or mobility.
It’s also important to note that many patients’ stroke recovery timeline includes more than one type of rehabilitation or therapy program. For example, a patient may start with inpatient rehabilitation for a few weeks before moving to outpatient therapy, and then home-based therapy.
The first six months of recovery after a stroke
Depending on which rehab program path was chosen after being discharged from the hospital, within the first six months after a stroke, many stroke patients have completed at least one rehabilitation program and may be continuing with one or more therapies at home.
During any inpatient or skilled nursing therapy programs, a patient’s care team likely included a range of therapists and specialists working with them regularly. But just because a patient has returned home, that doesn’t mean they no longer need stroke care.
Having a stroke is a major risk factor for having another. In fact, one in four strokes each year are in people who have had a previous stroke, according to the CDC. That’s why it’s important to establish relationships with both primary and specialty doctors who can provide ongoing care, including:
- A vascular neurologist – Vascular neurologists are neurologists who specialize in treating strokes and other cerebrovascular diseases. They can diagnose and treat strokes when a patient comes into the hospital, as well as provide post-stroke care.
- A primary care doctor – Primary care doctors are experts in preventive health, managing chronic conditions, and diagnosing and treating hundreds of conditions – from allergies to the common cold to skin rashes. They can help manage and monitor stroke risk factors.
- A mental health professional – Having a stroke is a major life event. And the recovery process can be emotional and frustrating. A mental health professional like a psychologist can help patients cope with anxiety, depression and other challenges or lasting effects from a stroke.
One year after a stroke and beyond
Around the one-year mark after a stroke, many stroke survivors have completed their rehabilitation therapy programs. Some may be back to their old selves, while others are adjusting to some new limitations and continuing certain therapy techniques at home. But stroke recovery is ongoing.
One way to continue the process is to take advantage of local stroke support groups. These groups are a community of people who understand what it’s like to experience a stroke – who can help provide empathy, support and even a little inspiration when it’s needed most.
We offer stroke support groups at Regions and Methodist Hospitals.
We’re here for you at every step of the stroke recovery process
From the minute you or your loved one arrives at the hospital, every step the stroke care team takes has healing and recovery in mind.
Our comprehensive stroke rehabilitation programs include a range of therapies and are specifically designed to help achieve the best possible outcome for each patient, whether a patient is in the hospital, transitional care or at home.
Having a stroke is life changing. And we’re here to help you cope and heal.
Learn more about our comprehensive stroke treatment and care for neurological disorders.