Major disability after a stroke

Stroke can sometimes cause severe and lasting disability, particularly in elderly people. This can lead to loss of independence and the need for long-term care either at home or in a nursing home. Major disability always involves impairment of more than one function' for example, loss of power in the right side is very frequently accompanied by loss of speech, and severe strokes of all kinds can be accompanied by loss of awareness, exhaustion, frustration and depression. Some strokes may also affect control of the bladder or bowel, or the ability to swallow properly. All major strokes affect mobility, and in those whose mobility was already impaired this can lead to dependency on a wheelchair, or sometimes the need for residential care. Severe strokes can place a great burden on the coping mechanisms of carers and family as well as patients.

The variety of disabilities which stroke can cause are illustrated in the section 'What problems did I have, and why?' Lasting inability to stand and walk independently is the most fundamental problem for many. The provision of suitable aids can make a big difference:

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On the other hand, some younger people who have suffered strokes are reluctant to have permanent adjustments made to their homes which reflect their status as "disabled"'
Problems with speech and swallowing can be major problem in the initial stages of recovery from stroke but can be overcome by suitable therapy and other measures such as thickening of drinks.
Problems with bowel and bladder control can cause distress and may need repeated attention from health professionals.
The need for help with basic functions can lead to frustration and embarrassment, especially in the early stages of recovery in previously independent people. Stroke can also lead to loss of emotional control which can be distressing both for individuals and carers. In addition people severely disabled by stroke often feel guilty and anxious about being dependent on others.

Most people with severe stroke felt that they had useful help from health professionals, especially physiotherapists, but that sometimes this was too hard to access'

Individuals severely disabled by stroke and their families use a variety of coping mechanisms. The need for a positive attitude is mentioned frequently. Often this involves goal-setting, for example being determined to participate in a major family occasion.
Each person interviewed found a different way of addressing the sudden and massive disruption which their major stroke had caused. Many felt that they had not received all the help that they needed, but reached a stable way of managing with the help of family and others. Several found that the Stroke Association and local groups could provide useful advice and support.

Last reviewed June 2017.
Last updated August 2013



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