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Common Roadblocks After a Stroke

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Strokes, known as cerebrovascular accidents (CVA), occur when blood flow is cut off in a part of the brain, depriving brain tissue of oxygen and nutrients. Brain cell damage or death can occur within minutes of such an event. There are a variety of effects on stroke survivors, depending on where the stroke occurred and how badly the brain tissue was damaged. Some survivors make a full recovery, but nearly 2/3 have some type of disability. Deficits can range from mild unilateral weakness to severe impairment in vision, speech, or the ability to walk independently. When you or a loved one has had a stroke, it can be very overwhelming and confusing. There are some common obstacles you may encounter after a stroke that can make it even more difficult to focus on your rehabilitation. This article discusses potential obstacles and suggestions for overcoming those obstacles after a stroke.

The 5 most common obstacles after a stroke

Find the right services:

If the stroke survivor was hospitalized, you were most likely assisted with what is known as “discharge disposition” and guided to the next phase of rehabilitation and recovery. The team can propose inpatient, outpatient or home rehabilitation, or no rehabilitation at all. If the stroke wasn’t severe enough to warrant hospitalization, you may not have guidance on next steps to cope with common psychological and physical stressors—even in the case of a “mild” stroke. Finding neurorehabilitation and mental health services can be difficult, especially if you live in a rural area. There are many clinics dedicated to rehabilitation from common impairments such as a torn rotator cuff or knee replacement. However, there are only a few clinics that care for patients with stroke. Access to adequate neurorehabilitation services is essential to recovery.

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Limitations in function or ability:

You may have noticed a change in stroke survivors’ ability to do tasks for themselves because of defects they suffered after the stroke. It can now be difficult not to do previously simple daily tasks or activities such as cooking, driving, or returning to work. This can be very disheartening and lead to changes in daily routines, which in turn lead to a change in role and the need for post-stroke care or services.

Change in emotions or depression:

Because of changes in everyday life and brain function after a stroke, depression or low spirits can be persistent and common. Although this is very common after a stroke, it can be very difficult to overcome and can interfere with your daily life and rehabilitation.

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Insurance coverage limitations:

Unfortunately, regardless of your insurance plan, coverage can dictate all aspects of stroke care, from hospitalization to medication to therapy. This can be incredibly frustrating and sometimes detrimental to your recovery. For example, if you are seeking outpatient therapy, some clinics may not be on the network, or you may be limited to a certain number of visits per therapy discipline. How can you focus on getting better and going back to previous routines when you are unable to get the services you need?

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Transport and care:

After a stroke, the survivor may not be able to do tasks such as bathing and dressing themselves, or may have limited ability to do things such as walking. This can be a major life change that requires part-time or full-time caregiving in many different forms.

How to overcome obstacles you face

Find the right services:

If you have not received support services from a local care team, finding services can be confusing and difficult. There are national references that can help.

You can also contact your local hospital system to inquire about local services and referrals. If you have a choice of multiple locations in the area that offer stroke rehabilitation services, it is highly recommended that you request a tour and survey multiple facilities before signing up. Most insurance companies allow only one covered assessment per calendar year, per illness and/or episode of care. If you start in a location that ends up not being right for you, it’s possible that not only will it be a hassle to switch therapy centers, but you’ll end up incurring the expense of a re-evaluation. Questions to ask the facility that might provide insight include: How long is your waiting list? Do you see your patients 1:1 or several patients in one hour? How long is a typical session (minutes)? What is a typical length of care for stroke survivors? What resources and technologies do you use in your facility?

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Limitations in function or ability:

The inability to take care of themselves or fulfill previous life roles is often the biggest change after a stroke. It’s important to be your own advocate, whether you’re a stroke survivor or a caregiver. If you can articulate your needs, tell your care team what you want and what you need. It is best to play a role in the decision-making process whenever possible. Obtaining the necessary medical equipment or adaptive equipment can also be crucial to increasing home independence and completing tasks safely, increasing the daily split between self-care and transfers. Finding rehabilitation services to meet your goals and help the stroke survivor achieve greater functional independence is an important part of returning to previous life roles. Rehabilitation can also help refer to other services along the way, such as B. vocational rehabilitation or driving assessments to help stroke survivors and families transition back to high-level activities after rehabilitation.

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Change in emotions or depression:

Talk to someone you trust about how you’re feeling. This doesn’t have to be a member of your care team in the beginning, it can just be helpful to talk about what you are going through and all the changes in your life. A family member or friend may have emotional support or helpful suggestions. If you are still not feeling better, please speak to your doctor or a member of your healthcare team about medication management and supportive services such as seeing a therapist or joining a support group.

Insurance coverage limitations:

This can be a severe limiting factor. It can be very helpful to call your insurance company before setting up any other services. You may be assigned a case manager through your insurance company to advocate for the survivor. They can help you find available services and also explain their policies. It is very helpful to determine which therapies are covered and for how many sessions. Medicare and Medicaid have very different rules compared to private insurance. Please contact your claims manager or a case manager at your medical facility to assist you with this.

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Transport and care:

This can be one of the most difficult “pieces of the puzzle” to solve after a stroke. When the survivor is unable to fend for themselves, it can be difficult to decide what type of support they need and how best to provide it. The hospital or insurance case manager may have resources available that are covered or partially covered to support transportation or care. It helps to know your choices before trying to decide everything for yourself. Talking to friends and family about taking turns or setting up a rotation schedule can also reduce caregiver burnout. Sometimes stroke survivors and their families choose to spend a little more time in a skilled nursing facility or assisted living facility to allow for more rehabilitation and healing time before returning home. Choices can be limited or huge. However, it is important to find out what works best for you and your family. We’ll continue to write about how articles support caregivers if you’d like learn more here.

Conclusion: Tips for a better life after a stroke

Life after a stroke can be full of obstacles, but also full of new joys and experiences. This article is designed to help you and your family “navigate the system” and advocate for yourself or a loved one. Do not give up. Roadblocks will persist in life, but it’s always possible to find new ways around the jam.

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