Recovery after stroke often occurs more quickly in the first months, then continues slowly and steadily over years. Rehabilitation programs are designed to help you improve your abilities and learn new skills.
Depending upon your specific needs, you may or may not need therapy after discharge.
Therapy can be provided in your home, in a rehabilitation setting, in an outpatient setting or in a skilled nursing facility. That determination is made prior to your discharge.
It will be important to your recovery that you take your medications as prescribed and practice lifestyle changes to reduce your risk of having another stroke.
If you drove before your stroke happened, you will need your doctor’s permission to continue driving. You may also need to have a driver evaluation prior to driving again.
Although stroke rehabilitation is increasingly successful at prolonging life, a stroke can be a disabling or fatal condition. People who have had a stroke may consider discussing healthcare and other legal issues that may arise near the end of life. Many people find it helpful and comforting to state their healthcare choices in writing with an advance directive while they are still able to make and communicate these decisions.
Advance directives can include the ability to refuse treatment in specific situations. The three main types of advance directives are:
Do not resuscitate orders (DNRs) typically request that no extraordinary measures be used to save your life. Extraordinary measures include cardiopulmonary resuscitation (CPR), use of an electrical shock to stop a fatal abnormal heart rhythm (defibrillation), intubation (placement of a breathing tube down your throat), or the use of lifesaving drugs. People with DNR orders will only be given drugs that make them more comfortable in their last moments. You may request that you be identified as a DNR if you wish to avoid expensive, uncomfortable, or invasive medical care that probably will not improve your long-term prognosis and may increase your discomfort.
Living wills are written documents that contain specific instructions about the type of treatment you wish to receive at the end of your life. Unlike a DNR order, which applies to a specific moment when you require resuscitation, living wills apply to more general situations.
One of two broad conditions must be triggered:
If your condition gets worse, you may want to think about palliative care. Palliative care is a type of care for people who have illnesses that do not go away and often get worse over time. It is different from care to cure your illness, called curative treatment. Palliative care focuses on improving your quality of life - not just in your body, but also in your mind and spirit. Some people combine palliative care with curative care.
Palliative care may help you manage symptoms or side effects from treatment. It could also help you cope with your feelings about living with a long-term illness, make future plans around your medical care, or help your family better understand your illness and how to support you.
If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.