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May 25, 2010 > Stroke: What Happens After

Stroke: What Happens After

Caregivers Play a Key Role in Stroke Survivors' Ability to Return Home

After a stroke, an estimated 80 percent of stroke survivors return home from the hospital, according to Washington Hospital's Stroke Program clinical coordinator Doug Van Houten, R.N.

"One of the main reasons stroke survivors are able to eventually come home is because there's a caregiver there," he says.

In the event of a stroke, life changes overnight - for both stroke survivors and their caregivers, who Van Houten calls one of the unsung heroes of stroke care.

On Tuesday, June 2, from 6 to 8 p.m., Van Houten and a member of the Stroke Program's medical staff will present a free seminar focusing on the future of diagnosis and management of stroke, as well as what happens after stroke survivors come home from the hospital.

Depending upon its severity, a stroke can leave survivors with observable challenges, such as difficulty getting around or speaking. But many of survivors with long-term disabilities face less easily seen obstacles.

"A lot of people after a stroke can walk around and might look fine, but often stroke affects memory and concentration," Van Houten says. "About 20 percent of stroke survivors never go back to work because they might have trouble with the little things that make work really happen. For instance, maybe they can't concentrate to work with figures or can't write a letter properly. You can have a conversation with them, but they might not be able to get a grasp those complex issues necessary in the workplace."

A stroke also changes the dynamic in the home, especially between spouses, according to Van Houten.

"Most times after a stroke, it's a spouse who is taking care of that person - and more often than not, it's a wife taking care of husband after a stroke," he points out. "In the older set, it's common that the wife may not have driven before, or she never took the car in for service, or never did the bills before. Roles change dramatically after a stroke."

"I think it's so hard, this role change for couples, who go from a married partnership to a caregiver/care receiver relationship, and it can affect a relationship's dynamics."

There are also the physical demands of being a stroke survivor's primary caregiver, including turning, bathing and managing feeding tubes.

"Learning to care for a stroke survivor is really 'on-the-job training,' except you don't have an instructor," Van Houten says.

For stroke survivors and caregivers adjusting to life after stroke, social support and community resources can make a huge different. But in most cases, Van Houten says, "They don't know about resources, and they don't know to ask."

He recommends the Stroke Support Group that he facilitates the fourth Tuesday of each month from 1 to 2:30 p.m. in the Neuroscience Conference Room, located in the Washington West Building at 2500 Mowry Avenue in Fremont. During the meetings, a licensed social worker is on-hand to help participants with resources, and an expert speaker - including physical therapists, dietitians and psychiatric social workers - covers a new topic at each meeting.

During the second half of the meetings, participants have the opportunity to share stories, challenges and solutions they have found, according to Van Houten.

"A lot of times our stroke caregivers come with the spouse to stroke support group, and we talk about these sorts of issues that are specific to life after stroke," he says. "We had one wife in the group who was very good at finding solutions after her husband had his stroke. He couldn't eat anything that wasn't pureed, so she learned to bring a small blender with her to restaurants and would ask for a table near an outlet so she could grind up his food. She showed some ingenuity and wouldn't let the stroke stop them from going out."

"I'm always amazed at how some people roll with the punches and still go out and still enjoy leisure time after a stroke. The caregiver finds a way to make things work."

Because the incidence of stroke goes up with age, many times it's an older person serving as the caregiver to the stroke survivor, according to Van Houten.

"They have health issues of their own and it can get hard for the caregiver, who can become physically isolated because they feel bad leaving the person home alone," he says. "They can't enjoy themselves if they go shopping or meet friends to play bridge because they're worried about their spouse while they're gone."

"I've seen it really beat some families down, and I've seen other families say, 'We can do this.' I'm always impressed with people who are can-do about life after stroke."

It's important, Van Houten says, to remember that stroke changes both the stroke survivor and the caregiver's lives.

"It's hard for a couple to have one person have a stroke and for it not to become an extremely important part of the other person's life as well," he says. "Despite all the negative things about stroke, many people say that things are just fine after stroke, that it almost brought them closer."

"One of the things I do in this talk is show a video about two men who had strokes. One of the last statements is by one of the wives who says, 'It's tough, but you can get through it.'"

Tackling life after stroke

To learn the latest about the future of diagnosis and management of stroke and find out how to optimize life after stroke, join Van Houten and a physician from Washington Hospital's Stroke Program on Tuesday, June 2, from 6 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium, located at 2500 Mowry Avenue in Fremont.

To register, call (800) 963-7070.

For more information about Washington Hospital's Stroke Program, visit

National Stroke Awareness Month

During the month of May, the National Stroke Association urges members of the public to increase their awareness of stroke and:

* STOP stroke through risk factor management of controllable risk factors, including lifestyle risk factors or medical risk factors, which can be changed or treated. Talk to your doctor, who can prescribe medications and advise on how to adopt a healthy lifestyle.
* Act F.A.S.T. to increase the recognition of and response to stroke symptoms.
* Spread HOPE about recovery from stroke.

For details on how you can help prevent stroke, recognize its symptoms and work toward recovery after stroke, visit

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