By Deborah Jeanne Sergeant
Approximately 795,000 Americans experience strokes annually with 610,000 of those first-time strokes and 185,000 recurrent strokes.
Of those patients, 39 per every 100,000 die.
Those who survive face different outcomes and challenges for recovery.
Some people notice no deficits; others may see varying levels of recovery for around a year afterward. Post-stroke fatigue can make recovery hard.
“Rehabilitation is where the real work and hope begins,” said physician Fahed Saada, board-certified neurologist with St. Joseph’s Health. “Not every patient rehabs the same. It’s not one size fits all. An interdisciplinary approach with social work, occupational therapy, physical therapy and speech therapy helps. A neurologist is one of the important providers that can guide all the therapists and recommend therapies. They get everyone together with the rehab process. We start as soon as the person is medically stable.”
Many patients undergo in-patient rehabilitation at a hospital or long-term care facility. They may have in-home therapies as well to ensure they can perform activities of daily living (ADLs).
Saada encourages caregivers to allow patients time to begin their morning routine and ADLs, as for a while at least, these may take much longer. Performing everything for the patient may reduce their ability to perform these tasks independently later.
Supporting someone recovering from stroke includes promoting at-home therapy.
“Caregivers should encourage their loved ones to participate in exercise programs. Programs that can help induce movement,” Saada. “Bedside range of movement exercises for their loved ones by lifting and stretching their arms and pushing and pulling on their legs, they could use a stationary bicycle or handheld devices can improve muscle flexibility and blood flow. Make sure the patient is taking their medications, especially blood thinners after an aseismic stroke.”
It’s also helpful for caregivers to support patients in controlling chronic health conditions like hypertension, along with their neurology visits.
He also recommends seeking a support group and as needed, seeking mental healthcare for the patient, as many stroke patients experience depression.
Saada added that assistive devices like shower chairs, Hoyer lifts and hospital beds can help patients and caregivers.
Care for stroke patients is collaborative both in and among organizations.
Mike Schafer, president and CEO of St. Camillus in Syracuse, said that his organization has “a dynamic collaboration with Upstate specialists who specialize in stroke. We’re able to optimize recovery and support successful transition back to the community.”
Physician Renante Ignacio, medical director at St. Camillus, describes stroke as a “brain attack, like a heart attack” which can affect the whole body.
Of course, most people want to recover at home, but that’s not always possible.
“We need to look at falls and depression,” he added. “In-patient rehabilitation is key factor in recovery. Not many people are not fully capable of rehab at home which is why we have in-patient recovery.”
In addition to in-patient rehab and family support, an organization like St. Camillus may recommend that discharged patients have in-home care.
“We look at other therapies in the community,” Donna Oram, rehab director at St. Camillus. “We may start with a healthcare agency coming to the house. We may transfer to an out-patient program.”
She also recommends community-based support groups for the patient and family caregiver for both practical strategies and building a sense of camaraderie.
“You are not alone on this journey,” said Michelle F. Vallelunga, registered nurse and data coordinator at Upstate Comprehensive Stroke Center. “Reach out to family and friends and share how you’re feeling. Emotional changes like depression or anxiety are common after stroke —recognizing this is an important part of healing. Asking for help is not a weakness; it is a strong and courageous step.
“Take advantage of available support, including your healthcare team, community programs, faith groups, and — most importantly — other stroke survivors and caregivers. Shared experiences can be incredibly powerful, offering understanding, encouragement and hope.”
She added that patients should take time for rest during the day and try to achieve quality sleep at night.
“Balance activity with rest,” Vallelunga said. “Gentle practices like deep breathing or relaxation exercises can reduce stress and help your body and mind recover.”
A newer therapy for stroke patients is the vagus nerve stimulator. This can help stroke patients with chronic deficits in their upper extremity. It is placed in the upper chest under the muscle. Patients swipe the magnet and it stimulates the nerve. It connects the signal from the brain that was broken. The implant is used in conjunction with physical therapy.
“Physical rehabilitation and cardiovascular exercises are important for recovery from stroke,” said physician Savita Kumari, neurologist at St. Joseph’s Health. “Early mobilization should begin once the patient is medically stable and at least 12 hours after acute stroke. American Heart Association recommends aerobic exercise in the subacute period, 11-78 days post-stroke, which is safe and effective for improving exercise capacity and walking endurance. Guidelines recommend aerobic exercises at least three days per week for minimum eight weeks and minimum duration of 20 minutes per session in the training.”
Recovering from stroke isn’t easy for many patients who have more severe strokes. But it is worthwhile to patients and their families.
“There is no doubt that having a stroke is life-changing,” said Josh Onyan master of science in nursing and stroke program manager at Upstate Comprehensive Stroke Center. “Whether the effects are mild, primarily physical or also impact thinking or speech, it can reshape daily life in meaningful ways.”
Onyan has worked closely with many survivors and caregivers and has “seen something powerful — recovery, resilience and progress over time.” He encourages patients and caregivers to remain patient with recovery and consistent with rehab.
“Staying engaged with therapy, appointments, daily movement like walking or stretching and medications truly matters,” Onyan said. “Even small, steady actions build momentum. Creating a simple daily routine can help you stay on track. Consider using tools like your phone or smart devices for reminders, music or calendar alerts to support your success.”