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I don't see a stroke section on this site, so I'm asking here. My 83 year old mother, who lives alone, had a stroke last week. She was transferred from the hospital to a sub-acute rehab place, where she will likely be for 30 days. She cannot move her left arm (and she is left handed), her short-term memory is shot, and she only has some control of her left leg.

I know every stroke patient recovers differently, but I'm wondering how likely it is that she will regain control of her left arm. Her long term memory is fine, but her "affect" is very flat and not like her usual self. Can that be regained?

Finally, after rehab I expect she will need 24/7 care. Not even sure where to begin there.

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Hi Xina,

Question: What did the admitting RN tell you at the sub-acute facility?

Did they explain the process? What is their arrangement for your mom's PT, OT, and ST = Physical Therapy, Occupational and Speech?

How do you know it will likely be 30 days?

Stroke : Did anyone explain to you what type of stroke? Where in the brain did the injury happen? Besides the right lobe, but where? That determines a lot of the answers you are seeking.

I don't understand what you mean about her "affect"? Meaning her mood?

Don't jump to conclusions. After rehab in sub-acute, many patients do go back to where they were before. Was she home?

The crucial time frame for best outcomes are what gets "done" in the first few HOURS after stroke. First few DAYS.......... So, the PCP has substantial knowledge of what is going on. Does she have a cardiologist now?

She must cooperate with therapy; if she refuses three times (Medicare in Calif), she can be "discharged" from PT, OT, ST. Not that she will be put on the street............what I mean is that those therapies are offered, and it is a voluntary decision upon the patient to accept or refuse. The problem is that now after the stroke, other cognitive processes are compromised, and she MAY NOT FULLY understand where they want to take her, example: the gym, where therapies usually take place.
Get as much information on the PLAN OF CARE for your mom.

The more you know, the better you can address things.

Don't panic. See / do the above, and tell us what happens.

HUGS,

M 8 8
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You need to ask these questions of the therapists. I would also learn more about the particular facility and what their experience is with post-stroke rehab. Some places, like the Rehab Institute of Michigan, have strong stroke recovery programs.

Do some research and find out if there's a place like RMI that she could go to on an outpatient basis after in-house rehab. Call local hospitals and find out if they have stroke support groups. Going to such a group meeting would be helpful for both of you.

But please do ask the therapists; they're the best ones to assess your mother's potential.
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I'll just tell my dad's story. He had an ischemic stroke when he was about 81 and was pretty bad for a couple of day; we weren't sure he was going to make it. His speech was garbled and his left side was pretty weak (he was right-handed). He couldn't sit up and would keel over if he wasn't supported.

After about two weeks in the hospital (I think?), he went for about 3 weeks of rehab at a local nursing home. They did a terrific job with him and he regained about 90% of his function. He was able to live in Independent Living and could walk and do things for himself. Later on (years later) he had some problems with swallowing and we had a little plastic vocal cord thing inserted to help him talk and swallow better. So don't give up and don't assume the worst. My dad worked hard in rehab and they got him back to being able to function pretty well on his own.

I agree that you need to make sure your mom is in the best stroke rehab place around. That can make a big difference, along with her willingness to do the hard work of rehab.
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P.S. My dad's affect also changed - he'd start to cry easily when talking. He was a retired Master Sergeant, so crying wasn't in his playbook until after his stroke. In some ways, it was kind of sweet, because I never saw that side of him before. So strokes can definitely affect someone's personality/affect.
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The most important part of my mom's recovery from stroke was the geriatric psych folks. Yes, speech, ot and pts were very important, as was the nursing staff, but the psych who was part of the rehab team in acute rehab started an antidepressant and when mom became delusional in subacute, it was the psych folks who did assessments to determine that what had been mild cognitive impairment before the stroke had advanced to vascular dementia.

Strokes cause brain damage. Some of that damage can be to the parts of the brain that mediate emotion, give a person control over their impulses to act or speak in inappropriate ways. Meds can help compensate. Don't be afraid to say yes to the pills.
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Xina,

An update would be very much welcomed. Please let us know how things are going?

M 8 8
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Yes, I wonder how her recovery is going. I know it varies a lot among individuals. My cousin's strokes caused her dementia. Her personality remained pretty upbeat, but it effected her short term memory, balance, and ability to function on her own. It actually damaged her mentally and physically. She resisted physical therapy and I suspect that she didn't have the ability to comply.
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