Advice needed on recovery from stroke

JamesN

Hi

A friend of mine had a stroke a few years back. They lost a lot of movement in one foot and most of the leg. They built back some movement but then had an accident which set them back quite far. Never really recovered from it and now they’re almost in a wheelchair constantly. To me it’s the mental side that’s the problem as they’ve shown they can improve mobility before. 

I want to try and help but there are issues on two fronts. Serious depression from the situation and motivation being very low as a result. Then the issue of mobility itself. Walking is very difficult and they need to build strength back up in their legs. But trying to figure out how to tackle it when it’s combined with low motivation. They’re approaching 70 and will sit and watch tv all day. I’m thinking maybe a small set of pedals on the floor that they can do whilst watching tv so it’s not much effort. They need to build strength and control in one foot and probably both legs. 

Not sure if it’s the right forum but couldn’t find a support forum that was popular for this on other sites. 

Thanks in advance 

Skint_yet_Again

I am sorry to hear about your friend’s health issues and can understand you wish to help them but I think they need to discuss this with their GP and be referred by them to physio/ mental health professionals. Without knowing their medical history or being a medical professional you could do more harm than good

Perhaps with support from a good friend such as yourself they could find a local support group to join 
https://www.stroke.org.uk/finding-support/support-services

JamesN

Skint_yet_Again said:

I am sorry to hear about your friend’s health issues and can understand you wish to help them but I think they need to discuss this with their GP and be referred by them to physio/ mental health professionals. Without knowing their medical history or being a medical professional you could do more harm than good

Perhaps with support from a good friend such as yourself they could find a local support group to join 
https://www.stroke.org.uk/finding-support/support-services

appreciate the advice thank you. The friend in question is a former GP so think they’d be lower risk of harming them self. It’s just the motivation to start again. Was hoping maybe there were some smaller things like a stationary bike that they could use whilst watching tv. It might just get that bit of motivation back to carry on trying again. 

They’ve become quite reclusive because of the lack of mobility and issues that brings. So I guess I’m hoping to work towards them getting into a support group. 

MalMonroe

JamesN said:

Skint_yet_Again said:

I am sorry to hear about your friend’s health issues and can understand you wish to help them but I think they need to discuss this with their GP and be referred by them to physio/ mental health professionals. Without knowing their medical history or being a medical professional you could do more harm than good

Perhaps with support from a good friend such as yourself they could find a local support group to join 
https://www.stroke.org.uk/finding-support/support-services

appreciate the advice thank you. The friend in question is a former GP so think they’d be lower risk of harming them self. It’s just the motivation to start again. Was hoping maybe there were some smaller things like a stationary bike that they could use whilst watching tv. It might just get that bit of motivation back to carry on trying again. 

They’ve become quite reclusive because of the lack of mobility and issues that brings. So I guess I’m hoping to work towards them getting into a support group. 

Hi, I'm also sorry to hear about your friend but would just like to say that just because they were a GP before doesn't mean that they are unlikely to harm themselves. He/she is still a human being and many GPs, sadly, do take their own lives.

But I do agree with the idea of urging your friend to see their GP and being referred for therapy, both psychotherapy and physiotherapy. It's one of those Catch 22 things though, how and when to get started. As someone who has just turned 70 myself I do feel for this person because I feel lucky that I'm able to get out and about and I do feel fit, in spite of some niggly pains and a bit of arthritis. 

You're a very good friend wanting to help - I have seen those small pedal-type things that people can use when sitting down to start getting the blood circulating, and you can go at your own pace. Pedal exercisers, I've seen them advertised for about £16 or £17, but you can pay more if you want to. . .  just do a google search, they're everywhere. As a former GP your friend will know that a bit of exercise gets the endorphins going and hopefully that will help get a bit of motivation going too. I do hope so, I hate to think of people who are not quite as old as me yet having such a poor quality of life. Thank you for caring.

Spoonie_Turtle

When you say they're in a wheelchair, is that around the house or mainly if they need to go out? Can they self-propel or not? (If they can but only for limited distances, then that basically counts as 'not'.) I just wonder, if they can't self-propel, whether some powered mobility option might help them to get out and then perhaps find some motivation for wanting to improve. It can be quite easy to find secondhand electric wheelchairs or scooters online, including ones that for up or dismantle to fit into a car boot. (Actually it can be easy to find truly lightweight 'active user' wheelchairs secondhand, but they tend to be more custom-built so ideally need a professional assessment and possibly professional adjustments once bought, too.)

I also think part of the answer will involve seeing/hearing other people's experiences. I think their generation often saw people who had strokes just not really get better because the support wasn't there, and maybe not the understanding of just how much people can get better - or even if they don't, how much they can adapt and live full lives despite lasting disability. There are plenty of young people who have had strokes and still live full lives with adaptations and accommodations, but without exposure to the possibility it can be very hard to believe that there is hope - again, even if they don't improve, but it is likely they can make some improvement even if it's not what their idea of 'getting better' looks like.

Whatever they work on, physically and mentally, it will need to be all about small steps. They clearly do need professional help, but they will still need help and support outside of medical professionals too. Perhaps you can gently try to engage them with any hobbies they can still do, or if they have favourite places to visit, whether you can take them there. Small, gentle, patient steps to perhaps help them find a small spark of joy in life again - but at the same time being mindful that some things will be emotionally painful, especially if there are things they enjoyed doing before that they either can't do now or can't do without modifications. (Doing things with adaptions is great, but it is something that has to be accepted and often the change mourned, particularly if it was something very important to them before.)

Living well with a disability is about being adaptable and adjusting to one's 'new normal', and accepting that things will be different now from how they were in the past. Quote honestly it usually means lowering expectations as well, feeling proud to accomplish small things it expect to enjoy an outing for a couple of hours rather than a whole day. You are right, mindset is key. Pride may well play a part, which is really difficult when the kind of goals and achievements possible are things we'd expect a small child to be able to do, or that sound really stupid when said out loud in comparison with what they could do before. The change has to come from within, and I think a big factor in that is normalising things, normalising small goals, normalising doing things differently, etc. That's something a support group *should* provide, but it depends on the group - some are more about moaning and commiserating than actually supporting and helping the members to cope and live well. So if your friend can join a support group, please help them to be mindful of whether it's actually helping or not.

Not sure if much of any of that makes sense! It might also be good to have a look on the Scope website and perhaps any stroke-specific sites as well; there may possibly be a forum where more people can give specific advice rather than the more general thoughts here.

sheramber

The depression and lack of motivation to do anything may be due to the fact they are  having to use a wheelchair. 
He  really  needs professional help with his state of mind as until that  is sorted I fear, you will be fighting a losing battle.

Nargleblast

There is also a possibility that your friend might have suffered a brain injury due to the stroke, if the area that deals with moods and emotions was affected. It all depends on where in the brain the stroke occurred and how extensive it was. You could try looking at headway.org.uk. Other than that, the Mental Health Foundation might help, as well as the stroke charity.

JamesN

MalMonroe said:

JamesN said:

Skint_yet_Again said:

I am sorry to hear about your friend’s health issues and can understand you wish to help them but I think they need to discuss this with their GP and be referred by them to physio/ mental health professionals. Without knowing their medical history or being a medical professional you could do more harm than good

Perhaps with support from a good friend such as yourself they could find a local support group to join 
https://www.stroke.org.uk/finding-support/support-services

appreciate the advice thank you. The friend in question is a former GP so think they’d be lower risk of harming them self. It’s just the motivation to start again. Was hoping maybe there were some smaller things like a stationary bike that they could use whilst watching tv. It might just get that bit of motivation back to carry on trying again. 

They’ve become quite reclusive because of the lack of mobility and issues that brings. So I guess I’m hoping to work towards them getting into a support group. 

Hi, I'm also sorry to hear about your friend but would just like to say that just because they were a GP before doesn't mean that they are unlikely to harm themselves. He/she is still a human being and many GPs, sadly, do take their own lives.

But I do agree with the idea of urging your friend to see their GP and being referred for therapy, both psychotherapy and physiotherapy. It's one of those Catch 22 things though, how and when to get started. As someone who has just turned 70 myself I do feel for this person because I feel lucky that I'm able to get out and about and I do feel fit, in spite of some niggly pains and a bit of arthritis. 

You're a very good friend wanting to help - I have seen those small pedal-type things that people can use when sitting down to start getting the blood circulating, and you can go at your own pace. Pedal exercisers, I've seen them advertised for about £16 or £17, but you can pay more if you want to. . .  just do a google search, they're everywhere. As a former GP your friend will know that a bit of exercise gets the endorphins going and hopefully that will help get a bit of motivation going too. I do hope so, I hate to think of people who are not quite as old as me yet having such a poor quality of life. Thank you for caring.

Thank you. To be honest. I read it more as hurting themselves physically by doing too much. But you’re absolutely right about the mental side of things. I’m going to see if they’ll try the pedal exerciser. Even if it’s just starting off small. 

Spoonie_Turtle said:

When you say they're in a wheelchair, is that around the house or mainly if they need to go out? Can they self-propel or not? (If they can but only for limited distances, then that basically counts as 'not'.) I just wonder, if they can't self-propel, whether some powered mobility option might help them to get out and then perhaps find some motivation for wanting to improve. It can be quite easy to find secondhand electric wheelchairs or scooters online, including ones that for up or dismantle to fit into a car boot. (Actually it can be easy to find truly lightweight 'active user' wheelchairs secondhand, but they tend to be more custom-built so ideally need a professional assessment and possibly professional adjustments once bought, too.)

I also think part of the answer will involve seeing/hearing other people's experiences. I think their generation often saw people who had strokes just not really get better because the support wasn't there, and maybe not the understanding of just how much people can get better - or even if they don't, how much they can adapt and live full lives despite lasting disability. There are plenty of young people who have had strokes and still live full lives with adaptations and accommodations, but without exposure to the possibility it can be very hard to believe that there is hope - again, even if they don't improve, but it is likely they can make some improvement even if it's not what their idea of 'getting better' looks like.

Whatever they work on, physically and mentally, it will need to be all about small steps. They clearly do need professional help, but they will still need help and support outside of medical professionals too. Perhaps you can gently try to engage them with any hobbies they can still do, or if they have favourite places to visit, whether you can take them there. Small, gentle, patient steps to perhaps help them find a small spark of joy in life again - but at the same time being mindful that some things will be emotionally painful, especially if there are things they enjoyed doing before that they either can't do now or can't do without modifications. (Doing things with adaptions is great, but it is something that has to be accepted and often the change mourned, particularly if it was something very important to them before.)

Living well with a disability is about being adaptable and adjusting to one's 'new normal', and accepting that things will be different now from how they were in the past. Quote honestly it usually means lowering expectations as well, feeling proud to accomplish small things it expect to enjoy an outing for a couple of hours rather than a whole day. You are right, mindset is key. Pride may well play a part, which is really difficult when the kind of goals and achievements possible are things we'd expect a small child to be able to do, or that sound really stupid when said out loud in comparison with what they could do before. The change has to come from within, and I think a big factor in that is normalising things, normalising small goals, normalising doing things differently, etc. That's something a support group *should* provide, but it depends on the group - some are more about moaning and commiserating than actually supporting and helping the members to cope and live well. So if your friend can join a support group, please help them to be mindful of whether it's actually helping or not.

Not sure if much of any of that makes sense! It might also be good to have a look on the Scope website and perhaps any stroke-specific sites as well; there may possibly be a forum where more people can give specific advice rather than the more general thoughts here.

No that’s really helpful thank you. I’ll see if there are any decent groups around. They had plenty of hobbies before it’s just some of them are probably too difficult now. Plenty of things to consider with the above so thank you. 

Trying to quote other posts and failing miserably. They’re on crutches but have gotten much worse on them rather than better. The main problem is getting to the toilet on time which is a big part of the confidence I think. 

Spoonie_Turtle

JamesN said: 

Trying to quote other posts and failing miserably. They’re on crutches but have gotten much worse on them rather than better. The main problem is getting to the toilet on time which is a big part of the confidence I think. 

Ah. Have they had any recent OT assessment? There are options but they really need professional input for what might be appropriate. With a decent OT that could even be a mid-/long-term goal, to be mobile enough with {whatever aid} to get to the toilet more reliably.

ruby_eskimo

Just want to echo what everyone above has said that it's amazing how you're looking out for your friend.  I used to work in a stroke service and we would always advise people to talk to the Stroke Association - they have amazing resources and would be able to link your friend back into the local neuro rehab team who will be able to provide appropriate mental and physical support to help build on what their current baseline is.