Effect on daily living activities
A person who has had a stroke may have problems with the simplest of daily activities such as walking, dressing, eating and using the bathroom. Unless the stroke is so severe as to cause death within a few days, a degree of recovery from the initial severe restrictions can be expected. Most of this recovery occurs within the first 6 months. After one year from the stroke further recovery is likely to be limited. Recovery and the effectiveness of rehabilitation depend upon many factors. These include the size and site of the brain damage and whether any other impairment is present.
Even if an upper limb remains without useful function, the use of technical aids may enable the person to manage alone. If the dominant arm is affected, full independence may be more difficult to achieve. The need for help with daily living activities is likely to be restricted to short but necessary periods in relation to specific tasks, such as dressing, washing and cutting up food.
Many younger people who have had a stroke without other complications are likely to achieve a considerable degree of independence. Most will be likely to learn to walk again although some will require assistance from mechanical aids such as a walking frame, tripod or stick. Such persons are likely to be independently mobile within the house, but when out of doors they may be restricted in terms of distance and speed. If the cerebellum has been affected then walking may be adversely affected by balance problems (ataxia) and disturbances of gait. Following a less severe stroke, other areas of the brain may take over the function of the damaged part. This may result in considerable functional improvement.
Hemianopic Visual Field Loss – diagram
A homonymous hemianopia (a loss of one half of the visual field) or aphasia or dysarthria are likely to make communication very difficult. If these problems are present then considerable help will normally be required. Additionally, homonymous hemianopia is often associated with ‘neglect’ syndrome reducing still further the person’s ability to care for themselves and get around.
