8 ways to support someone after a stroke

Strokes are the leading cause of adult disability in the UK, with around 100,000 occurring every year.

They happen when the blood supply to part of the brain is cut off by a blood clot or haemorrhage, killing brain cells. But the effects can vary widely, depending on where the stroke happens in the brain, and how big the damaged area is.

As a result, it’s impossible to be prescriptive about supporting people who’ve had strokes, as symptoms can vary from weakness or paralysis on one side, cognitive issues like memory or speech problems, emotional effects including depression and increased anger, or crushing fatigue.

To mark World Stroke Day (October 29), we have spoken to Sarah Adderley, an associate director at the Stroke Association, who says around 240 people have a stroke every day, which is the equivalent of about one stroke every five minutes.

“As you get older, your risk of stroke increases, but it’s a complete fantasy that this is something that only happens to older people – we’re seeing more and more people of working age having strokes each year,” she explains.

There are 1.4 million stroke survivors living in the UK, she says, and around a third of them will have their speech affected, but there can also be diverse physical or cognitive effects. “It will be really unique, and that’s the challenge in terms of supporting people after stroke,” she points out.

“If you’ve seen one stroke, you’ve seen one stroke – they’re all completely different, because the brain is such a complex organ.”

Austin Willett, CEO of Different Strokes, which promotes independent stroke recovery for younger stroke survivors, says around a quarter of strokes happen to people of working age or younger.

“A stroke can strike without warning and change life completely, not only for the person affected but for the people who love them,” he warns.

“Some of the most difficult challenges are invisible, which can make stroke particularly isolating. But because every stroke’s different, there’s no one-size-fits-all approach to recovery. Each survivor’s needs are unique, and it’s vital that support reflects that individuality.”

But there is some common ground for the support needed when people have strokes. Here’s what the experts suggest…

1. Press for early rehabilitation

Early and consistent rehabilitation gives people the best possible chance to regain skills and confidence, says Willett, while ongoing access to therapy and support helps sustain progress over the long-term.

“Listening, understanding, and tailoring rehabilitation to the person not the diagnosis makes all the difference,” he stresses. “Access to timely, specialist rehabilitation is crucial – no-one’s recovery should be held back by gaps in the system or time-limited services.”

Adderley explains that survivors whose speech is impaired, for example, should have support from a speech and language therapist, which she says are hard to get hold of at the moment. Physical impairments might need support from a physiotherapist or occupational therapist.

“How much support people get will depend on where they live,” she explains.

“But more and more we’re hearing it’s the hidden impacts that really affect their day-to-day lives – things like the psychological impact of stroke, a devastating event that just comes out of nowhere. There’s a lot of trauma involved, and worry about whether it could happen again, that kind of thing. The psychological impact is huge.”

2. Try to understand the depth of fatigue

Adderley says fatigue is a big problem after a stroke, and points out: “We hear all the time from stroke survivors that people don’t understand what they mean by fatigue – they’re not just a little bit tired, they’re exhausted, and they have to stop when they hit that point in a day.

“Those hidden impacts can be as significant as the physical ones that are quite visible.”

She explains that for some people, the post-stroke fatigue “can last forever”. It might be better on some days than others, and some survivors might regularly need a nap so they can ‘reset’.

“It knocks them off their feet – it’s a game-changer,” she stresses, pointing out that if a survivor has recovered enough to return to work, they may need to organise their working day so they can have a little rest at some point.

3. Help them practice therapy

Adderley says there are practical ways family members can help stroke survivors, such as encouraging them to practice therapeutic exercises they’ve been given.

“So with speech therapy, physio etc, practice and repetition is key,” she stresses. “Definitely, with communication issues, we know that if people are encouraged to talk and communicate with their loved ones and find ways to make sure they’re connecting, that’s really, really powerful.”

4. Don’t finish their sentences

Adderley points out it can be tempting to finish sentences for people who’ve got speech difficulties after a stroke, but it’s not always the best thing to do. “It’s human nature to finish other people’s sentences or jump in if there’s a long silence, when actually, for someone with communication difficulties, you need to give them time to process it before they actually try and get the answer out,” she explains.

5. Help them connect with others in their situation

Willett says it’s very important to help stroke survivors connect with others who truly understand what they’re going through. “To combat isolation, a sense of community and belonging can be vital for wellbeing,” he explains, “offering hope, encouragement, and the reassurance that no-one has to face recovery alone.

“With the right support and understanding, stroke survivors can and do live fulfilling lives.”

6. Remember it’s not just the stroke survivor that needs support

Family members and carers also need support, and Willett stresses: “They play an essential role in recovery, yet the toll on them is often overlooked.”

Adderley says the Stroke Association runs carer support groups, and carers of stroke survivors may also benefit from the help of other generic carer organisations. She explains: “It’s about giving carers the ‘permission’ to know the stroke’s impacting them as well, and they can seek help for their needs as well as the stroke survivor.

“There’s a lot of guilt associated with that, so it’s important that people are connected to others in similar situations, so they know they’re not alone. We need to make sure they understand what’s happened and how they can support the stroke survivor and also keep themselves well.”

7. Take advantage of support groups

Adderley stresses that just knowing there are specialist support organisations out there is critical. “So many people feel like they fell off a cliff after a stroke and feel really lonely, so knowing they can get support from people who understand what they’re going through is really key.”

8. Be patient

Recovery from a stroke can continue for many years, explains Willett, who says: “We shouldn’t impose arbitrary time limits on progress – people often keep making small but meaningful improvements long after the early months.”

Adderley adds: “You see people doing things that nobody ever anticipated, and reaching goals that people thought were unachievable. So the recovery period is ongoing.”