Depression

There can be enormous loss and grief associated with a stroke including the changes to your sense of self, role or professional identity, self-image, physical function, intimacy and favourite activities. Adjustment to these losses may be life-long and it is important to understand you may go through a grieving process. This may be most evident when you go home after stroke, as you may find that the changes to your life are overwhelming.

The grief or sense of loss you may feel is a normal reaction but it can happen on top of the effect that a stroke can have on your feelings, personality and behaviour. This may lead to depression. It is common for people to feel anxious or stressed and get depressed especially in the first year or so after the stroke. You may also feel like crying or laughing for no obvious reason.

Your motivation may also change. You should talk to your doctor if you experience any of these things. Your doctor may prescribe medication or suggest you talk to a psychologist. Talking to other people who have had stroke may also help. Further assistance is available from your State Stroke Association or the National Stroke Foundation.

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Driving

People who have had a stroke may have difficulty returning to driving. This might be because of weakness in parts of the body, or because they have difficult seeing things the way they did before the stroke.

Following a stroke it is very important that you talk to your doctor about driving before you start to drive again. In some cases, you may not legally be able to drive and it may be necessary for you to have an assessment. Even if you feel capable of driving, you may not be insured if you have an accident when driving without the right approval.

An occupational therapist can also help you with the rehabilitation and information you might need to return to driving.

Leisure

There can be enormous sense of loss associated with a stroke including role and professional identity or participation in pleasurable or favourite activities.  It is important that stroke survivors resume their old hobbies and interests if possible, and explore new interests where appropriate.

Health professionals can help work out what is easier or more difficult to do and outline ways that help the person be as active as possible. Community centers that provide leisure activities can also be explored with help from the allied health professionals.

Return to work

Returning to work can be difficult after a stroke for a number of reasons: physical changes, lack of motivation, attitudes and policies of the previous employer, fatigue, lack of concentration or memory. However going back to work may be important for personal and financial reasons (eg. self-esteem, social contact with workmates, and the desire to do things yourself again).

If you are unable to go back to the same job and want to continue to work, then you can consider other options such as changing jobs or working part-time. There are a number of agencies and services within the community that can provide assistance in helping return to work.

Finances

Stroke can have an effect on the financial security of a stroke survivor and family particularly if they are still working.  If you are unable to return to work, you may be eligible for a Disability Support Pension. If you were receiving a benefit before the stroke, this will continue as before.

Your social worker can provide you with help in understanding the financial impact a stroke may have on your life. You can also get more information from Centrelink.

Sexuality

Many people have difficulty adjusting to the physical and emotional changes after stroke which can have an effect on their relationships and on their sexual relations. In some instances, the ability or desire to have sex may be changed by weakness on one half of the body, difficulty communicating, or because of changes to a person's self image and esteem. Medications may also affect the ability to have sex.

Many stroke survivors are embarrassed to ask for advice about the best way to return to sexual activity but it is important to do so. The stroke team can provide advice on positioning and other techniques that can make it easier for the stroke survivor and his or her partner.

Some people are afraid to resume sex as they are frightened this can trigger another stroke.  However, there is no relationship between sex and stroke.  If you have any concerns about resuming sexual relations, or are having difficulty with intimacy, talk to your doctor or someone you feel comfortable with.

Sexuality after Stroke PDF

Family roles and relationships

You and your family may also need to consider help from others. Often people will find it difficult to accept outside help, however it is important that the needs of all the family members are considered. You should discuss such changes with your
family. You may benefit from professional help such as that provided by a relationship
counsellor.

Any change in the family can be hard to adjust to for all family members. It is normal for anyone involved to go through their own grieving process. Assistance from a trained professional during this time may also be beneficial.

Children

Special issues may occur if children are part of your family. Often there are a lot of questions and fears that will need to be discussed over time in a sensitive and understanding way.

Such issues include any physical changes due to the stroke, changes in family roles (eg. roles of mum and dad), and especially changes in communication and sharing of emotions. Children should be considered and involved in family discussions and/or counselling sessions.