The information was created by our in-house Occupational Therapist to help guide you through the process of what happens following a stroke. We understand it can be a very confusing time with lots of different professionals involved. This article aims to help remove the confusion around who is who and who is doing what. It is important to note that all professionals who work with you in the hospital will liaise together regularly, so please talk to anyone involved in your care and ask as many questions as you would like, they are there to help.
Doctors and nurses
They will be involved with the medical care and support of the patient. Initially, when admitted the person may require surgery depending on the type of stroke (see what is a stroke). The person will also require ongoing review of their medication whilst in hospital and post discharge from hospital to help reduce the risk of future strokes or manage the current symptoms.
During day to day life on the hospital ward the nurses will play a very important role in the care and comfort of the person post stroke. They will often work closely with the therapists who will advise them of current rehab goals.
Physiotherapists initially will review the person’s range of movement as soon as possible following their admission to hospital. From this initial assessment they will review the person’s ability to complete transfers, this means getting from the bed to the chair. If the person is able they will review there mobility and may consider using aids such as a walking frame or a gutter frame. If the person is unable to get out of bed safely with assistance from the therapists or nurses they may consider using equipment such as a hoist.
From their first review they will set goals with the person to achieve while in hospital. Rehabilitation goals made by each professional will depend on the extent of the stroke and the progression shown during the rehabilitation. On discharge from the hospital they may be referred to a community rehabilitation team where ongoing goals can be set.
An occupational therapist will be involved in rehabilitation when the person is in hospital. They, like the physiotherapists, will complete an initial assessment of the person’s abilities post stroke and will then create goals for the person to achieve. Occupational Therapists focus on rehabilitation of everyday tasks such as washing, dressing or even using a mobile phone.
For discharge, Occupational Therapists like to work closely with the patient as well as family/carers to plan for what will be needed to be put in place at home before the person is discharged home. This may include meetings, home visits, equipment provision and social services support. (see discharged from hospital and what to expect)
Speech and Language Therapists
Speech and language therapists are not just involved with the development of speech but also with eating and drinking. If the person has any difficulties with swallowing this will be reviewed with the therapist who may advise a soft diet or thickened fluids. The therapist will then aim to help encourage improvement in swallowing ability during the persons time in hospital and can be referred onto community support if required.
When it is deemed to be time for speech exercises the speech therapist will undertake exercises on the ward. It is vital that the advice of the speech and language therapist is followed and the exercises carried out very regularly. An app which is recommended by the Stroke Association is SmallTalk Oral Motor exercises. Also, Smalltalk Aphasia is free and has a natural human voice to help support a person with everyday communication.
A dietitian at times will see a person post stroke to look at levels of nutrition and the regulation of diet. If the person is unable to eat or are losing weight a dietician will help figure out how many calories the person needs to help maintain an appropriate weight. In addition, advice may be given regarding consumptions of food to help lower cholesterol and blood pressure with the aim of helping to prevent another stroke.
For more information look at
Following the stroke a person’s hearing may be impacted depending on the area of the brain affected. An audiologist can be used to determine the extent of the hearing loss and provide advice as to whether a hearing aid is needed. Hearing loss is not routinely assessed after stroke. It can also remain undetected due to other severe symptoms present. However, it may have important implications for rehabilitation.
As a result of the stroke the person may experience some vision disturbance or loss. An orthoptist or ophthalmologist may complete an assessment in the hospital to determine the extent and type of vision loss and may suggest treatment if possible.
For more information look at https://www.stroke.org.uk/sites/default/files/visual_problems_after_stroke.pdf