Silent strokes, can the patient recover?

[AgreeableDragon]

Does any one have any experience of this?

MiL (96) is currently in a stroke ward having been diagnosed with this. Over a few short weeks she’s lost the use of her legs and one arm. She’s mostly her usual self, but occasionally says something very odd, so it seems to have also impacted her cognitive behaviour slightly too.

Nurses are all very breezy about it, talking about rehabilitation and getting her home. Is this realistic? Seeing her as she is now, to the woman who was living on her own just weeks ago, it seems overly optimistic.

I’d be interested to hear other people’s experiences.

If there is no one at home to care for her it’s hard to see how she could be sent home from rehab any time soon. (And it takes long enough to get someone into rehab in the first place.)

I have known people in their 70s recover well from loss of use on one side of their body; your MIL’s damage is more extensive and she’s much older - it does seem unlikely that she’ll ever recover much mobility. Which would mean a wheelchair and possibly quite extensive alterations to her home to accommodate both the chair and her reduced capabilities.

Really it would seem cruel to release her to a couple of 15 minute visits from carers - even after several months of hospital and rehab.

Thank you for your reply and honesty.
This was my thinking too. But the hospital are making it sound as if this isn't an issue and she'll be all better soon.

I'd appreciate a more realistic approach from them, but it's so hard to get anyone to talk to in a calm, quiet place.
Don't get me wrong. They agree doing a great job, and are really professional.
But we just want to know what we really can expect so we can plan.

We're going to try and talk to a Dr on the ward to day (hopefully in a private place not in front of all the other patients).

Well they will be saying that. They will want the bed.
Be very very careful of what she and they they expect of you here. Carers popping in and out probably won't cut it.
If she's not almost back to her baseline you're probably better at looking at residential care. Do not be swayed by what the hospital feels is the best plan. Use your eyes.

My experience is hospitals are full of unrealistic people. Generally they have also not worked in the community so have no idea what it is like. So they talk about getting home when you mean is she going to get back to exactly as she was before.

Have your partner (and you) not had a full scale meeting with her whole hospital team where they set out the prognosis and short term and long term plans for her? (It may be that things have changed and that’s no longer offered?)

Obviously nothing can be considered long term with someone of your MIL’s age. I recall being told that if a stroke victim gets through the first few days / weeks without another worse stroke, one can begin to be optimistic - but she is very old. I don’t think any realistic plan could involve her living alone again, surely?

Be aware that being confined to one room with a commode and 4 visits a day is regarded as a perfectly acceptable solution.

However, your MIL will need regular moving to avoid bed sores. So care home or nursing home looks a more realistic option.

The hospital, quite reasonably, will want her out as soon as she can no longer benefit from medical treatment. It’s also good for her to be away from hospital and the risk of hospital-induced dementia.

Thank you everyone. It's early days yet, and she's only been on the stroke ward for a couple of days.
A meeting with the doctors is the next step.
I'm very grateful for the replies. Your all confirming what we've been thinking.

Both my parents had strokes- dad was in hospital for 4 months, mum 8 weeks so still very early days for your MIL. A nurse explained a stroke can be like a bruise which gets worse in the beginning then slowly gets better. The staff were amazed to see how well my dad was when mum was admitted to the stroke unit as they don’t have a clue what happens to patients after discharge. Have a chat with the HCAs on the ward who are actually looking after your MIL - they can often give useful insights. I remember feeling in a bit of a vacuum trying to get information from doctors- there’s so many people involved.

My dad went to a local hospital for rehab (from the stroke unit) it was more like a home and he eventually went home making a full recovery.
Mum was 88 and sounds similar to your MIL -but she was mainly sleeping and not able/willing to engage with the hospital physio so we arranged for a discharge home rather than a nursing home as I didn’t think she had long left - she’s still with us 6 years later and we live together as a family.

Good luck 💐

Ah, sorry - hadn’t realised your MIL has only been in hospital for a few days. You probably have that meeting to come.

My relative who had a stroke in their mid-70s had a good quality of life for about 12-15 years afterwards but has declined rather steeply more recently. But they didn’t live alone so that was never a consideration.