Hello. I’m wondering if anyone could help me navigate this. My mom had a severe stroke just over a month ago. Was down in her home for over 24 hours. She’s now still experiencing paralysis on her left side, confusion and loss of bodily functions but she also refuses to do any therapies. She’s also very combative and volatile. She was kicked out of one rehab for behavioral issues and is now in a horrible one since they are one of the few centers that take patients with behavioral issues. She has a permanent feeding tube but won’t even try speech therapy to work on regaining her swallowing abilities. She screams and fights if we even try to readjust her in bed let alone do any personal care or pt exercises with her. I live out of state so i can’t be there that often but my brothers are there regularly. I don’t know what to do anymore. We’re trying to get her in a better place but she may be denied because of her history of being combative. How do I help her? She knows she’s had a stroke but thinks if we just get her up she can walk out and leave. If we go along with what she’s saying and try she’s screams and fights us with every touch. At this point I’m so exhausted by even spending a small amount of time in the room that it’s hard for me to even think about going back to continue care.
@mrgnflynn - firstly, welcome to the community.
I am sorry you are having a challenging time trying to help your Mum. What you describe sounds tricky and it is difficult to try to know where to start, at least from where I stand.
It seems to me, in order to help your Mum there are some questions that need to be asked and answered. For example
- what level of understanding does your Mum have about what has happened to her and what she needs to do to start the recovery process?
- what is her communication like - is it reasoned?
- Is she emotionally stable - has she accepted what has happened to her?
- How is she as a person now compared to how she was before the stroke? How has the stroke changed her personality?
- Is she is refusing help, is she capable of doing things herself? How severely has the stroke impacted her mentally and physically. The fact she is in rehab suggests the healthcare professionals see potential for recovery
- Does she need time to think things through?
Trying to help someone who does not want to be helped can be tricky, but for me the first thing to understand is why she does not want to be helped.
I am sorry I don’t have specifics for you, but I have no doubt others will soon follow with ideas you can try to work with.
Maybe you should step back and have a think yourself as to what you can do if you are not being allowed to help. If your Mum has the mental capacity and knows what she wants, I guess we might have to accept that she knows what she wants and we have to respect that.
I wish you all the best.
Namaste|
Wha a terrible situation for you to be in. Yes, people are often combative after stroke and you/your mother need health professionals who are aware of this and willing to work within it. How you find these I do not know. When I was in the stroke ward there were many patients like this, so I think it must be pretty usual. Sorry I can’t offer any advice on where you can go from here, but there must be some areas of the health professions that are used to it and willing to manage it. I wish you all the best.
@mrgnflynn , it sounds to me that she is more scared than anything else. I’m guessing that she doesn’t know what’s going on. Probably why she is lashing out. My mum is going through a tough time stroke wise. She has a similar type of stroke as your mum (i.e. paralysis on one side of her body) and slurred speech but she isn’t lashing out. Do you have other family members who live near you? Ask them to help you. Seeing some who is in a bad way due to any kind of stroke is soul destroying. If you have anymore queries, use the Carersuk.org website. There are people on there who could steer you in the right direction.
Okay so she understands she’s had a stroke and will respond with “I’ve had a stroke” when someone asks why she’s there and what’d happened and will say my body isn’t working right when you talk to her about what’s going on but she’s very delusional about her capabilities. She has zero ability to do anything for herself. She can’t sit up assisted, use the restroom, eat or anything really her mental status is severely altered to the point where conversations are very rudimentary. She can basically accuse people of hurting her and saying let’s leave, help me up and we’ll go. Reasoning with her is basically impossible as she just reverts to what she was saying before you tried explaining it to her. She’s in a rehab facility but it’s pretty common that that is where people go post hospitalization and she may regain some things but the likelihood of her ever getting back to baseline is zero considering the severity of the brain damage. She was stubborn before her stroke but understanding of reason. At this point i don’t know how much more time i can give her. She won’t talk to mental health or physical therapy and she’s already been kicked out of a facility for violent behavior towards staff. She even tried to bite me.
Hi @mrgnflynn and welcome to the community. Sorry to hear of your mom’s stroke.
Stroke can affect someones behaviour & personality and I have copied in a Stroke Association leaflet for you to have a read off which may help a little bit.
https://www.stroke.org.uk/stroke/effects/emotional
It’s difficult if your mom won’t engage with rehab etc butit may be that 1 month in is just too soon for her to do so. She is probably scared & not sure what is going on. The first 6 months the brain tries to rewire itself & needs plenty of rest. But on the positive side people often improve over time and things start to settle. She may never get back to how she was previously but if she tries to engage in recovery she should make some improvements. It is a long journey though & given the severity of her stroke you need to be prepared for that.
Is it possible to find some innovative ways to so “rehab” with her. Make it more like an everyday thing rather than something specific she has to do.
Has anyone told her about her behaviour? Told her it is unacceptable? Sometimes you need to be very blunt with them.
I don’t know if these links will help but aggressive behaviour has been discussed before on the forum.
Wishing you all the best
Ann
OK, I think we need to remember this is a very difficult time for your Mum.
She might be frightened, confused or worried. It may even be that she is not fully aware of exactly what has happened to her.
As Ann @Mrs5K has said, one month after a stroke might be way too soon for her to be receiving “hard core” rehab. Maybe she first needs to be seen by a psychologist - has she been seen by a psychologist after the stroke? Has her mental condition be assessed.
I can’t be sure, but it seems to me, you are not getting the best professional support. I am surprised that her professional rehab team is not better managing this. I wouldn’t have thought this is a new thing for them to deal with.
Personally, I feel you must try to sit down with your Mum and include other family members if possible and just talk to her. You need to be sure she fully understands her situation - her saying she’s had a stroke and her body is not working right is not enough.
Her trying to bite you and other behaviour you describe suggests to me she might be frightened and may feel threatened. This is a difficult time for her and it is difficult for me to assess from a distance, but thinking about how my Mum used to behave and react suggests your Mum needs to be reassured she is in a safe place and people are there to try to help her.
Her therapists and helpers should be giving her time and space, otherwise she might feel her space is being invaded and so she goes into defensive mode.
Is there anyone she feels comfortable with?
I feel her mental state should be assessed to understand how she feels, what she really understands about her condition and how she can be helped.
Barging in and trying to get her to do things will likely result in backlash and rejection.
I think she needs to feel trusted and safe.
Does she know who you are? Sounds like a daft question, but she might even see you as her enemy.
Have you seen this guide?
behaviour_changes_after_stroke_guide.pdf
I feel your Mum might not be ready for the sort of rehab she is getting, but as I said, from a distance it is hard to assess.
Maybe you should speak with her stroke consultant and psychologist and ask them to explain what they think is happening with your Mum - is she getting the right care.
It seems to me, there is a communication issue - your Mum might feel she is not being listened to. Perhaps, this is something you can try and get a feel for.
You will need lots of patience - your Mum sounds to be like a frightened and vulnerable person who has gone on the defensive and she needs to feel comfortable again and for that to happen, she has to be able to talk to someone who she is comfortable with.
When my Mum feels like this, we stand back, talk to her calmly and slowly. Give her time to understand/digest what has been said.
Hold her hand (if she allows), stroke her head and hand.
Tell her you love her and you want to help her, and that she should allow you to help her.
Even ask her if there is anything she would like - did she have a favourite comfort item? Something that would remind her - maybe a toy or a photograph, or music.
Is there any music she used to like listening to?
We played lots of music for Mum - this can be very therapeutic.
If you are to help your Mum, I feel you will need support as you may be overwhelmed if you try to do it on your own, You will need lots of patience and you must be ready for pushbacks.
It can be done - trust me 
Hi and welcome @mrgnflynn firstly sorry to hear what your mom has suffered, said too often here but not something any of us would wish on anyone not even our worst enemies. The comments before me are from intelligent people who know what they’re talking about and comes from a sound place. I hope I van keep up the good work.
Sadly mom has suffered trauma to her brain possibly our most vital organ, imagine its been scrambled somehow and that everything you knew was not in order,sequence or worse trapped somewhere in a vault you can’t open. Than you have people telling you yup you have had a stroke. My response was similar= sir you’ve had a stroke I’m so sorry. My reply was because I’m dyslexic and from a backwater in Scotland “aye ok, when we starting rehab” followed by some colourful language. But I knew the words was walking and talking. I was in denial - and for a long time but now am working hard on a better recovery.
I’m suspecting mom is very much like most mom’s always busy and doing things, stroke has robbed her of this, her mobility, recall / processing skills , dignity and so much more give her some time for you and the family to adjust as well as her. Keep her close and remember the good times they will hopefully come back and all I can add is wishing you mom and family the very best recovery.
@mrgnflynn Sorry to hear of all the issues you are facing. Has someone had stern talk to your mother as she is behaving like a small child. I don’t do sympathy, I do empathy. I am a stroke survivor and many of my family have suffered strokes as well. Stroke survival is a hard road. Which country are you from? I am Scottish but live and work in England. There is no magic answer to your questions. Its trial and error. A little at a time, brings good results. Maybe your mother needs medication to stop her acting like a child. This must be a drain on your family as all you want to do i help and you have someone fighting against you. I do not and never have felt, “oh poor me I had a stroke.” I took it on as a challenge to do better. I wish you well and I am sure there will be others on here who ill answer you 
Hi @mrgnflynn
Welcome to the community, I’m sorry to hear of your moms stroke and difficult behavior you’re now facing, it sounds like you and family are in a really difficult situation.
I can see you’ve had lots of responses which I hope have helped. Some information has been shared from our website about behavioral problems after a stroke which may have been of help and you can have a look over this forum for other posts about behavioral problems by using the 
in top right corner.
As others have already said, stroke recovery can take a long time and it may be that your mom needs some more time to adjust to how her mind and body are now. I understand that this is a difficult time for you all, you need to make sure you’re looking after yourself too and getting any support that you need. I hope you’ll find this community a helpful space for you to ask questions and get support.
If you need anything whilst you’re using the Online Community, please don’t hesitate to tag me using the @ symbol and my username.
Anna
@mrgnflynn , @ManjiB is not wrong. You’ll have some authorities pushing you back. Also, be careful if you have a social worker assigned to you or relative. Some SW’s could hinder rather than help you. Like you, I’m having a tough time with my mum’s stroke (for different reasons). It’s a long and difficult road. I’ve been a carer (until recently) for 30+yrs, it’s a lonely road to walk. As @Anna_Moderator said, use this forum or try contacting their hotline (online or over the phone) for help and advice. Also, I can give basic caring advice if needed. 
Sorry for everything your mother is going through. It’s pure agony to see a loved one suffering and adrift from reality.
There are no guarantees, but for what it’s worth, doctors were starting to suggest my Mum’s cognitive capacity was permanently gone, and then she felt as if her mind cleared suddenly 7 weeks after her stroke. Before that she went through a phase of being resistant to therapy, and screaming when moved or touched (although she wasn’t actually violent), and after that a phase of trying to get out of bed despite being too frail to do so safely. She also couldn’t form new memories reliably so sometimes denied having had a stroke. Yet it turned out her brain was rewiring well in the background and she became lucid again, spent 3 weeks more in hospital learning to walk a little bit with a zimmer frame and is now back home on early supported discharge.
I don’t know how common it is to have that kind of a breakthrough but it does make me think that there’s still time for improvement if your Mum is still only one month after a stroke. You didn’t mention if the cause was a clot (ischaemic stroke) or a bleed (haemorrhagic stroke), but in the second case it takes several weeks for the survivor’s brain to reabsorb the blood which leaked, and before then it’s hard to make progress with recovery.
Whether any of this helped I’m not sure, but what we tried to do while Mum was in a bad way was: visit often but for short periods not to tire her; talk about things she’d been interested in in normal life; reassure her that we wanted to hear her thoughts even if we couldn’t understand everything she said due to aphasia; explain what was going on repeatedly but on an adult level. Wishing you all the best luck communicating.
Wha a terrible situation for you to be in. Yes, people are often combative after stroke and you/your mother need health professionals who are aware of this and willing to work within it. How you find these I do not know. When I was in the stroke ward there were many patients like this, so I think it must be pretty usual. Sorry I can’t offer any advice on where you can go from here, but there must be some areas of the health professions that are used to it and willing to manage it. I wish you all the best.
Hi @kimkomnb and welcome to the community. Just popping y to say hello and hope that you are getting on ok after your stroke. Look forward to hearing more from you.
@mrgnflynn - I think this post from @Amanirenas is the best and most helpful response for the situation you find yourself in. It covers all the points that are important and relevant, for example, the fact it is still early days for your Mum and so there is no reason why she can’t do what @Amanirenas Mum’s did.
I see exact parallels between your Mum and @Amanirenas’ Mum.
This is another piece of excellent advice
Thank you @Amanirenas for sharing your experience and I really feel this will help @mrgnflynn tremendously.
Hello @kimkomnb - welcome to the community and thank you for sharing your experience
… - they find you
Namaste|
Hi @kimkomnb
Welcome to the community, I hope your recovery is going well and that you’ll find this community helpful.
If you need anything whilst you’re using the Online Community, please don’t hesitate to tag me using the @ symbol and my username.
Anna
@ManjiB , well put. You’ve put it better than I could.
That’s kind of you to say. I’m glad if it helped. Mum’s stroke was a fairly unusual kind, though (moderate-large bleed in her speech area, but it was from a peripheral blood vessel that mostly drained into the sub-arachnoid layer) - and then it somehow provoked blood clots elsewhere in the body including a massive pulmonary embolism that nearly killed her and needed emergency surgery. I haven’t got enough specialist knowledge to work out how she survived let alone managed to switch most of her brain back on again. Just hoping other people stuck in an altered state of consciousness can someday be as lucky.
I think in many cases, for people in this state, their brains are working away repairing the damage but we can’t see it and we don’t know how long it will take. I don’t think anybody does, but many expect results or signs “yesterday”. This desire to see results quickly seems to be problematic as when results are not seen they don’t get the support and encouragement they need, even if that is as simple as letting them rest and allow the brain to do the repair work.
I think your Mum getting the time and space and not being rushed must have helped. You / her care team gave her time and after a long period of her lying there she started showing signs of recovery and once she did, it was significant;
Not everybody is afforded this kind of support 