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[Alison9]

Hi

My Mum had a stroke a couple of months ago. She is 88, was in hospital for four weeks and has been home for four and is receiving regular therapy sessions at home.

Having read some of the stories here, I can see that we are very fortunate in that Mum seems to be improving all the time. Her speech is ok and she is mobile (though wobbly).

My question is how much should she be doing? I know there is no ‘right’ answer to this. I ask because the physio has her doing these strengthening exercises and says to aim for doing them twice a day (when?? now? in a few weeks’ time?). But she has all her other activities to do, not to mention eating, going to the toilet, having a sleep, etc, etc. There just doesn’t seem enough time in the day.

I was worried they were pushing her too hard but actually the exercises did seem to energize her. She’s had a couple of hospital appointments recently and was dreading them but she did really well and I think the change of scenery did her good. So, I do see the need to challenge her a bit but I’m wondering how to find a balance. Yes, the exercises may be a good thing but I’m also concerned - she is 88!!! OK, she needs to strengthen her body but I don’t know if she has nutritional deficiences (she’s lost weight). I’m going to speak to the doctor but I just want a bit of advice from those who have been through this.

I have read posts which say trust your own intuition about things. I do feel the pressure for her to improve ‘in the first’ six months’. but I’m also starting to get the sense that I need to chill out a bit and let things take their course. The physio’ s have been really good but I do also feel they just pop in for half an hour, tell you what to do without really understanding what else is going on in her life (or the rest of the family for that matter).

Any advice much appreciated.

Thank you

[SimonInEdinburgh]

Hi @Alison9

Welcome to the forum sorry you had a reason to join us.

You’re right about the “pop in without awareness of what else is going on” - You need to let them advise but not instruct.

Nutrition and sleep are very important I dare say emerald will be along soon with some words about both. She always gives sage advice

I would suggest you prioritise rest first including sleep, food second, living life third and exercises to regain capability to fill in the gaps. That will then be self-regulating in that too much exercise will cause an excess need for rest if there isn’t already - Which is very common.

The first 6 month thing is a red herring. You will see the most improvement because that’s when capability that wasn’t destroyed by the death of brain tissue but was compromised will return. The exercises are building neuroplasticity and hopefully holding neuroplasticity that equates to learnt non-use and new patterns of avoiding lost capability at bay.

Yes you’re right that helping to be motivated is good but it doesn’t sound as if that’s any deficit - something to be grateful for if true

If you’ve been reading round particularly if you’ve used the magnifying glass above to search for “mum (dad partner…) had a stroke” likely seen the threads we would recommend.

The journey post stroke is a rest of life one not a six month one so possibly some chilling is a good thing.

Caio
Simon

[Susan_Jane]

Hi Alison and a big welcome to this forum. So sorry to hear of your mum’s stroke. We are a merry band of stroke survivors and their families and carers. There’s always someone here to offer advice and information.

Considering your mum’s age, it sounds like she’s making great progress in her recovery. As others have said it’s important that she eats well and gets plenty of rest between exercise sessions.

In my experience Neuro Physiotherapists have always been a great source of information and support and I’m sure if you sat down with them at one of your mum’s sessions they would be able to advise you on a reasonable programme of exercise.

Stroke recovery is a long and difficult road, so for your sake as much as hers, I would say that you need to take this slowly
and try to fit her exercise routine around your everyday commitments and routine.

Look forward to hearing how her recovery is progressing.

Regards Sue

[Mrs5K]

Hi @Alison9 & welcome to the community. Sorry your mum has had a stroke. Sounds like she is coming along ok.

I remember thinking at the start how on earth I was going to fit in all the exercises they were asking me to do & i was 40 years younger than your mum when i had my stroke. In the end I just did what I could manage because doing too much bought on fatigue & all i could then do was sleep. You could perhaps try building the exercises into her normal activities…i don’t know what they’ve given her to do but I for example would do some of my arm exercises whilst watching TV or walking ones when waiting for kettle to boil. But it will of course depend on what your mum is capable of doing.

In regards to her weight loss try adding some supplements to her diet. Things like ensure plus, complan etc. Also fortify her food with things like milk, butter & cheese in mash potato & scrambled eggmarvel milk powder to yoghurt, thinfs like angel delight are higher calorie etc. Try & sort it early on as too much weight loss will lead to other issues. Keep your mum moving as much as poss8ble too to minimise muscle loss.

The first 6 months are important but recovery continues well beyond that point as long as effort is put into it. Sounds like your mum will make that effort so try & relax a bit more about it all.

Best wishes to you both.

Ann

[EmeraldEyes]

Hi @Alison9 and welcome It sounds like your mum is doing good and progressing well. That’s what matters most! So she must be doing something right

@Alison9

I ask because the physio has her doing these strengthening exercises and says to aim for doing them twice a day (when?? now? in a few weeks’ time?).

With the emphasis on aiming to; gradually building up to twice a day as her ability, speed and stamina improve. And that can take days/weeks/months depending on where she’s at right now. The advice the physio is giving is a guide, because she doesn’t know your mums abilities well enough to be more precise.

This is not boot camp and besides, her brain just will not allow her to do more than it is ready for anyway. My brain was a right stubborn cuss for not letting me do things when I wanted to

As @Mrs5K has already said, fatigue is the price you pay for doing too much. This is learnt through trial and error but she will soon learn to pace herself…at her own pace. You can’t push but you can encourage, as well as remind, because short term memory will be poor. The brain is too busy healing and repairing to hold on to short term memories long enough to process and store them. So lists are a godsend, just keep them short and simple to read

Frequent breaks between each activity/exercise is good. 5mins here, 10mins there, 15mins etc. Just taking that time to sit and shut your eyes and just be, while the brain takes a rest or time to process what’s just been learnt. And the same goes for the rehab activities and physio exercises too, 5 to 15 mins, half an hour at most depending on what it is. Your mum will soon learn her own pace and adjust accordingly

@Mrs5K

or walking ones when waiting for kettle to boil.

I used to practice walking a straight line on the tiled kitchen floor while waiting for the kettle Or just standing still with my eyes shut to practice centring my balance.

So many of the physio exercises can easily be incorporated into her daily routines. She doesn’t need to specifically set aside a couple of hours to exercise. Making the bed, loading and unloading the washing machine, making a cup of tea. And these are familiar activities to spark the brain and trigger muscle memory, probably quicker than any unfamiliar physio exercises because she has to learn them in the first place. It’s always good to have a mix and switch things up

I’m not speaking as an expert, this is all just based on my own stroke recovery. So do actually speak with her physio to see what she suggests.

But hopefully with all of the above advice, it might bring you some peace of mind. It’s time to relax a little, take a breather and bring some rational thinking back into your mind. This stroke has been a shock and very distressing time for you so you need to look after yourself. Don’t forget to take time out for you too and don’t be afraid to take help wherever its offered. You need your health because you’ve still got your whole life ahead of you to live

[Alison9]

Thank you all for the reassurance.

I am starting to calm down a bit and be a bit more rational. She is definitely making progress so something must be going right and I need to trust in that more.

I appreciate the advice to work exercises around sleep and eating and living life. It does feel a bit like boot camp sometimes because of the six month thing - you feel under pressure to do the right thing.

I also know that I need to look after me. I just need to come up for air long enough that I can plan. I did read here, somewhere, that things will sort themselves out eventually and I think that will be the case, we just have to get through this period.

I have loads more questions so am sure I’ll be posting again soon.

Thank you again, is much appreciated.

[SimonInEdinburgh]

Hi @Alison9
Glad you’re calming

Forget the ”6mths" It’s a misleading nonsense that will take more discussion to clarify meaningfully.

You must prioritise your self without any feelings of guilt too as you’ll be important to the long term

Good that there is progress. Don’t get depspondant when this appears to be going backwards - it’s very common.

Things generally improve as long as effort & direction are applied. They don’t have to be excessive just guiding

Caio
Simon

[EmeraldEyes]

Good to hear you are calming down a bit, it will get easier as routines develope. And don’t try to do everything for her as that can slow progress. Let your mum do things for herself as much as possible and only intervene when necessary. This is all part of retraining her brain.

I remember I used to get so frustrated and sick of having to ask for every other thing. I sometimes wonder if that frustration helped speed recovery along for me.

My family hovered and fussed a lot to begin with. I couldn’t go pee without someone tailing me, and only had to stand up to have them asking where I was going and what did I need. That got old soon enough for all of us So it might be a relief to your mum to see you relax a little too

[Mrs5K]

Sounds like all is progressing as best as it can right now. Good to hear you’re a little calmer…very important to look after yourself too.

Things will naturally calm over time out of necessity if nothing else.

As @EmeraldEyes says try & resist the temptation to do everything for her. My hubby used to snaffle things off me because I was taking too long which, whilst well intentioned, frustrated the hell out of me as I wanted to try.

The 6 month thing is misleading. As long as effort is applied progress can be made for the rest of someone’s life. Maybe a little slower but still progress.

Best wishes

Ann