An occupational therapist going through some activities with a stroke survivor.

Sheena Astilla is an occupational therapist at SPD’s Transition Programme for Employment. She works with those diagnosed with stroke or spinal cord injury to get them back into employment. Sheena shares how stroke survivors can be successfully integrated back into mainstream society.

For people who have experienced a neurological injury such as a stroke, integrating them back into the community can be challenging.

Stroke is the leading cause of disability and the fourth-leading cause of death in Singapore.

While more people survive stroke, many survivors also find themselves having to grapple with occupational loss and the difficulties of getting back into activities that they had previously enjoyed.

Apart from the physical disabilities evident after injury, the clients may also face other challenges including dependency in doing activities of daily living such as dressing and eating, role shift within the family, altered body image, decreased self-esteem and depression.

There is a multitude of resources available to help stroke survivors cope with integrating back into the society. Service continuation after an in-patient rehabilitation programme is very important, along with client and family counselling to have positive outcomes and quality of life.

According to studies, the following will support patients in their community integration after acquiring a neurological injury:

1. Involvement of stroke survivors, family members and caregivers – While it is important that everyone involved is informed and supportive of all aspects of health-care needs, it is also recommended that family and caregivers are also knowledgeable and trained in handling the equipment that the patients use;

2. Opportunities for work or vocational interests – Resumption of work roles for those who have been employed before the injury should be encouraged to increase quality of life. If the stroke survivor is not able to return to his previous work, vocational counselling should be offered to explore other possible employment opportunities;

3. Re-engaging in leisure activities – After injury, stroke survivors often have difficulty resuming leisure activities that they once enjoyed. Re-engaging in previous leisure activities or learning new ones can be useful in improving life satisfaction;

Occupational therapists can help in finding modifications and adaptations if needed to allow for meaningful participation in the community;

4. Being informed of community resources available – Community resources such as stroke support groups or community centre courses can provide information, activities and assistance to stroke survivors, their families and caregivers.

Support groups provide an avenue where stroke survivors and caregivers alike can share experiences and interact with each other to support physical and emotional healing. Support groups have shown to be helpful for a client’s recovery and quality of life. Stroke clients can also volunteer to share their own experiences and provide peer support to fellow survivors.

Community centres also conduct various courses and activities throughout the year that stroke survivors can engage in to help them keep an active and healthy lifestyle.

Stroke survivors continue to live with their disabilities long after they are discharged from the hospital. Learning to resume their usual activities and integrate back into the community after their injury will be a lifelong challenge for many. With adequate support from family members, caregivers, the health-care team and the community, they will be able to access the same opportunities as anyone else.

References:
Bhogal, S. K., Teasell, R. W., Foley, N. C., & Speechley, M. R. (2003). Community Reintegration after Stroke. Topics in Stroke Rehabilitation, 10(2), 107-29.

Duncan, P. W., Zorowitz, R., Bates, B., Choi, J., Glasberg, J., Graham, G., . . . Katz, R. (2005). Management of Adult Stroke Rehabilitation Care. Stroke, 36, 100-143

Parker, C. J., Gladman, J. R., & Drummond, A. E. (1997). The Role of Leisure in Stroke Rehabilitation. Disability and Rehabilitation, 19(1), 1-5.

Venketasubramanian, N., & Chen, C. L. (2008). Burden of Stroke in Singapore. International Journal of Stroke, 3(1), 51-4.