Living with a Stroke
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
More about the experts All content is checked by medical journalists.
A stroke often turns life inside out - that of the person affected and that of their relatives. What does the professional future look like? Can and may the patient continue to drive a car? Are vacation trips possible? What should relatives consider when dealing with stroke patients on a day-to-day basis? You can find answers to these and other questions about life after a stroke here!
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. I63I64I61I69
Stroke & Profession
Especially with younger stroke patients, the question of their professional future arises. Even during rehabilitation you should talk to your doctor about a possible return to work or reorientation.
The most important contact persons for such questions are the employment agency and the pension insurance institutions. Among other things, they promote measures for professional reintegration through induction grants and retraining. The central task of vocational rehabilitation is to find the right job for you. There are basically the following options:
- Return to the previous job (if necessary with an adaptation of the workplace)
- gradual reintegration (such as part-time work)
- Change of job within the previous company
- Retraining in another profession
Whether you can resume all or part of your previous job depends on your occupation and the degree of physical and mental impairment after the stroke. It must be determined whether and how your employment can be improved or restored. Get detailed advice on options for adapting your workplace, retraining or part-time employment.
Partial reduced earning capacity
A partial reduction in earning capacity (formerly known as “occupational disability”) exists if the earning capacity is possible for at least three but less than six hours per day due to illness or disability, with a normal 5-day working week. If this is the case for you, you can apply for a partial disability pension. This is intended to compensate for your reduction in wages if you can no longer work full-time.
Complete disability
Fully incapable of work are people who, due to illness or disability, are unable to exercise any gainful activity on a regular basis for the foreseeable future. Specifically, this means: someone is able to work less than three hours a day within the framework of a 5-day week on the general labor market.
People unable to work can apply for a pension due to total disability. She should replace the wages. The disability pension is usually paid as a temporary pension, i.e. limited to a maximum of three years. The time limit can be repeated on request. Usually, after a total of nine years, it is assumed that the person concerned will be permanently unable to work. The temporary pension payment can then be converted into an unlimited permanent pension.
Stroke & Driving
After a stroke, your ability to drive can be affected in two ways. On the one hand, there is a risk that you will suddenly suffer another stroke. On the other hand, your performance can be reduced by the consequences of the stroke, for example by paralysis, visual disturbances or slower reactions. In both cases, you would endanger yourself and other road users at the wheel of a car.
Personal responsibility required
Legislators require every driver's license holder to take responsibility for themselves - whether or not a stroke patient: everyone should check himself again and again whether he can drive a vehicle safely through traffic. After an illness such as a stroke, however, the law requires that the person concerned takes "appropriate precautions" so that he does not become a danger at the steering wheel. This includes the patient getting expert help.
Ask a doctor
The first point of contact is your treating doctor. As a rule, he or she can better assess whether you can still get behind the wheel or whether you should do without driving for safety reasons. This waiver can either be temporary - until you are fit enough to drive again - or permanent, for example in the case of permanent paralysis.
Inform the authority
In addition, you should voluntarily inform the competent authority (driver's license office) about the stroke and submit a specialist medical report that is not older than six months. This can be, for example, the discharge report from a rehabilitation clinic or the opinion of a neurologist with a traffic medical qualification. This expert decides whether, for example, additional driving lessons, a trip to the ophthalmologist or a neuropsychological report are required.
The authorities can usually decide on the basis of the documents whether you are allowed to continue driving (possibly subject to conditions or restrictions) or whether you have to surrender your driver's license. If the authority is not satisfied with the report, it will arrange for a medical-psychological examination (MPU).
MPU
The MPU is carried out by assessment bodies for fitness to drive. There are such accredited test centers at TÜV, for example. The MPU is divided into several parts:
Firstly: On the basis of a medical examination, a specialist, specialist or rehabilitation clinic draws up an up-to-date report on your state of health.
Second: A performance test will check your ability to react, concentrate and perceive yourself. For example, you need to press a key as quickly as possible in response to certain computer signals. Make sure that the test is handicapped-accessible if necessary, for example if you have difficulty pressing buttons due to a slight paralysis in your arm.
Third: A conversation with a psychologist should find out whether you have coped mentally with your stroke, whether you have the confidence to drive and whether you feel fit and responsible for driving.
Driving test
Many stroke patients are restricted in their mobility and need a converted vehicle. This can be a car with a steering wheel knob, for example. There are driving schools that specialize in stroke patients and have converted cars that patients can use to take driving lessons. You can then take the driving test at TÜV or DEKRA.
The decision
The driver's license office will decide on your fitness to drive on the basis of the documents you have submitted (specialist medical report, MPU, driving test). In the best case, the authorities come to the conclusion that you can keep your driving license without restriction.
Often, however, requirements or restrictions are entered in the driver's license based on the expert opinion. For example, after a stroke, some people are only allowed to drive a car with specially adapted steering. Others are no longer allowed to drive at night or on motorways.
costs
The MPU and the driving report cost several hundred euros, which stroke patients have to pay themselves. Financial support is only available in individual cases for the expert opinion or a necessary vehicle conversion.
Provide certainty
Although it's not cheap and you may end up with your driver's license revoked, it is important to have your fitness to drive checked after a stroke. An objective assessment by experts brings certainty in the event of possible self-doubt.
Above all, however, it is important that anyone who is unfit to drive and still sits behind the wheel is endangering themselves and others, making themselves liable to prosecution and risking their insurance cover.
Stroke & Travel
When you have recovered from your stroke, you can usually go on vacation again. Even air travel is permitted in principle. But it all depends on how fit you feel.Do not overestimate your ability to perform - it is important to consult your doctor in detail. He will also take into account any comorbidities that many stroke patients have. This can be, for example, coronary artery disease (CHD), diabetes mellitus (diabetes) or high blood pressure.
The general rule is: No extremes! Mountain tours over 2500 meters above sea level, deep sea diving, a photo safari through the jungle or cruises in the Arctic are not suitable travel plans for stroke patients.
Prepare your trip well
Prepare yourself well for the trip. For example, book accommodation for the disabled if necessary. Find out about local medical care. Check with your doctor about recommended vaccinations. You can also have him issue you a certificate stating your diagnosis and treatment (possibly in English). Also, make sure that you have sufficient amounts of any medications (or prescriptions) that you need to take regularly (such as anticoagulants or antihypertensive drugs) with you. Ask your doctor or pharmacist how to properly transport and store the medication.
Before traveling abroad, you should also take out international health insurance with repatriation in the event of illness. This saves you high costs in an emergency!
Healthy on the go
In order not to overload your cardiovascular system, you should avoid long car or bus journeys in extreme heat. Strong temperature differences are also unfavorable for the heart and circulation, for example due to the air conditioning in the hotel room or car and outdoors.
Sitting for long periods (e.g. in the bus, car or plane) slows down the flow of blood in the leg veins. This encourages the formation of blood clots, which can clog a vessel. Regularly moving your feet and legs and wearing support or compression stockings can counteract this. Also, do not cross your legs and drink enough.
Divide the medication you need between your hand luggage and luggage in the event that one of the pieces of luggage should be lost. At the holiday destination, make sure that you store the medication correctly (as indicated in the package insert) so that it does not lose its effectiveness.
Stroke: tips for loved ones
The consequences of a stroke affect not only the patients themselves, but also the people who share their lives. The relatives need a lot of time, patience and empathy. In addition, they often have to completely change their own lives in order to be able to offer the patient the help and support they need that nurses or therapists cannot provide on their own.
The stranger in your own house
It is particularly problematic for relatives of stroke patients if the personality of a familiar person changes as a result of the illness. Many sufferers react to the helplessness and the sudden loss of their own abilities with despair and depression, others become aggressive.
Sometimes the feeling control in the brain is also affected as a result of the cerebral infarction. Then it can happen, for example, that the sick person suddenly laughs or cries in inappropriate situations. This can put a considerable strain on relatives. In moments like this, it is important not to automatically relate aggression and tears to yourself.
Lovingly and with respect
Relatives should not make decisions over the head of the person concerned. It is better to let the patient speak for themselves. This is especially true if the person concerned has difficulty making himself understood due to the stroke. Give the patient time to share.
Between asking and helping
Relatives are the most important helpers for stroke patients on their way back to a life that is as independent as possible. Because the therapy sessions alone are not enough to regain language, attention skills or movement control, for example. Everyday life is a training course for those affected. Relatives should therefore resist the temptation to mother the person concerned too much, to relieve them of every handshake or to finish incomplete sentences for them. You should only intervene to help if the person concerned cannot cope with a situation at all or is too exhausted to do so.
On the other hand, some relatives make the mistake of turning the day into continuous training. This can completely overwhelm the patient. Life with a disability is very exhausting, especially at the beginning, so breaks are urgently needed.
Strengthen self-confidence and zest for life
A stroke robs a person of many skills that they could previously rely on and that have defined themselves. That can really gnaw at one's self-esteem and zest for life. Relatives can make an important contribution to helping those affected win them back, for example with joint activities, excursions or meetings with friends. But be careful: For people with aphasia (speech disorder), many everyday situations are very stressful - this includes, above all, loud background noise.
Dealing with aphasic patients - special features
Dealing with people who suffer from impaired language skills (aphasia) can quickly become difficult for relatives because of the communication problems. Some helpful tips:
Do not take the word out of the mouth of the aphasia sufferer: People with aphasia often speak hesitantly and look for words for a long time. In that case, one should wait patiently to see whether the aphasic does not find the term they are looking for. Every linguistic sense of achievement is important to him. He often succeeds in expressing himself if you give him enough time.
Facilitate communication: fellow human beings should speak slowly and clearly to an aphasic person and underline what has been said with facial expressions and gestures.
Ensure understanding: Sometimes someone is not sure that they have correctly understood an aphasic. Then you should make sure with simple yes / no questions that you are correct: "You are talking about Ms. Schulze?" If the aphasic appears confused, one should ask whether he has understood everything.
Don't Correct Too Much: If an aphasic person makes mistakes in sentence structure or in the use of a term, it should not be corrected. Because that also frustrates and unsettles those affected. Some aphasic people then refuse to speak at all for fear of making shameful mistakes.
Facilitating contact with others: Most people are initially unsure when meeting aphasic people. Family members should encourage other people to communicate with the stroke patient and help them with their own tips and experiences.
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