Has your lifestyle changed after a stroke? Some stroke survivors have trouble performing daily living as they did before. You should know how to manage those changes for adaptation and recovery. In this article, we’ll let you know what you should do in your daily living and 7 actionable tips for your successful stroke recovery.
7 tips for stroke recovery in daily living
2. Eat right
3. Maintain proper posture
4. Do more aerobic exercises (cardio exercise)
5. Sleep well
6. Mental care - Manage stress & Post-stroke depression
7. Other tips - dressing, taking a shower
Self care is an act of taking care of yourself to meet your physical, mental and emotional needs. It comes in a variety of forms — i.e. eating healthy, drinking water, exercising, sleeping well, getting dressed, personal hygiene, other meaningful/ recreational activities, etc.
Self care practice promotes overall quality of life, health, mood, performance in daily life, and relationships. Self care practice also plays a significant role in stroke recovery and prevention of other health problems.
So, how do you actually take care of yourself after a stroke? Start by being mindful of your feelings, conditions & needs, and asking for help when needed. Even if you need help with some of the basic daily activities, knowing when & how to ask for help is an act of self care.
Moreover, complying with the rehab treatments, taking medications as instructed, going to the doctor's appointments, making healthy choices to maintain healthy lifestyle and engaging in activities that you enjoy are the examples of self care, which will help you get stronger and healthier.
As we go forward, we will discuss more about healthy lifestyle changes, mindfulness, and tips on how to take better care of yourself.
What do you eat on a typical day?
What did you have yesterday?
Are you keeping a balanced diet?
It is important to be aware of the eating habits, because what and how we eat affect the health of our body and brain. For example, almonds have protein that helps improve your memory. Also, chewing your food slowly and thoroughly stimulates the brain to increase blood flow and boost concentration.
You’re probably well aware by now that a stroke happens when there’s a clog or a burst in a blood vessel in the brain. The risk factors for stroke include: high blood pressure, diabetes, cardio disease, family history. Obesity, alcohol intake, stress, and smoking are also the risk factors that could affect the blood flow.
It is important to maintain a healthy diet when recovering from a stroke (as well as to prevent a stroke). After all, our cells are made up of and maintained with protein, carbs, fats, vitamins, and minerals we consume.
Did you know? When your blood sugar and lipid levels rise, waste materials gather up and damage the vessels. That’s why cutting down on fatty and sugary foods and taking in healthy ones is essential. That doesn’t mean you should forever part with fats and sugars.
You just need to replace them with sugary veggies and fruits or take in fats that are healthy. Just a little tweak in your daily diet, and you’ll feel the difference! Why don’t we learn more about the healthy eating habit? Learning about healthy ingredients, cooking methods, and assembling a balanced diet will surely keep your body weight in check!
We recommend you stick to the following 5 habits.
Diet & nutrition tips for stroke recovery
1) Eat healthy after a stroke
Healthy diet is important as it reduces risk of having another stroke or other health complications by helping manage blood pressure, cholesterol levels, and body weight. It also provides nutrients that your body needs for stroke recovery, energy, and improves brain function.
The essential nutrients for healthy diet include: protein, carbohydrates, fat, vitamins, and minerals.
- Fresh fruits and vegetables, low-fat meat, fish, and nuts are usually good choices for healthy diet.
- Vegetables not only contain essential minerals but are also rich in nutrients and fiber.
- The fiber in fruits is better absorbed when they are eaten whole and not juiced.
- Fish contains high levels of unsaturated fatty acids.
- Lean meats are healthier.
- Try to consume less oil and fat.
- To reduce sodium intake, try seasoning your food with different herbs and spices.
- Replace highly processed, sugary food with whole grains, or healthy carbohydrates found in fruits.
- And, don't forget to drink water!
Every stroke journey calls for different practices. We understand changing your diet is always easier said than done. But your health also depends greatly on what you put into your body. Sticking to healthy eating habits is crucial during recovery. Be sure to talk to your doctor about your unique needs before you fill up your fridge with different foods.
2) Take in 5 essential nutrients in balance.
Healthy eating is consuming all five essential nutrients in a balanced diet. There is no such thing as an all-in-one superfood, so we have to make a conscious effort to get our nutrition sources in suitable proportion..
Carbohydrates provide the energy for our body and brain. The best source of carbohydrates are whole grains, oatmeals and whole-wheat bread. Limit your intakes on sugar, white pasta and bread.
Proteins are essential in building and maintaining muscle mass. The best source of carbohydrates are lean meats, eggs, beans, and nuts.
Fats also provide the energy for our body, help regulate body temperature and protect our organs. Healthy fats include olive oil, nuts, seeds, avocados and fish that contain omega-3 fatty acids (salmon).
Minerals are not the energy sources, but they are essential in keeping us healthy and alive. Iron (spinach) is important in making red blood cells, and potassium (banana) helps the heart muscle to work properly.
Like minerals, vitamins are not the energy sources, but they are essential in keeping us healthy and alive. Vitamin C boosts our immune system. Vitamin D helps absorb calcium, which strengthens our bones and teeth. We should be able to get the nutrients through a balanced diet, but sometimes we have to take supplements.
These essential nutrients come from various food sources, and they are vital for the optimal health. Body functions may deteriorate after a stroke, and if the immune system gets weaker, one may be prone to pneumonia, flu, urinary tract infection, etc. Therefore, it is important to keep a well-balanced diet.
3) Eat an appropriate amount of food
Calorie is the measurement of the energy you get from food. The amount of calories you need to consume everyday depends on your age, sex, height, weight, and level of physical activity.
If you eat more than you need, the excess calories are stored as body fat, which can lead to obesity and other health problems. However, you don’t eat enough, it slows down metabolism, and causes nutritional deficiency, fatigue, weakness, and irritability. Consumption of nutrient dense foods is important for stroke recovery, as it provides the energy for your body to heal.
The USDA Food Pattern suggests a healthy balance of foods: veggies, fruits, whole grains, fat free or low fat dairy, seafood, poultry, meat, eggs, nuts, seeds, and soy products.
More information can be found on: USDA Food Patterns. It is important to eat the right portion of a balanced diet at consistent times each day.
*Speak to MD or dietitian before starting a new diet as certain types of food can interfere with medication.
4) Incorporate healthy fats into your diet
Many stroke survivors tend to avoid eating greasy food or meat altogether to forego fats. However, not enough fat in the body will cause malnutrition and weaken your body. Too much fat is unhealthy, but an appropriate amount of healthy fat is recommended in healthy diet!
Some food contain enough dietary fat as is, but we often end up adding more when we cook. Let’s go over some of the tips for healthy meal prep.
- Choose healthy ingredients.
Have you thought about the quality of ingredients? Pay attention to the amount and type of fats - healthy vs. unhealthy fats - that your food contains. Here are some healthy picks:
- Select plant-based fats instead of animal fats.
- Select healthier oils such as olive oil, avocado oil, and sunflower oil instead of trans fats.
- Choose healthier cooking options.
Deep fried foods are tasty but not healthy as they contain high trans fats.
- Boil, steam, bake, or grill instead of frying.
- Air fryer, oven, and grill require less oil to cook than deep frying.
- Use small amount of oil to stir-fry.
Stir-fry is easy, tasty, and less in calories, making it a healthier option.
- Use small amount of oil to stir-fry veggies and proteins.
- To reduce sodium intake, use less salt and add garlic, herbs and/or spices to season.
- Eat lean meat.
Eating meat and/or plant-based protein like tofu and quinoa is necessary for a healthy diet. But consuming too much meat or fatty meat is unhealthy.
- Stick to lean meat.
- Try using only small amount of salt and oil when cooking meat.
- Cut back on store-bought dressing or sauce.
Salad dressings and sauces add flavor to food. But more often than not, they contain unhealthy fats and chemicals. Make your own salad dressing with fruits, yogurt, or olive oil!
5) Prepare healthy and satisfying meal
You already know why it is important to eat healthy after a stroke. Healthy diet not only helps reduce the risk of having another stroke, but it also provides nutrients that your body need for the recovery. Here are some tips for healthy and satisfying meal preparation!
- Cut down on salt.
Too much sodium in your diet can contribute to high blood pressure and other heart problems. There's no time like the present to explore the wide and delicious world of low-sodium and salt-free seasonings!
Some of these products replicate salty tastes with a lower sodium content; however, give herb and other spice-based products a decent try as well.
- Ditch the deep fryer.
Yesterday, we talked about healthy cooking options. And we can’t stress enough the importance of cutting down on fat. Too much dietary fat can lead to heart disease and inflammation. The good news is that there are a ton of other lower-fat cooking methods out there—including air frying, stir frying, sauteing, baking, broiling, and steaming. That's a mouthful!
Giving some of our favorite, formerly deep-fried foods a lower-fat makeover can still satisfy cravings as well as American Heart Association Diet and Lifestyle Recommendations. Everybody wins!
- Maximize meal prep.
How often do you make excuses about eating healthy when you're dining on the fly? Avoid this pitfall by doing some healthy meal prep!
Make your meals and snacks ahead of time so you're not tempted to run for the drive thru or vending machine when hunger strikes. Start by picking one meal for the next few days to a week to experiment. Target low-fat, low-sodium recipes that will keep you full to avoid cravings. Splurge on a fun container to add to the anticipation!
What's the first step you can take towards making healthy cooking a habit? Make your own salt-free seasoning blends for use in daily cooking or weekly meal prepping! You'll soon be reaching for these flavorful mixes instead of the salt shaker!
-Italian seasoning blend:
2 tablespoons oregano
1 tablespoon marjoram
2 tablespoons thyme
1 tablespoon dried basil
1 tablespoon dried sage
- Cajun seasoning blend:
1 tablespoon chili powder
1 tablespoon black pepper
1/2 teaspoon oregano
1 tablespoon garlic powder
1 tablespoon onion powder
1 1/2 teaspoons cayenne pepper
1 tablespoon paprika
1 tablespoon thyme
- Mexican Seasoning Blend:
5 tablespoons chili powder
2 teaspoons garlic powder
1 teaspoon onion powder
2 teaspoons paprika
3 tablespoons cumin
2 teaspoons black pepper
2 teaspoons cayenne pepper
Some of us are very sedentary and we spend a majority of our time in sitting throughout the day, while eating, watching TV, working and more. However, sometimes it is difficult to maintain proper posture after the stroke due to muscle imbalance, joint contracture, and other complications.
Poor posture can lead to other problems such as back pain, joint pain, and decreased functional skills. It can also affect your gait, balance, and movements of your limbs. On the other hand, good sitting posture and balance will allow you to safely engage in various functional tasks such as dressing, using a computer, writing, and other table top activities.
So, we encourage you to try the following to improve your habits to maintain good sitting posture:
- Sit up straight. Try not to learn forward or backward while sitting.
- Open up your chest and bring your shoulders back.
- Engage your core and lower back muscles to sit up straight
- Instead of dangling your feet or crossing your legs, have both feet comfortably touch the ground.
- Feel for the slight contraction of the muscles. Pay attention to how it feels in your core, back, and legs.
- Stand up from your seat every 30 min to stretch and walk around if you have good balance. If not, try to stretch out your neck, arms and legs every 30 min while seated.
You’re well aware by now that maintaining a healthy lifestyle that consists of healthy habits is essential in stroke recovery. We encourage you to add this to your daily routine so that you can make a habit of it — “aerobic exercise" (a.k.a. cardio exercise).
Aerobic exercise is a physical, cardiovascular exercise that requires the use of oxygen to burn energy. It helps improve the health of lungs and heart, as well as cut down body fat. The examples of aerobic exercises include — walking, jogging, cycling, swimming, and dancing. Such exercises are performed in low to moderate intensity continuously for an extended period of time.
How does aerobic exercise help after a stroke?
A stroke weakens the respiratory system, scaling down your cardio and lung capacity. This affects one’s strength, endurance, and/or function to carry out daily routines. This is one of the reasons why stroke rehab consists of strengthening and conditioning exercises to improve overall function.
Therefore, it is important to engage in the aerobic exercises to build up your stamina, and improve your cardiovascular and respiratory system! According to the studies, aerobic exercise helps improve your gait, balance, strength, endurance and physical health, as well as cognitive function.
If you are not used to the aerobic exercises, start with simple, easy routines and gradually increase the intensity and duration of the exercises as tolerated.
Remember to go at your own pace and challenge yourself only as tolerated. Avoid the risk of injury by stretching well before/after the exercises, and not overworking yourself.
“Sleep” in biological terms is the state of subconsciousness with relatively reduced sensory activity and interaction with the environment. But Voltaire, a French writer, had a different idea about sleep: “Providence has given us hope and sleep as a compensation for the many cares of life.”
He emphasized the importance of sleep, and it’s no overstatement as it takes up about a third of our lives.
Let’s explore why sleep deserves such limelight. Its main roles are:
- Releases good hormones
- Improves the memory
- Relieves depression
- Sleep releases good hormones
When we’re asleep, the melatonin, or “the sleep hormone”, is released and neutralizes the oxygen radicals, cleaning up toxic substances in the body. This is why your skin regains that fresh look in the morning after a good night's sleep!
- Sleep improves memory
During REM (rapid eye movement) sleep, the information contained in the cerebral cortex is relayed to the hippocampus, where it stores the memory. The stored information remains there for several days, and is transferred to long-term memory every time you’re in REM sleep.
- Sleep relieves depression
Melatonin—which determines the quality of sleep—is produced when serotonin is released. Serotonin is released during the daytime. Naturally, not enough of it will hamper the production of melatonin, and diminish the quality of sleep.
Serotonin is also related to your mood as well as physical functions such as sleep, appetite, and actions. It’s also called the “happy hormone” because it’s involved in making you feel just that. So when you had a good nights’ sleep, it means there was a sufficient amount of serotonin during the day to draw in enough melatonin. Then it’s only fair to conclude that there is a strong connection between depression and sleep.
If sleep has that much impact on you, wouldn’t you agree that good sleep is something we just can’t do without? Take a moment to reflect on how well you’ve been sleeping since you had a stroke. Lack of good sleep will cause fatigue, lack of focus, and more tension. Surely, they don’t help with your rehab efforts.
If you had problems sleeping after a stroke because of deteriorating functions, then improving your quality of sleep should definitely be on your rehab to-do list. We’ll give you some tips to help you.
3 Tips for better sleep
1) Enjoy plenty of sunlight during daytime.
Melatonin is produced only when there’s enough serotonin around. Then what do you need to ramp up your serotonin level? Vitamin D! Last time we told you it’s also called the sunshine vitamin. When you’re exposed to sunlight, your skin produces vitamin D. So get yourself out in the sun!
2) Keep regular bedtime & active hours.
Given the positive correlation between the daytime serotonin and nighttime melatonin, a regular routine around the 24-hour clock helps to regulate your biological rhythm.
3) Avoid excess caffeine!
Caffeine is found in coffee, red tea, and soda. Since each person’s sensitivity to caffeine varies, there is no rule of thumb for the right amount. But too much of it can cause symptoms such as nausea, headache, or increased blood pressure. Caffeine can have these effects because of its influence on your autonomic nervous system, keeping your body in a state of arousal.
Stress can be caused by any event, threat, and/or demand in life, which could be related to illness, financial situations, work, relationships, other challenges and circumstances. Sometimes stress could be used as a motivator and actually help you get through the perceived threat. However, chronic stress over a prolonged time could affect your health and wellness.
Stress can wear you down with negative energy, anxiety, depression, confusion, and apathy. If it goes on for days, It could contribute to serious physical, emotional, and mental health problems. When you are under stress, your brain prepares your body to "fight or flight" by releasing the hormones from the adrenal glands: adrenaline, norepinephrine, and cortisol.
Adrenaline and norepinephrine are responsible for the 'immediate' reactions, which makes you feel more aware and focused. When there is a perceived threat, these hormones cause your heart beat faster and increase blood flow to the brain and muscles.
Cortisol, which is known as the 'stress hormone', works a little differently than the above, and affects different functions in the body. Cortisol controls the blood sugar (glucose) levels, metabolism, blood pressure and sleep cycle. Depending on the needs, cortisol can suppress some of the functions in the body systems, in order to help you cope with the perceived threat.
When you are under too much stress over a prolonged time, it causes your body to constantly pump out the cortisol. Too much of it in the bloodstream shakes up the metabolism and can lead to protruding belly, high cholesterol levels, and cardiovascular diseases. It could also suppress immune system, and cause rapid weight gain. It also affects the brain function by hampering the signals sent out from the hippocampus (part of the brain that is responsible for learning, memory and emotional regulations)
Therefore, it is important to manage stress with a healthy lifestyle -- regular exercises, healthy eating, meditation, relaxation, good quality sleep, and mindfulness are all known to be effective in stress management.
Manage post-stroke depression
A stroke can affect people in a variety of different ways, such as impacting muscle movement, cognition and speech but emotional and behavioral changes can sometimes be the most challenging to cope with. Post stroke depression is more common that you might think.
Depression can be caused by the physical changes made in the brain after a stroke but it can also be caused by how the stroke has affected your outlook on life.
Many people often find themselves feeling angry, frustrated, anxious, hopeless, and sad because the stroke has changed their lives and they no longer feel like they are the person they used to be.
- Tips to treat post-stroke depression
1) Taking an active role
Actively planning the process of recovery can reduce the possibility of psychological issues and improve outcomes overall. Active roles might include befriending other stroke survivors, volunteering, doing creative new hobbies, attending support groups, scheduling physical activities, or doing your daily missions with Rehabit!
2) Finding Joy
Creative, stimulating or energizing activities can help you to remember that you can still keep up with old hobbies or learn new skills. Easy activities that may bring a sense of fun & fulfillment may include coloring pages, crosswords, making music, Rehabit daily missions, board games, etc. It’s easier to feel more self-confident and validated in your abilities when you realize that you can continue to participate in tasks that bring joy.
3) Spending time in the community
Unexpected life changes like stroke can make people want to hide from the world especially if you are experiencing anxiety and depression. Spending time with your loved ones outside of the home and participating in group activities can help you to remember that you are part of a community. Check out the local gym or shopping center, work on gardening tasks, play team games like bowling, visit a movie theater, or just sit at a cafe and people watch. Remember that the things you enjoy are still awaiting you.
4) Enjoy the sun!
When exposed to sunlight, your skin produces vitamin D, a.k.a "the sunshine vitamin”, or the “happiness vitamin”. Why these nicknames? It’s because our happy friend serotonin gets triggered. Serotonin is a neurotransmitter in charge of your senses like mood, as well as sleep, appetite, and motor functions. It’s a kind of amino acid made in tryptophan. It’s called a happy hormone because it makes you feel just that!
1) Dressing Tip
How is getting dressed going? Think about the ways you dress and undress throughout the day. Seriously! Even your routine daily tasks are an opportunity to exercise your arm and benefit your brain!
First off, do you do the task independently or do you get some help? Ensure that you are trying to take ownership of some parts of your dressing routine and contribute within you available movement safely and comfortably. Try your best first, and then ask for help if you need it!
Secondly, are you doing your tasks largely one-handed? Is there an opportunity to incorporate your affected side? Remember, we have to use it to improve it! Trying to be two-handed is important, even if all your arm can do is help stabilize at this time
Challenge yourself in the following ways when you get dressed:
- Level 1: Use your affected arm to stabilize clothing as you fold or unfold it for the day. Your affected arm has a roll in stabilizing your shirt, pants, socks, shoes and more as you get your outfits ready! It is okay to use your strong arm to position your affected arm if it cannot do this by itself.
- Level 2: Try to reach your affected arm into your sleeves, as opposed to bringing the sleeve over the limb first. Attempt to grasp clothing to adjust, straighten, and stabilize it when dressing. Try to pull the front of your shirt down or your pants up with help from your affected arm.
- Level 3: Tackle clothing fasteners: buttons, zippers, belts, clasps, snaps, and ties! Progress from bigger fasteners to smaller to improve your two-handed manipulation skills.
2) Taking a shower and bathing
How is bathing going? Do you sit in the tub, stand in the shower, or take a sponge bath at the sink? No matter what you're doing to get clean, try to squeeze in some opportunities for functional arm use!
Make sure you are in a safe position if attempting new skills when bathing. Ensure you are well supported for your bathing method, whether that is in bed for a sponge bath or on a tub bench in the shower. You do not want to lose your balance in the process!
Challenge yourself in the following ways when you bathe:
- Level 1: Use your affected hand to hold down a shampoo bottle as you open the cap, or washcloths as you apply soap with your unaffected arm. You may have to place your affected arm with your opposite arm to help stabilize objects. Try to tell the difference between textures (smooth bottle, slippery soap, rough washcloth) and water temperatures (hot, cold, just right) with each hand as you clean off.
- Level 2: Try to rub your body with a soapy washcloth using your affected arm and hand. Can you grip the washcloth while scrubbing? Start by rubbing the washcloth on your thigh and progress to body parts that are farther away if you can! Try to dry off with a towel the same way!
- Level 3: Try to lather up a washcloth or loofah with a bar of soap! Switch the washcloth between hands as needed to wash your whole body. Dry off by gripping your towel with both hands and moving both arms to reach all parts. Can you dry off your back this way
You should always remember to take care of yourself every moment.
Small efforts each day go a long way. If you’re a smoker, you may avoid smoking. You could try to wriggle your fingers when sitting or lying down. If you’re unable to move due to paralysis, try holding up the bad arm with the good one to move the joint.
You’re well on your way to a successful rehab if you’re correcting your habits and exercising every moment you’re awake. Rehab is not something to set aside for a certain time of the day. It’s a 24-hour job that requires your full attention in everything you do.
So remember, rehab is a full time job! Rehabit is here to make it as pleasant and effective as possible! Install Rehabit now and reclaim your health and happiness!
Which tip will you start first? Please leave a comment with your ideas.
- June LeeClinical Manager / Physical Therapist