The results of a stroke are, in many cases, easy to recognise, and the more they are recognised, the more help there is to manage them. However, paralysis and weakness, speech and language problems, swallowing difficulties, incontinence, and vision impairment aren’t the only symptoms to manifest after a stroke. Some symptoms, while debilitating, are more subtle, and may be undetectable to all but the person experiencing them, or their close family members. One such symptom is ‘post-stroke fatigue,’ a daily challenge for those who suffer from it, and one often misunderstood in the community.
Post-stroke fatigue can come as a shock to stroke sufferers and their families, especially in the way it presents. Fatigue is not simply a matter of feeling tired after hard work, such as digging in the garden or playing a vigorous game of tennis. Depending on the severity of it, fatigue can be an all-encompassing feeling of exhaustion that impacts both body and mind. It can often manifest as a mental fogginess and a desperate need to sleep or at least lie down and close the eyes. Or it may be more mild but nevertheless, noticeable. Unfortunately, rest won’t necessarily do much to help alleviate the sort of fatigue that is the result of a stroke, which makes it a challenge even for those who were previously fit and healthy. It is not unusual for those suffering from post-stroke fatigue to lose the ability to socialise as they once used to, and to enjoy family life, such as time spent with grandchildren, to the same degree.
The reasons for post-stroke fatigue are many, and often involve a complex interplay between several challenges. Initially, in the weeks after a stroke, a sufferer’s brain is in repair mode from what is, essentially, a head injury. Along with the physical repair process, a sufferer will be working hard to rehabilitate themselves, which involves intense physical and mental concentration. This can come at a time when sleep patterns have been altered because of the effects of stroke, so sleep hours are reduced. It is also not unusual to experience insomnia following a stroke. Post-stroke fatigue can leave a sufferer feeling low and/or anxious as they struggle to accept their changed circumstances, and these feelings can contribute to poor sleep.
While a person suffering from post-stroke fatigue must take time to rest, it’s important for close family members and friends to acknowledge their loved-one’s need for this. Some couples cope by scheduling socialising for times of the day when fatigue is less likely to strike. Others find short bursts of activity rather than longer stints of socialising is the answer. Some people who have post-stroke fatigue find intense cognitive activities such as studying, reading, or enjoying discussion tires them more quickly than, say, playing a game with their grandchild. In any given situation, it is important there is an opportunity for someone with post-stroke fatigue to excuse themself, at short notice, in order to find rest. Which is why it is important to let friends and family, especially children, understand this need has nothing to do with their own actions.
Post-stroke fatigue can improve over time, but this is not a given, and it can persist for some sufferers. Some people find it gives them a sense of control to keep a diary of their daily activities so they can look back and see they are, in fact, achieving tasks, even when it may not feel like they are. Others find it helpful to be frank and open about their situation with friends so cancelling outings or a social get-together at short notice doesn’t cause offence. Perhaps what is most important, however, is helping to spread the word that post-stroke fatigue is a very real issue. It is not simply a matter of growing more tired with age, as those who do not understand, may suggest.
If you, or a loved one, is suffering from post-stroke fatigue, and need further information or support, talk to your health professional or reach out to Stroke Aotearoa New Zealand
