A stroke often changes the whole life – that of the person concerned and that of his relatives. What is the future career? Can and can the patient continue to drive? Are holidays possible? What should relatives pay attention to in everyday handling of stroke patients? Answers to these and other questions about the life after the stroke can be found here!
Stroke & profession
Especially in younger stroke patients, the question of the professional future arises. Already during the rehabilitation you should talk to your doctor about a possible return to work or a new orientation.
The most important points of contact for such questions are the Employment Agency and the pension insurance institutions. Among other things, they promote measures for occupational reintegration through induction grants and retraining. The main task of vocational rehabilitation is to find the right job for you. Basically, there are the following options:
- Return to the previous job (possibly with an adaptation of the job)
- gradual reintegration (such as part-time work)
- Change of job within the previous company
- Retraining in another profession
Whether you can resume your previous activity in whole or in part depends on your profession and the degree of physical and mental impairment after the stroke. It must be determined if and how your work can be improved or restored. Get detailed advice on job adaptation, retraining or part-time employment opportunities.
Partial loss of earning capacity
A partial reduction in earning capacity (formerly referred to as “occupational disability”) occurs when the ability to work is due to illness or disability at least three, but less than six hours per day, on a normal 5-day workweek. If this is the case, you can apply for partial retirement benefit. This should compensate for your wage reduction if you can no longer work full time.
Full reduction in earning capacity
Persons who are unable to work for a certain period of time for any reason in the foreseeable future due to illness or disability are completely unable to work. Specifically, this means that someone can work in the general labor market for less than three hours a day as part of a five-day work week.
Unemployed people can apply for a full disability pension. It should replace the wage. The reduced earning capacity pension is usually paid as a temporary pension, ie for a maximum of three years. The time limit can be repeated on request. In most cases, it is assumed after nine years that the person concerned is permanently unable to work. Then the temporary pension payment can be converted into a perpetual long-term pension.
Stroke & driving
After a stroke, your ability to drive may be impaired in two ways. For one thing, there is a risk that you will suddenly have another stroke. On the other hand, your performance may be diminished by the consequences of stroke, such as paralysis, impaired vision or a slower response. In both cases you would endanger yourself and other road users at the wheel of a car.
Self-responsibility demanded
Legislators demand individual responsibility from every driver’s license owner – whether stroke patient or not: everyone should check themselves time and time again whether they can steer a vehicle safely through the traffic. After a disease such as a stroke, the law requires, however, that the person concerned “takes appropriate precautions” so that he is not at risk on the steering wheel. This includes having the patient get knowledgeable help.
Ask a doctor
The first point of contact is your doctor. As a rule, he is better able to assess whether you can still get behind the wheel or whether you should forgo driving for safety reasons. This waiver can either be temporary – until you’re fit enough to drive again – or permanent, such as permanent paralysis.
Inform the authority
In addition, you should inform the competent authority (driving license) about the stroke voluntarily and submit there a specialist opinion, which is not older than six months. This can be, for example, the discharge report of a REHA clinic or the opinion of a neurologist with a traffic medicine qualification. This expert decides whether, for example, additional driving lessons, the visit to the ophthalmologist or a neuropsychological report are required.
In most cases, the authority can decide on the basis of the documents, whether you (possibly with conditions or restrictions) may continue to drive or hand over your driver’s license. If the authority does not provide the report, it will initiate a medical-psychological examination (MPU).
MPU
The MPU is carried out by assessment bodies for fitness to drive. Such accredited test centers are available for example from TÜV. The MPU is divided into several parts:
First: On the basis of a medical examination, a specialist, a specialist or rehabilitation clinic compiles a current report on your state of health.
Secondly: A performance exam will check your responsiveness, concentration and perception. For example, you need to press a key as quickly as possible to specific computer signals. Make sure that the test may be accessible to the disabled, for example if you have difficulty pressing keys due to a slight paralysis in your arm.
Third: A conversation with a psychologist should determine whether you have mastered your stroke mentally, trust yourself to drive a car and feel fit and responsible for the traffic.
driving test
Many stroke patients are limited in their mobility and need a retrofitted vehicle. This can be for example a car with a steering wheel knob. There are driving schools that specialize in stroke patients and have converted cars that allow patients to take driving lessons. The driving test can then be taken by the TÜV or DEKRA.
The decision
On the basis of the documents submitted by you (specialist medical report, MPU, driving test), the driving license office will decide on your driving ability. In the best case, the authority comes to the conclusion that you may keep your license without restriction.
Often, however, conditions or restrictions are entered in the driver’s license on the basis of the report. For example, some people may only drive a car with a specially adapted steering after a stroke. Others are no longer allowed to travel at night or on highways.
costs
The MPU and the Fahrgutachten cost several hundred euros, the stroke patients themselves have to pay. Only in individual cases there is financial support for the report or a necessary vehicle conversion.
To provide certainty
Although it is not cheap and you may eventually be deprived of driving license, it is important to check your fitness to drive after a stroke. An objective assessment of professionals provides certainty about possible self-doubts.
But above all, it is important to know that anyone who is unfit for driving and nevertheless takes to the wheel endangers himself and others, makes himself liable to prosecution and risks his insurance cover.
Stroke & Travel
If you have recovered from your stroke, you are usually allowed to go on vacation again. Even air travel is allowed in principle. But it depends mainly on how fit you feel. Do not overestimate your performance – an exact consultation with the doctor is important. He will also consider any comorbidities that many stroke patients have. This can be, for example, coronary heart disease (CHD), diabetes mellitus (diabetes) or hypertension.
The general rule: No extremes! Mountain tours over 2,500 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 travel well
Prepare yourself well for the journey. If necessary, book a disabled accommodation, for example. Find out about local medical care. Inquire with the doctor about recommended vaccinations. In addition, have him / her issue a certificate of diagnosis and treatment. Also, be sure to take enough medication (or equivalent prescriptions) that you need to take on a regular basis (such as anticoagulant or antihypertensive). Ask your doctor or pharmacist how to properly transport and store the medication.
Before traveling abroad, you should also take out a health insurance with return transport in the event of illness. This saves you high costs in an emergency!
Healthy on the way
To avoid overloading your cardiovascular system, avoid long car or bus journeys in extreme heat. Unfavorable for heart and circulation are also strong temperature differences, such as the air conditioning in the hotel room or car and the outdoors.
Sitting for a long time (for example in the bus, car or plane) slows down the blood flow in the leg veins. This promotes the formation of blood clots that can clog a vessel. Regular movements of the feet and legs and the wearing of support or compression stockings can counteract this. In addition, avoid beating your legs and drink enough.
Distribute needed medication on your hand and luggage if one of the pieces should be lost. Make sure that you store the medicines correctly (as indicated in the instruction leaflet) so that they do not lose their efficacy.
Stroke: Tips for relatives
The consequences of a stroke not only affect the patients themselves, but also the people who share their lives. The relatives have to spend a lot of time, patience and empathy. In addition, they often have to completely change their own lives in order to provide the patient with the help and support that nurses or therapists can not afford on their own.
The stranger in his own house
It is particularly problematic for members of stroke patients if the personality of a familiar person changes as a result of the disease. At the helplessness and sudden abolition of their own abilities, many sufferers first react with desperation and depression, others become aggressive.
Sometimes emotional control of the brain is affected as a result of brain infarction. Then it can happen, for example, that the patient suddenly laughs or cries in inappropriate situations. The relatives can burden this considerably. In such moments it is important not to automatically relate aggression and tears to oneself.
Loving and with respect
Relatives should not make decisions about the affected person’s head. It is better to let the patient speak for themselves. This is especially true when the person concerned is difficult to understand due to the stroke. Give the patient time to communicate.
Between demanding and helping
Relatives are the most important helpers for stroke patients on the way back to a life as independent as possible. The therapy sessions alone are not enough to regain language, attention-ability or movement control, for example. All day life is a training course for those affected. Relatives should therefore resist the temptation to overprotect the person concerned, remove every handshake, or finish incomplete sentences for him. They should only intervene to help if the affected person can not cope with a situation on his own or is too exhausted.
Some relatives on the other hand make the mistake of turning the day into a perpetual training. This can overwhelm the patient completely. Above all, life with a disability is very tiring at the beginning, so there is an urgent need for rest.
Strengthen self-confidence and zest for life
A stroke robs a person of many of the abilities he has been able to rely on and has defined. This can gnaw on self-esteem and vitality. Relatives can make an important contribution to helping those recovering, for example, by having a joint venture, outing or meeting friends. But beware: For people with aphasia (speech disorder), many everyday situations are very stressful – especially loud background noise.
Dealing with aphasics – special features
Dealing with people who have a limited ability to speak (aphasia) can quickly become difficult for relatives because of communication problems. Some helpful tips:
Do not take the word out of the mouth of the aphasic: People with aphasia often talk haltingly and search for words for a long time. In that case you should wait patiently for the aphasic not to find the term you are looking for. For him every linguistic sense of achievement is important. Often he succeeds in expressing himself, if he is allowed enough time.
To facilitate the communication: People should talk slowly and clearly to an aphasic and underline what they said with facial expressions and gestures.
To secure the understanding: Sometimes someone is not sure to have understood an aphasic correctly. Then you should make sure with simple yes / no questions that you are right: “You speak of Mrs. Schulze?” If the aphasic appears confused, one should ask if he has understood everything.
Do not correct too much: If an aphasic makes mistakes in sentence construction or the use of a term, one should not correct it. Because that frustrates and confuses the person concerned additionally. Some aphasics refuse to talk at all for fear of shameful mistakes.
To facilitate contact with others: Most people are initially uncertain when encountering aphasics. Relatives should encourage other people to communicate with the stroke patient and help them with their own tips and experiences.