Severe Disability After a Stroke

The devastating consequences of a stroke can leave some stroke survivors bedridden for a long time, even for years. Severe stroke outcomes are dramatic lifestyle changes for patients and families. 

If you are bedridden, you may eventually improve your mobility, regaining your ability to walk over time. But if you improve very slowly, there are several common complications associated with long-term immobility that you should know about.

Find out how many of the complications of being bedridden can be avoided, or at least minimized.


Depression is a response to stroke, to the realization of one’s limitations, the loss of freedom, the inability to continue to work, the awareness of mortality and a number of other lifestyle changes after a stroke. Additionally, stroke in itself can induce changes in the brain that contribute to depression. And, after a stroke, the lack of physical activity and missing out on regular sunlight produce biochemical changes in the brain that lead to depression.

Solution: Awareness of the risk of depression and identifying the early stages of depression are important first steps. Depressed patients who understand that there is a way out of depression are more likely to overcome depression. Therapy, medication, and social support can all work together to help combat depression.


Hopelessness can occur when it seems that the situation will not improve.

Solution: Understanding that even those who are confined to bed after a stroke can still continue to lead full lives. This can be achieved by reaching out to others who have been through similar experiences.


Disorientation is very common after a stroke. This occurs because of several factors, including the lack of participation in regular activity and lack of regular contact with the outside world.

Some types of stroke can produce disorientation.

Solution: Helpful tools include calendars, schedules, frequent social visits and television or computer activities that support a connection with current events.

Change in Personality

Changes in personality can occur because a stroke is a serious lifestyle change and also as a result of changes in the brain itself after a stroke.

Solution: Understanding that personality changes are often a result of physiological changes and trying to maintain interests and hobbies as much as possible.


Blaming is a common but destructive reaction to devastating illness.

Solution: Talking to a trusted friend or family member may alleviate this problem. Hearing the experiences of others who have been through similar experiences is often an irreplaceable method of dealing with the reaction of blaming. For many, talking with clergy or leaning on spiritual faith can help maintain a broader perspective in such serious situations.


Isolation and loneliness are natural results of home confinement and may lead to depression. Also- depression can cause a bedridden patient to reject visits and social opportunities.

Solution: Attempts at socializing through in-person visits, phone calls, and even social media mediated visits can help relieve the sense of loneliness and isolation.

Some patients find that staying in a group care environment can help alleviate this problem.


Infections can occur due to deceased immunity, depression, and malnutrition. Absence of a fresh, clean environment can increase the risk of infections and depression.

Solution: Maintain good hygiene and good nutrition. Schedules may help in remembering to launder or change sheets and clothing.


Aspiration is caused by choking on food and can lead to pneumonia.

Solution: Obtain a professional swallow consultation for swallowing therapy and food safety recommendations.

Bladder Problems

Trouble urinating or incontinence may occur due to weakened urinary muscle control after a stroke and also due to deceased fluids.

This can ultimately lead to a bladder infection or a more serious kidney infection.

Solution: Drink enough fluids and make sure to urinate at least a few times per day (on a schedule if necessary) to keep muscles active.

Bed Sores

Bed sores are caused by pressure of the bed on the body. They can be painful, and may bleed or become infected.

Solution: Frequent scheduled changes of position in bed and adequate padding and support.


Atrophy is muscle loss due to lack of physical activity combined with deceased calorie intake. Atrophy result in weak muscles that are difficult to rebuild, causing a self-perpetuating cycle.

Solution: Get as much physical activity as is safe combined with good nutrition.

Muscle Stiffness

Muscle stiffness develops as a result of changes in muscle/nerve interaction after a stroke, and may be exacerbated by lack of movement.

Solution: Active movements of the muscles that are not impaired by stroke combined with passive movements of muscles that were affected by a stroke can prevent muscle stiffness. In severe advanced muscle stiffness, muscle relaxants, or​ Botox injections are used.

Vitamin D

Vitamin D deficiency from lack of sunlight can contribute to weakness and mood changes after a stroke.

Solution: Make every effort possible to get some sun exposure a few times per week.

Loss of Appetite

Loss of appetite has many causes, including mood changes and decreased calorie requirements due to lack of physical movement. Constipation (see below) can contribute to loss of appetite.

Solution: Make an effort to prepare food that is appetizing and served in a pleasant setting.


Malnutrition results from a lack of appetite and limited food choices. Deficiency of vital nutrients can contribute to illnesses.

Solution: Try to maintain a well-rounded diet. Consult with a nutritionist and supplement with vitamins and minerals if necessary.


Constipation is a consequence of lack of physical activity and dietary changes, as well as changes in the body's ability to maintain normal colon muscle activity.

Solution: Encourage as much physical activity as is safe. Maintain a diet rich in fiber and fluids. Use over the counter or prescription medication if necessary.

It is Challenging to Care for a Bedridden Patient. 

Overall, being confined to bed due to a stroke is not a pleasant experience. However, even bedridden stroke survivors have some options when it comes to proactively managing complications and overall health. While these actions are unlikely to dramatically alter neurological function after a stroke, they undoubtedly can have a positive effect on neurological recovery after a stroke. More importantly, avoiding the complications associated with immobility can help prevent serious illnesses that may be even more difficult to overcome.

And of course, caring for the little things can have a significant impact on state of mind, and overall well-being. Bedridden patients are naturally prone to feeling neglected so personal attention and support helps a person who has suffered a disabling stroke continue to feel alive and important.

Continue Reading