Cognitive Rehabilitation and Recovery After Stroke
As the previous chapters have described in detail, many of those fortunate to survive their stroke do so with detrimental alterations to their cognitive and psychological well-being. These impairments impact the affected individual’s ability to participate in, and benefit from, multidisciplinary stroke rehabilitation, to safely and independently carry out activities of everyday living, and to resume pre-morbid personal, social, and vocational roles [1–4]. Previously automatic and effortless tasks require exhausting levels of concentration and, despite the efforts invested, often end in perplexing and de-motivating failure. Uncertainty in one’s own abilities and reliance on others makes people with cognitive problems vulnerable to frustration, humiliation, worry, and feelings of hopelessness. These topics are covered elsewhere in this book. The current chapter focuses on cognitive rehabilitation by exploring the evidence base from the perspective of informing clinical service improvements and strives to root cognitive recovery firmly within a broader psychological context.
KeywordsDepression Europe Dementia Aphasia Hemiplegia
We are grateful to the authors of the national clinical guidelines (Australia, Canada, Scotland, RCP London) and the NHS Improvement—Stroke program for England and to Wiley for allowing us to reprint sections of their work. Our ideas are the result of collaborative working with the RCP London’s Intercollegiate Stroke Working Party, and especially the members of the cognitive psychology subgroup: Janet Cockburn, David Gillespie, Andrew Bateman, and Peter Knapp whose input we wish to acknowledge.
Potential Conflict of Interest: Audrey Bowen is a member of the RCP London Intercollegiate Working Party for Stroke that produces the National Clinical Guideline referred to as UK (except Scotland), and author of some of the studies referred to in this chapter.
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