Cognitive rehabilitation and recovery after stroke

Abstract

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.