Advice and support in Spain - Information paper : In the event and aftermath of stroke

  1. What is Stroke?
  2. Pre-discharge from Hospital.
  3. Preparation for care at home.
  4. On Leaving Hospital.
  5. Domiciliary Care at Home.
  6. Residential care. 

1. What is Stroke?

The writer of this paper is not a medical person but a carer and member of the Torrevieja Stroke Support Group (TSSG). More extensive medical information should be sought from a qualified medical practitioner or learned books, or from the Stroke Association in the UK – who have full and comprehensive information about Stroke. TSSG is affiliated to this body. This paper is intended as helpful information/suggestions from the personal experience of the group in the event and aftermath of stroke in Spain.

The word Stroke comes from the Greek verb “to strike”.

Even in antiquity it was recognized that a stroke can occur like lightening out of the blue with little or no previous symptoms and often with catastrophic results.  Each year in the UK about 150,000 people suffer a stroke and it is the largest cause of disability in the UK.  Most occur over the age of 65, but a stroke can occur at any age even in babies.

In simple terms there are two main types of stroke: 

Blood Clot: 7 out of 10 strokes are caused by a blood clot in an artery of the brain, or by a blood clot which has formed in some other part of the body and travels to the brain and similarly blocks an artery which prevents oxygen reaching cells in an area of the brain. 

Burst Blood Vessel: 3 out of 10 strokes are caused when a blood vessel bursts in the brain and causes blood to seep into the nearby brain tissue causing the effected brain cells to lose their oxygen supply. This likewise damages or kills cells in that part of the brain.

It depends upon where in the brain and how much damage to brain cells has occurred and the speed of initial treatment as to how affected the stroke victim will be. There may be other separate or related causal problems too. In general, the physical affects of stroke are usually seen on the side of the body opposite to the area of damaged brain i.e., left hemisphere damage can result in loss of sensation in the right side and speech problems, and right hemisphere damage can result in loss of sensation in the left hand side and feelings of imbalance. In some instances there can be related sight, hearing, or breathing problems.

  • 10 percent of stroke survivors recover almost completely.
  • 25 percent recover with only minor impairment.
  • 40 percent experience moderate to severe impairment requiring some special care.
  • 10 percent require nursing home or other long-term facilities.
  • 15 percent die shortly after the stroke.

As per above the majority (40 percent) experience moderate to severe impairment, and are the people we see mostly a stroke support meetings. The most common symptoms at first are loss of function in leg, arm and hand on one side, inability to stand or balance. There could be loss of speech and difficulties in swallowing requiring food to be liquidized at first. There could be incontinence though this is soon recovered.  Sometimes the survivor feels pain sensations in the affected side. Obviously the patient feels bewilderment, fear and frustration particularly if unable to communicate. There may be some lack of understanding of the spoken word, but it is most likely that the survivor will understand language well and quiet patient explanation at all times of what is happening and what you are doing is necessary.

The prognosis of stroke recovery particularly at the beginning is complicated and difficult to assess, even for medical people. Much depends upon where and how much damage has occurred in the brain, age of the person, general health and his/her own personality etc. 

Although the survivor´s nearest and dearest at this time will be suffering trauma and fear at this tragic event, it will help both the carer and survivor if the carer begins to start considering the immediate future.

2. Pre-discharge from Hospital

i) Try to find out from the consultant neurologist, after tests are completed why stroke has occurred and medical prognosis. This may be difficult however to assess accurately at this stage.

ii) Ascertain what medication the patient will need to take and when, on leaving hospital.

iii) Watch and learn from the nurses how they move, change, wash, and feed the patient etc. (You have a need to know and understand all this information if you are to be a carer on his/her discharge from hospital.

iv) Physiotherapy on affected limbs is best started early, depending on the patient’s stabilization. Ask to see the hospital´s rehabilitation physiotherapist. Maybe you can do some massage yourself. Find out before discharge the patients abilities to stand/walk etc. In the new Hospital in Torrevieja early physiotherapy assessment is already good practice.

v) Much reassurance is necessary at this stage. The survivor may show anxiety, frustration and possibly temper at not being able to communicate or move as he/she once could. This is stressful for both and patience, explanation and your calmness are important. 

vi) Normally the hospital will give you good warning of discharge. Try to prepare family, friends, private or social services domiciliary help if needed.

 vii) Make sure to obtain a discharge report from the hospital, “Full d´Informe D´Alta”, and make several photo-copies keeping the original safe. You will need copies to give to your GP, rehabilitation center, social services and others.

 viii) Try to remain positive, it is surprising how we can cope, both patient and carer, and hopefully there will be gradual improvement, though this can feel painfully slow when all are both tired and stressed.

3. Preparation for Care at Home

i) Consider access into the house or flat should a wheel chair be necessary and if disability likely to be long term – a ramp or lift. 

ii) Raised toilet seats, shower facilities with seat, hand rails etc. These accessories and others can be hired or obtained from specialist shops locally when known what may be necessary and particularly if needed long term. 

iii) Wheel chairs may be hired from either Age Concern or Help or This email address is being protected from spambots. You need JavaScript enabled to view it. . If one is necessary for longer term then they can be obtained on prescription from the Rehabilitation doctor. This will cover a good standard chair, but if you wish a lightweight aluminum chair, it is possible to pay the difference to obtain this. 

iv) Bed pads for bed bathing etc, urinal bottles and pans can be obtained from the farmacia. Initially the survivor may be incontinent and the necessary day/nights pads can be obtained on prescription from the G.P. It may be useful to have a urinal bottle/pan by the side of the bed for night use later on.   The hospital or GP will advise on short term catheter use if necessary. 

v) Bed washing is not a great problem if you have watched the nurse in hospital perform this task. But as soon as possible encourage the recoverer to do some of these tasks for themselves. Shaving should be done, again when possible, by the person himself. Preserving self dignity and taking up some self responsibility as soon as possible is important. 

vi) Eating and swallowing some foods can be difficult for some and solids may need to be liquidized at first. 

vii) Depending upon the stroke survivor´s recovery you may wish to discuss preparation for home discharge with an Occupational Therapist and/or a Speech and Language Therapist and the TSSG can be contacted for further information on communicating with these volunteers.

4. On Leaving Hospital

i) Register immediately with your GP, giving him a copy of the form “Full d´Informe D´Alta”, and requesting rehabilitation appointments, consultant appointments for check ups, regular blood pressure checks, and further prescriptions necessary. Also informing him of any other related problems discovered or known previously. Sometimes in the UK appointments are made automatically for you. Here in Spain in general you are more likely to need to do this for yourself). If you do not speak Spanish it is always best to take along a Translator.  

ii) To obtain full medical care you do need to be resident in Spain; have a SIP number, and be registered on the “Padron”; be over 65 years or have a work permit and paid in full appropriate taxes. Or you can now voluntarily contribute to receive National Health care. Otherwise you are a “visitor” on an International blue card and only really entitled to emergency medical care. The medical authorities are being strict on this now. There are several private Health Care Schemes available. PLEASE SEE ALSO SEPARATE PAPER FOR FULL INFORMATION ON MEDICAL SERVICES AND SOCIAL SERVICES PROVISIONS FOR EX-PATRIATES. 

iii) Should you realise before leaving Hospital or on reaching home that you need domiciliary care/help you can approach Social Services Departments, usually found in your local Town Hall. However there is a pre-requisite that the applicant should  have been “resident” in Spain for 5 years. (please see above mentioned separate paper on medical services and social services provisions). Explain the position and request assistance. A translator may be necessary and it is best to write down before hand all the questions you wish to ask and take along any medical information/reports you have.  Assistance is dependent on financial assessment (as in the UK) so take along pension slips etc. My experience prior to 2007 was that I interviewed 2 care workers with the social worker but over the weekend found I could cope and so cancelled this assistance. Later on I found a cleaner lady to be of the most valued help.  

The new Hospital in Torrevieja is well organized and can facilitate Social Work intervention whilst the patient is still in Hospital. If you not reside in the Torrevieja area, you should approach your area Social Work Department, usually in your local Ayuntamiento.  

iv) An application to Social Services can be a fairly lengthy process and should be started early whilst still in hospital if possible. There are many forms to complete though the Social Worker will help. In the short term however it may be necessary to enlist the help of a private domicillary care service if you feel you cannot manage alone.

 5. Domiciliary Care at Home

i) Very short term emergency domiciliary help may be obtained from Age Concern – 966 786 887 

ii) 3”C´s” – care, cleaning, companionship – This email address is being protected from spambots. You need JavaScript enabled to view it.  Contact Anne Muff - 634 318 769 or 671 865 875. 

iii) “Care for you in Spain” - 968 198 590 - e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.  

iv) ”Caras Felices” - contact Sue Bradley 634 146 375 - e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.  

v) Help at Home – This email address is being protected from spambots. You need JavaScript enabled to view it.  

vi) Paul Cunningham Nurses – 966 790 363 - email This email address is being protected from spambots. You need JavaScript enabled to view it.  

vii) For anyone who has been in HM Forces, The Royal British Legion has a local Branch with case workers:  Wendy Dengate on This email address is being protected from spambots. You need JavaScript enabled to view it. or telephone 965 480 534 or 666 023 815. 

viii) Ex-RAF Association has a welfare officer – 

ix) A new company "Senior Assistance" can offer assessment and full services (probably good for those not able to obtain NH care.) Please see separate paper.   

The above agencies are not in any order of preference and carers should contact for their own information.

x) Recently a “meals on wheels service” has opened which provides freshly cooked lunch time meals five days a week with hot home delivery service. At present this service only provides urbinizations along the CV90 between Ciudad Quesdada and the outskirts of Torrevieja. Email – This email address is being protected from spambots. You need JavaScript enabled to view it. or telephone Karen on 965 073 401 or 646 985 758.

xi) The British Consulate can be contacted and the Department of Works and Pensions at the Consulate (Mr. Martyn Standing) tel: 965 216 022 - for full information on pension and allowances and any other help they may be able to offer. Or consult their web-site:

6. Residential care

Sometimes residential care is necessary on a short term basis to assess continuing progress, or to prepare the home for wheel chair access etc. or on a longer term basis. The under-mentioned private residences are mainly Spanish-speaking maybe with some English-speaking staff. It is best to ask regarding their rehabilitation/physiotherapy and care programmes. 

In some instances the Health Service may arrange this at no charge, but not very often and not for long (again as in the UK).

Residential care homes under social services do exist and should be discussed with a Social Worker, TSSG do not at this moment have details on admission criteria/procedure, though I understand there is a waiting list in this area.

i) Private residential care can be arranged with Casa Verde who provide good facilities in Almoradi or Pilar de Horadada. Telephone 902 330 203 or e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. They are both mainly Spanish-speaking, but they do have some English-speaking carers and staff, especially at Pilar; on the other hand there are better Physiotherapy facilities at Almoradi , I understand. 

ii) Residential Rojales, C/Zeus, Pueblo Lucero, Rojales - 966 715 071 

iii) Residencial Mediterranea, near Formentera de Segura - 966 715 863 

iv) Residencial Virgen de Gracia, Guardamar - 965 728 712 

v) Residencial Los Jardines de Clara, Parque de las Naciones, Torrevieja - 965 704 102 

vi) Residencial Mediterranea, Rojales - 966 715 863 

vii) Residencial Rojales, Pueblo Lucero, Rojales - 966 715 071 or 965 710 545 

viii) Casa Verde also provide holiday respite care and day care facilities (as i) above. 

ix) Another care facility just beyond Cartagena in Murcia Province offers full care or respite holiday care, run by a British couple – John and Pat Bartlam - 968 437 010 - e-mail This email address is being protected from spambots. You need JavaScript enabled to view it. or  They also offer b&b as a Casa Rural or self-catering with a mix of care too.

There are several other private residential homes. (They all tend to cost in the region of 1300 to 2000+ per month.).

Should anyone prefer repatriation then the British Consulate can be contacted, or the Help organization or Age Concern have personnel who can assist and advise:  

CONSULATE - 965 216 022    HELP - 965 704 282      AGE CONCERN - 966 786 887

Again this list is not in order of any preference and contact and assessment should be made by a carer themselves.