A patient surviving a stroke has only won half the battle. The road to recovery after treatment is often exhausting, marked by physical limitations, emotional turmoil, and financial strain.
For many Indian families, the relief of survival soon turns into uncertainty — not knowing if their loved one will ever walk, talk, or work again.
The scale of the challenge
In India, stroke cases are estimated at a staggering 1.8 million new incidences each year, making it one of the leading causes of adult disability. While treatment facilities and awareness about early warning signs have improved, the country continues to lag behind in rehabilitation — a crucial component for helping patients regain independence.
Ideally, rehabilitation should begin within 24 to 48 hours of a stroke, involving coordinated efforts by physiotherapists, speech and occupational therapists, and psychologists, as highlighted by World Health Organization data from 2023. However, less than 20% of stroke survivors in India receive structured rehabilitation, according to a 2018 report in Archives of Physical Medicine and Rehabilitation. Most patients return home with limited mobility, speech difficulties, or cognitive decline. Without follow-up therapy, these conditions can deteriorate further.
The cost of recovery
The economic burden of stroke care is significant. The acute treatment phase — including imaging, clot-busting medication, mechanical thrombectomy, and other interventions if required, typically costs between ₹2 lakh and ₹8 lakh. But the real challenge begins with post-stroke rehabilitation, which costs ₹10,000–₹30,000 per month, depending on the intensity of therapy.
For many Indian families, this represents a heavy financial burden. Since rehabilitation is rarely covered by insurance, expenses are often paid out of pocket, pushing families into debt. Those living in smaller towns and rural areas face additional challenges — a lack of rehabilitation centres, limited access to trained professionals, and overdependence on informal caregiving.
The emotional and social fallout
Behind every stroke survivor is a caregiver whose life changes overnight. The sudden shift into a full-time caregiving role can lead to emotional exhaustion, financial stress and social isolation. Studies show that over 60% of caregivers of stroke patients experience depression or anxiety within the first six months. . Yet, in India, formal support systems for caregivers remain almost non-existent.
In many households, the loss of income from both the survivor and the caregiver worsens financial instability. Emotional fatigue, combined with inadequate professional support, traps families in a cycle of debt and distress.
Bringing rehabilitation mainstream
Rehabilitation is not an optional service — it is an essential part of stroke recovery. Unfortunately, India’s healthcare system still prioritises acute treatment over long-term rehabilitation. Rehabilitation units are mostly confined to large hospitals in metro cities, leaving a vast majority of survivors without access to post-stroke care.
Going forward, multidisciplinary rehabilitation units must be integrated into district and tertiary hospitals. Insurance coverage should be expanded to include long-term rehabilitation, and greater investment is needed to train physiotherapists, occupational therapists, and speech-language pathologists.
Technology can also bridge accessibility gaps. Telerehabilitation platforms, AI-assisted recovery tools, and community-based rehabilitation networks can make quality post-stroke care more affordable and accessible beyond urban centres. However, such efforts require policy-level support and stronger public awareness.
The road ahead
India’s stroke response must evolve from saving lives to restoring them. Public health messaging should extend beyond recognising stroke symptoms to emphasising the rehabilitation window — the crucial first few months when recovery potential is highest.
Timely and consistent rehabilitation can determine whether a person walks again, regains speech, or returns to work. Stroke care should also be about restoring the quality of life.
As India grapples with a growing burden of non-communicable diseases and an ageing population, it must confront the reality that rehabilitation remains the weakest link in stroke care. For India’s stroke survivors, true recovery begins after survival. It is time our systems, policies, and priorities reflected that truth.
(Dr Vikram Huded is senior consultant, director and clinical Lead of Interventional Neurology Programme, Narayana Health. vikram.huded.dr@narayanahealth.org)
Published – October 28, 2025 05:56 pm IST
