THURSDAY, Jan. 26, 2023 (American Heart Association News) -- Barbara Bartels and a friend were catching up over coffee on a Sunday morning in August. They'd met up at a café not far from Bartels' home in Santa Cruz, California. As an artist and a bit of a self-professed hermit, Bartels didn't socialize much beyond her regular art critique group. But she did occasionally accept invitations to go out.
At 87, Bartels recently had felt herself slowing down. She still did yoga every day, but not as vigorously. To compensate, she added qi gong, a Chinese-based practice that involves movement, mindfulness and breathing.
Both physical and mental health have always been important to Bartels, a mixed-media artist and former fashion designer. Like most of her artist friends, she had been a moderate smoker when she was younger, but she quit in her early 50s. Her only serious health issue was hereditary high blood pressure, for which she took medication.
As Bartels sat at the café with her friend, she noticed her sentences were no longer making sense. Words were coming out of her mouth jumbled. She felt like she was removed from the scene; instead, it was as if she was hovering about it.
Her friend was concerned enough to take Bartels' phone and dial the first number she saw under "favorites."
Bartels' niece answered.
When the niece heard that Bartels had trouble speaking, she told the friend to call 911.
"Are you sure that's necessary?" the friend said. "She just wants to go home and rest."
"I'm sure," said the niece, who knew that speech problems could be a sign of stroke. "Call them now."
Bartels indeed was having a stroke. Thanks to her friend's action, she reached the hospital within the time frame to be treated with clot-busting medication.
While she was unconscious, her daughter and other relatives arrived at the hospital.
Doctors warned them she would likely require weeks – if not months – of intense rehabilitation at a facility.
Yet when Bartels awoke, she could walk and talk. She had no paralysis and no cognitive deficits. She was released to go home three days later. Doctors recommended outpatient rehab to strengthen her muscles but were OK with her choice to stick with her usual custom of exercising at home.
To Bartels' family, it almost seemed too good to be true.
What about the weeks or months of recovery they'd been told to expect? They also carried the long-held belief that strokes are devastating for older people.
Her son came from Oregon to stay with her for a week. Her daughter and granddaughter, who live 45 minutes away, joined them during the day.
Although they could see that she was on the mend, they were still concerned.
Her daughter wanted Bartels to move, preferably to an assisted living facility or even a nursing home.
"Mom, you've had a stroke," she said. "You need someone watching you."
"Just hold on," Bartels said. Divorced at 30, she had lived alone since her children were adults. The only help she had before the stroke was a housecleaner who came twice a month.
"Look how well I came out of this," she told them. "I can do this."
Her longtime friend Andrea Borsuk happened to be present for this discussion.
Borsuk is the organizer of the art critique group that Bartels regularly attended. She knew what her friend was capable of handling. She also appreciated the importance of someone her age maintaining her independence. In fact, Bartels herself had made that point when Borsuk worried about whether her own independent 90-year-old mother might need to move to a nursing home.
"Tell them I'll be OK," Bartels pleaded with Borsuk.
"I'll make sure she's taken care of for the next couple weeks," Borsuk told Bartels' family. "We'll have people check in on her every day. Then let's see how this plays out."
Using an online scheduling system, Borsuk arranged for members of the art group to help. Every day, friends visited Bartels, brought her meals and ran errands. Bartels' landlady, who lives next door, also volunteered to help.
"I know it helped Barb's morale to be surrounded by so many people who care," Borsuk said.
Bartels' biggest frustration was that doctors at the hospital never corrected their initial dire prediction of her recovery. Had they amended it based on how well she was doing, perhaps her family would've dropped their assumption that older people don't recover from stroke.
The facts speak for themselves: Six weeks after the stroke, her doctor cleared her to drive. Six months in, she's feeling more energetic and stronger.
"I'm always forgiving myself for not being able to do things at the level I was doing things at before," she said. "But it's also important to push yourself. Plus, I had to prove to my kids that I could make it."
American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.
By Diane Daniel, American Heart Association News