FOUR OAKS, N.C. — More than 600,000 Americans have strokes every year. Most patients survive with varying degrees of disability, but doctors are stressing the importance of having a strong and loving caregiver.

For almost 45 years, George and Shelba Keene have shared meals in their Four Oaks home. Since her husband's stroke in January, Shelba has been his caregiver.

"It's changed us. We've changed. Some of it for the better," Shelba Keene said.

Doctors said spouses are usually the first to take on the caregiver role.

"Between the spouse and the children you're getting probably 85 percent of who takes care of stroke survivors," said Beth Rudisill, a rehabilitation case manager at

WakeMed

.

Rudisill said stroke patients need someone to lean and depend on.

"Many of our patients who don't have that caregiver or that person who's willing to step up to the plate, often end up in long-term care facilities. That's how critical it is," said Rudisill.

However, she added that taking on new roles can sometimes strain relationships.

"It often causes people to have to sit back and look at who used to do what tasks at home," said Rudisill.

Rudisill also said it is important for caregivers to avoid becoming overwhelmed by making sure to take time for themselves.

"Nobody is going to survive this without taking time for themselves. They're just not. You're going to end up with the person who's had the stroke and the caregiver who's also had some stress-related problem if they don't take care of themselves," Rudisill said.

Keene said she and her husband have a strong support system. She has helped him grow and he has taught her patience.

"He says thank you a lot and tells me he loves me and he appreciates me more," said Keene.