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The confused, cautious stroke survivor needs an ordered environment. The
stroke survivor with poor judgment must be guided when
making important decisions. The apathetic stroke survivor,
on the other hand, should not live in a world so quiet and
simple that there is little to react to. The caregiver needs
to be aware of the reasons for the stroke survivor's
behavior, without overlooking the fact that he or she may
also be depressed. |
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Depression |
Depression is
nearly universal among people who have had a stroke. It can
be overwhelming, affecting the spirit and confidence of
everyone involved. A depressed person may refuse or neglect
to take medications, may not be motivated to perform
exercises which will improve mobility or may be irritable
with others.
The stroke survivor's depression may dampen the family's
enthusiasm for helping with recovery or drive away others
who want to help. This deprives the stroke survivor of the
social contacts which could help dispel depression, and
creates a vicious cycle.
It is possible
that as time goes by and a stroke survivor's deficits
improve, the depression may lift by itself. Family can help
by trying to stimulate interest in other people, encouraging
leisure activities and providing opportunities to
participate in spiritual activities. If necessary, chronic
depression can be treated with individual counseling, group
therapy or antidepressant drugs. |
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Emotional Lability |
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Sudden laughing
or crying for no apparent reason and difficulty controlling
emotional responses, known as emotional lability, affects
many stroke survivors. There may be no happiness or sadness
involved, and the emotional display will end as quickly as
it started. |
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Some stroke
survivors neglect the side of their world corresponding to
the side of their brain which was injured by the stroke.
Those with left-sided neglect do not perceive what is on
their left side. For example, the stroke survivor with
left-sided neglect may ignore the left side of the face when
washing or not eat food on the left side of the plate. If
the stroke survivor's head is moved to the left, neglected
objects may become apparent. If the plate is turned around,
he or she will finish eating the meal. |
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Memory Loss |
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Some changes in
behavior, such as memory loss, can be so subtle the family
may not notice them at first. A stroke survivor may be
anxious and cautious, needing a reminder to finish a
sentence or know what to do next. Some stroke survivors have
difficulty with numbers and calculating. Their family will
need to learn to keep things in the same place, do things in
the same sequence, tell the stroke survivor in advance what
is going to happen and possibly take over some
responsibilities. |
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Communication Problems |
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If a stroke
causes damage to the language center in the brain, there
will be language difficulties. Some stroke survivors are
unable to understand or speak at all. Others do not make
sense when they speak. Some can no longer read or write.
Many have difficulty pronouncing words. Communication
problems are among the most frightening after-effects of
stroke for both the survivor and the family, often requiring
professional help. |
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Dressing & Gooming |
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If a stroke
causes damage to the language center in the brain, there
will be language difficulties. Some stroke survivors are
unable to understand or speak at all. Others do not make
sense when they speak. Some can no longer read or write.
Many have difficulty pronouncing words. Communication
problems are among the most frightening after-effects of
stroke for both the survivor and the family, often requiring
professional help. |
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Stroke survivors
will find that completing simple tasks around the house,
which they took for granted before the stroke are now
extremely difficult or impossible. Many adaptive devices and
techniques have been designed especially for stroke
survivors to help them retain their independence and
function safely and easily. The home usually can be modified
so that narrow doorways, stairs and bathtubs do not
interfere with the stroke survivor's ability to care for
personal needs.
Helpful bathroom
devices include grab bars, a raised toilet seat, a tub
bench, a hand-held shower head, no-slip pads, a long-handled
brush, a washing mitt with pockets for soap, soap-on-a-rope,
an electric toothbrush and an electric razor.
There are
many small electric appliances and kitchen modifications
which also make it possible for the stroke survivor to
participate in meal preparation. |
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Skin Care |
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Decubitus ulcers
(sometimes called bed sores) can be a serious problem for
stroke survivors who spend a good deal of time in bed or who
use a wheelchair. The sores usually appear on the elbows,
buttocks or heels.
To prevent bed sores, caregivers should make sure the stroke
survivor does not sit or lie in the same position for long
periods of time. Pillows should be used to support the
impaired arm or leg. The feet can hang over the end of the
mattress so that the heels don't rest on the sheet, or
pillows can be put under the knees to prop them so that the
soles of the feet rest flat on the bed. Sometimes, a piece
of sheepskin placed under the elbows, buttocks or heels can
be helpful. Special mattresses or cushions reduce pressure
and help prevent decubitus ulcers.
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