• Denae Asel-Templin

What To Know About Strokes?

A stroke is a mass brain bleed, also known as a hemorrhagic stroke, or a loss of blood supply to the brain, known as an ischemic stroke. A stroke is also referred to as a cerebrovascular accident/CVA or cerebral infarct.

What might a person who had a stroke experience afterward?

As with most conditions, it is rare for two individuals who experience a stroke to present in the same way. Depending on the area of the brain affected, a range of symptoms can result. An injury to the left side of the brain will likely result in motor and sensory impairments on the right side of the body (e.g., right arm, right leg, ride side of the face, etc.) and vice versa. For example, an individual who recently had a stroke may have severe speech impairments, while another individual who experienced a stroke in a slightly different area of the brain may demonstrate little to no deficits in speech and communication.

Individuals who have experienced a bleed or any brain damage to the left side of their brain can experience impairments in movement, sensation, and vision of the right side of their body and visual field. Additional impairments may include delayed or absent visual and verbal processing, spatial deficits, oral motor and movement deficits, impaired verbal memory, impaired short-term recall and facial recognition, impulsivity, and difficulty processing verbal and auditory information.

Individuals who have experienced damage to the right side of their brain will likely experience impairments in movement, sensation, and vision of the left side of their body and visual field. Additional impairments may include delayed or absent non-verbal memory and auditory processing, visible field cuts, depression and anxiety, deficits in non-verbal auditory processing, difficulty interpreting abstract concepts, and tone to oral, upper, or lower extremity muscles.

When family members interact with individuals who have had a stroke, they should keep in mind the following:

  • Behavior may be different in your loved one, as is common after an injury to the brain. Be patient with bouts of irritability, agitation, or inappropriate behaviors.

  • Remain mindful of your loved one’s independence. Some or all of this may have been lost in a short period. If your loved one is demonstrating signs of depression (e.g., loss of motivation, decreased energy, loss of appetite, suicidal thoughts, feelings of hopelessness), contact his or her physician.

  • Encourage participation in therapy. There will be additional changes to the brain within the first several weeks after the stroke. This means some initial deficits will come back, but others may return only after intensive therapy or not at all.

  • Work closely with your loved one’s therapist. Therapists may want the family to participate in some training or education to ensure your loved one is safely and expertly cared for upon their return home.

  • Collaboration is key. Asking questions and staying involved is crucial if you wish to play a role in the care of your loved one.

When therapists interact with individuals who have had a stroke, they should keep in mind the following:

  • Encourage your patients to do their best in therapy and use empathy in all interactions. Loss of independence can be difficult, especially in the early stages.

  • Be accommodating to your patients’ needs. If they perform best in the morning, try to be flexible and give them an early appointment.

  • Patience is the best virtue. Patients will be slow to move, as both their bodies and minds are dealing with a lot. Support them throughout this.

  • Use clear and concise communication. Patients who have had a stroke will have difficulty expressing themselves, but also difficulty processing what others are saying and doing. This can cause fear and avoidance in patients.

  • Stand within your patient’s field of vision when speaking with them. Some patients will have poor or no vision on one side. This will help them feel included and more comfortable with their surroundings.

When patients have had a stroke, they should keep in mind the following:

  • Recovery takes time. Be patient with yourself and try your best in therapy.

  • Ask questions and try to learn about your diagnosis. Cognitive impairments may make this difficult but knowing what to expect help.

  • Tell someone if you are not feeling safe, supported, or well cared for. This includes any form of abuse, worsening feelings of depression and/or anxiety, and not getting the most out of therapy. There are many resources available for all of these issues and more.

  • Ask for activities or exercises to do at home and regularly complete them. Most therapists are diligent in providing these. However, if you were not given any, are struggling to complete them, let your therapist know.

  • If specific symptoms are worsening rather than getting better, tell someone. Notifying a therapist, neurologist, or primary care doctor is essential to prevent complications from arising.

What treatments are typical for someone who had a stroke?

Individuals who have experienced a recent or past stroke will be seen in nearly all treatment settings, including acute inpatient rehab hospitals, skilled nursing facilities, and outpatient therapy clinics. Depending on the severity and type of deficits resulting from the stroke, individuals will be candidates for physical, occupational, and speech therapies.

Physical therapy treatments typically address deficits related to walking (gait), moving from one position to another (transferring), smoothness and fluidity of movement (coordination), and strength. Treatments include walking within parallel bars, using assistive devices such as a wheelchair, walker, or cane, strengthening and range of motion exercises, along with gross motor activities ranging from completing tasks while standing to throw weighted balls.

Occupational therapy treatments typically address deficits related to the arms (upper extremity rehabilitation) including strength and coordination. Another significant part of this treatment is focused on self-care tasks, meaning the use of upper extremities to bathe, groom, dress, toilet, and feed yourself. Treatments include training in self-care tasks, strengthening, and range of motion exercises for the arm and hand, along with excellent motor activities ranging from using eating utensils to writing.

Speech therapy treatments typically address deficits related to the oral motor system including strength and coordination, the ability to swallow and tolerate specific diets including solids and liquids, along with the ability to communicate clearly (secure communication) and understand others’ communication (receptive communication). Treatments include the practice of feeding at mealtimes, exercises for strengthening and coordination of the muscles in the mouth and throat, along with memory activities and communication exercises.

Are strokes preventable?

The majority of strokes result from a blockage of blood flow to the brain. While there are many conditions and lifestyle choices which can increase the likelihood of a stroke occurring, some individuals may have genes which make them susceptible to having a stroke. Smoking and obesity both significantly increase an individual’s risk of having a stroke. The good news is these are lifestyle choices which can be prevented or stopped with a change in nutrition and vitamin intake, activity and stress levels.

An individual’s genetic predisposition to conditions including diabetes, high blood pressure, and high cholesterol can also be something to monitor. This means these individuals’ genetic makeup makes them more at risk for these conditions. Fortunately, a healthy lifestyle can help prevent these conditions from developing at all, meaning their risk of having a stroke is significantly less.

In summary

Health prevention is essential for someone who is at risk for a stroke or has a history of stroke. With current advances in healthcare and technology, the prognosis for someone with a stroke is vastly different from what it once was. Disciplines such as physical, occupational, and speech therapies can strengthen and rehabilitate individuals who have a range of deficits after a stroke.

Healthcare professionals can also utilize high-tech and low-tech tools to assist in the rehabilitation process. Low-tech tools may include reachers and dressing sticks, which can be used for basic tasks such as dressing and retrieving items. Individuals who have experienced a stroke can also utilize or be trained on independent use of high-tech. High-tech tools can assist in a range of deficits which may result from a stroke, including impaired memory, safety awareness, coordination, range of motion, strength, and more. With the help of skilled professionals and a variety of tools, most individuals can return to their previous level of function after a stroke.

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