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Caring for a loved one after a stroke

Recovering from a stroke can be a challenging time for stroke survivors as they relearn how to care for themselves, overcome mobility issues, or change how they communicate. Caregivers can help by encouraging their loved one to be as independent as possible, helping them make their own decisions, and promoting participation in leisure activities. Caregivers may ease the transition from hospital to home by taking steps to ensure the safety, comfort and continuing recovery. Changes to the home can be customized to meet the patient’s specific requirements in certain areas, such as the:


Kitchen.If a stroke survivor uses a wheelchair they may benefit from an over-the-stove mirror so they can see what is on the stove and a roll-under stove for easier access. Make sure oven mittens and hot pads are available to prevent burns and a fire extinguisher is within easy reach.

Bedroom. Make sure there is a clear pathway to the bathroom to avoid tripping over something in the dark. Place a commode chair next to the bed if the stroke patient has difficulty getting to the bathroom quickly enough. Change handles on cabinets so drawers can be opened with a fist, rather than fingers. Place clothes in easily accessible drawers and lower the hanging bar in the closet. Help the stroke patient select clothes that close in the front, have Velcro fasteners rather than buttons or zippers, and avoid pull-over shirts. Buy dressing aids such as a long-handled shoe horn to help the stroke patient get dressed on their own.

Bathroom. Install grab bars to assist with stability getting into and out of the shower. A bathmat or non-skid bath decals on the floor of the shower provides traction on a slick area. A transfer tub bench, foldout bath bench or a roll-in shower can make it easier to get in and out of the tub or shower. Make sure levers on faucets have long handles so they are easy to turn. Mark settings on heat control knobs so the stroke patient can select the proper temperature. You may need to adjust the water heater temperature to prevent scalding. Purchase a long-handled sponge and soap pump to help aid in the washing process. Place towels and towel bars at a height within easy reach.

Types of language problems Back to top
Many people have problems speaking and understanding speech following a stroke. This difficulty with communication is called aphasia. It usually comes on suddenly as a result of a stroke or head injury, but brain tumors and infections of the brain can gradually cause language problems. Aphasia affects one in every 250 people, and about one million Americans currently have aphasia.
Aphasia occurs when the language centers on the left side of the brain are affected by a stroke, head injury or brain tumor. Depending on the exact nature of the injury, the symptoms of aphasia can vary. There are three main categories of aphasia:
Nonfluent aphasia occurs when the injury is near the left front of the brain. With nonfluent aphasia, a person has problems getting words out and generally speaks in very short sentences. The person also may leave words out, so sentences become short and choppy like “Want food” or “Walk store.” With this type of aphasia the person listening usually understands the meaning. A person with nonfluent aphasia may understand what is being said to them, but they know they are having problems speaking and may get frustrated.
Fluent aphasia results from damage to the middle part of the language center of the brain. A person with fluent aphasia uses long, complex sentences that don’t make sense. They also may use words that don’t make sense or are incorrectly used. The person generally doesn’t understand what’s being said and may not be aware of their problems speaking.
Global aphasia is caused by extensive damage to the brain’s language center. The person with global aphasia has severe problems speaking and understanding language.


Treatment of Aphasia Back to top
Recovery from aphasia depends on the severity of the damage to the brain and on how quickly treatment is begun. The recovery process is slow, and few people completely regain their language skills. Early treatment is important.
Treatment for aphasia involves working with a speech-language pathologist who will help the person relearn language skills. The speech-language pathologist begins with simple tasks such as naming objects and gradually building to more complex language skills. In some cases, the person may need to learn ways to make up for the loss of his or her language skills by using gestures or drawings.
How to interact with a loved one
If you know someone who has aphasia, here are some ways you can help:
Use simple sentence and speak more slowly.
Don’t finish sentences, correct errors or speak for the person.
Only talk about one thing at a time.
Reduce distractions by turning off the television, radio or moving to a quiet place.
Write down key words or a short sentence to help explain something.
Use a book of words, pictures or photos to help with conversations.
Use drawings or gestures to help get your meaning across.
Include the person in conversations when possible.
Make sure you have the person’s attention before talking.

Stroke Rehabilitation Back to top
There is no cure for the disabilities left by a stroke. The goal of stroke rehabilitation is to help survivors relearn the skills that they lost following the stroke and teach them new ways of performing tasks to circumvent or compensate for the skills that they have lost. The hope is that stroke survivors may be as independent and productive as possible following their rehabilitation. There are several different types of rehabilitation therapies, including:
Physical therapy to restore movement, balance and coordination
Occupational therapy to relearn basic skills such as bathing and dressing

Speech Therapy Back to top
Rehabilitation experts agree that an important element in any rehabilitation program is carefully directed, well-focused, repetitive practice. This is the same type of practice used by most people trying to learn a new skill such as playing the piano or pitching a baseball. Stroke rehabilitation often begins within the first 24 to 48 hours after the stroke when nurses and other medical personnel work to prevent problems such as stiff joints, falls, bedsores and pneumonia.
Once the patient has been discharged from the hospital, he or she, along with family or friends, will need to decide on care and living arrangements. While some stroke survivors are able to return home, many have complications that require regular medical attention through a formal rehabilitation program. These types of facilities and services may include an inpatient program, outpatient program, nursing facility or home-based rehabilitation. At Sierra Medical Center we offer both inpatient and outpatient rehabilitation.

Inpatient Rehabilitation Units Back to top
Patients usually stay in the facility for two to three weeks, engaging in a coordinated, intensive program of rehabilitation. These programs often involve at least three hours of active therapy a day, five or six days a week. Inpatient facilities usually offer a comprehensive range of medical services including full-time physicians and therapists specializing in post-stroke rehabilitation.
Outpatient rehabilitation units: Patients typically spend several hours, often three days a week, at the facility taking part in therapy sessions. They then return home at night. Outpatient facilities often provide access to physicians and therapists and offer treatment programs as intense as those of inpatient facilities. However, they sometimes offer less demanding regimens for patients with lower physical capacities.
Family and friends play a very important role in stroke rehabilitation. A caring and able spouse, partner or family member can be a positive factor in rehabilitation. It is also important for family members to understand what the stroke survivor has been through and how disabilities can affect the person so they can know what to expect and how to handle problems once the patient leaves the hospital. For more information, call the American Stroke Association at 1-888-4-STROKE.

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