Safe guided therapy

Living With Stroke and TIA

Stroke can have far-reaching consequences for people who’ve had them, their families and friends. The right care and support can allow those who’ve had a stroke to live a full life. Information at the right time is one of the most important aids to coping with stroke, especially once the stroke survivor is back in the community and the care of their family.

Recovery After Stroke

It’s not unusual to find it difficult to do everyday activities such as dressing, cooking, shopping and continuing employment after a stroke. An occupational therapist will assess the ability of a person who has had a stroke to carry out such activities.

They will know ways to do potentially dangerous things (shaving, getting into a hot bath) safely, and help people become better at activities such as dressing and cooking. They may be able to suggest equipment that will help overcome the obstacles that someone who has had a stroke faces when doing everyday activities such as feeding, bathing and dressing.

The occupational therapist may visit someone at home and see if there are any adaptations that can be made so they can live as normally as possible. This is normally done prior to hospital discharge by the ward occupational therapist.

Recovering from the Emotional
and Psychological Effects of a Stroke

A great deal happens whilst the person is in hospital and much recovery takes place. However, once the stroke survivor returns home the long term work begins for both survivor and family.

A stroke is a major event in anyone’s life. Strokes frequently cause problems with thinking, remembering, planning and learning. Strokes make people feel tired, and it may take a few months to recover previous levels of energy. These changes happen partly because there is some physical damage to the brain. The psychological changes may depend on which part of the brain is injured.

Being in hospital and facing the possibility of long-term disability may also be difficult to comprehend, whatever has happened to the brain. Feelings of anger, anxiety, depression, frustration and bewilderment are all common to stroke survivors and carers, although they may fade over time.

Cognitive and communication problems and personality changes can affect how a person thinks and feels about himself. These changes are sometimes subtle and not readily apparent to those who do not live with them. Problems can often arise just as the professional support fades and changes in personality and psychosocial behaviour starts to have an impact.

Stroke survivors may not have any awareness of their cognitive problems and the impact it can have on their carer, family and friends. Their sense of self has been damaged and they are faced with the task of rebuilding their ’self’, a piece at a time. It is like putting the layers of an onion together, building from the inside out, sometimes the layers don’t fit, so they have to be discarded and new ones created.

Communication problems are not just about speech and language; it is also about how people enter back into society and how others manage the situation. Often families and friends have no real understanding of the cognitive difficulties for the stroke survivor and carer. Psychosocial problems can often mean carers have to face negative reactions of others, thus increasing social isolation.

What Can Impact on the Family

  • Stroke affects all family members, particularly the main carer. A change in one member of the family affects every other member.
  • Families are often unprepared to deal with cognitive, emotional and behavioural effects of stroke. Social issues are not always apparent to professionals in a more formal setting.
  • Financial changes can often have a devastating effect on a working family.
  • Hidden disabilities often cause distress, especially when behaviour is variable and impossible to predict.
  • Issues that affect family and relationships after stroke are not confined to people whose initial strokes are dramatic and severe.
  • Quality of life can change dramatically, the health and psychological well-being of the main carer can be compromised and affect other family members.

Familes may need support to cope with:-

 

  • Agitation and impatience
  • Anger
  • Irritability
  • Impulsivity
  • Emotional lability
  • Self-centredness
  • Childishness
  • Lack of initiative
  • Little or no self-awareness of problems
  • Aggressive behaviour
  • Apathy and poor motivation
  • Depression
  • Anxiety
  • Over sensitivity
  • Obsessional behaviour
  • Sexual problems
  • Inappropriate and irresponsible social behaviour
  • Poor judgement
  • Inability to profit from experience

Carers often get forgotten as all the attention is on the recovery of the stroke survivor. Hidden disabilities often cause distress, especially when behaviour is variable and impossible to predict. With adjustment, however, comes the ability to talk about what has happened; recognise what has changed and move on with life for carer and stroke survivor. Life after stroke has changed and there is no going back.

The loss of a previous life and a different future can be profound and the grieving process can be long and often chronic. It is like a process of bereavement but for some without resolution, as the source of the grief (the effect of the stroke) is ever present. Sometimes stroke survivors or carers can find themselves trapped in the mourning process. Etymologically the word mourning means “to remember” and stems from the same root as memory. In mourning we are held in the memory of what has been lost and finding resolution can sometimes feel impossible.

It is very important to recognise that some or all of these feelings and problems may arise for both stroke survivors and carers. The impact of stroke on the stroke survivor is just as great on the carer. It is important that no one feels alone with a stroke.

 

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