A stroke takes place when the blood circulation to the brain is cut off for some reason. This happens when a blood vessel feeding the brain becomes clogged or bursts. Neglecting a stroke can lead to permanent damage to the brain and the affected person can lose a number of brain functions. Death does not occur immediately, unlike in the case of a heart attack. However, continued internal bleeding may cause severe damage and can be fatal.
Strokes are often caused by a hit to the head, falling down, high blood pressure, or any other cardiovascular problem. In some cases, chronic depression, stress and anxiety disorders have also led to strokes. Symptoms of stroke have sometimes occurred on the side opposite to the damaged hemisphere and depend mainly on the location and extent of the stroke. Only a qualified doctor is best equipped with the knowledge to determine the causes and extent of a stroke.
A person who has suffered a stroke must be taken to the hospital immediately for treatment. In extreme stroke cases, the doctors may perform a surgery to treat the clogged or damaged blood vessel.
STROKE: HOME CARE AND REHABILITATION
Stroke care doesn’t end with just the hospital treatment. After returning from the hospital, the affected person would needs to continue therapy at home, to prevent another stroke from occurring.
Medical doctors recommend that before taking the patient back, a room should be prepared where the person will be staying. The room should be furnished in such a way that it facilitates the person’s care and performance of daily activities. The lighting should be kept ambient and temperature should be maintained around 20 degrees Celsius. The bed should have a height of about 63-65 cm. The type of beds used in hospitals with wheels, a raised headboard and railings is perfect as it allows the person ease of movement.
Special care should be taken to ensure that the person’s head is in a comfortable, resting position throughout the day. For clients that are unable to move on their own, the care should prepare rehabilitation pillows and a pressure-relieving anti-bedsore mattress. It may also be necessary to provide the client with a wheelchair, which can be used to move and go for walks with the family or with the carer, if the patient’s condition allows it.
Just because a person has had a stroke does not mean that they should be completely confined to the bed, 24/7. They should be allowed to go outdoors and enjoy the lifestyle that they are used to. Research suggests that this can help speed up the healing process significantly.
Next to the bed, the carer should place a small cabinet where all the necessary utensils and medicine for the patient should be kept. Objects with more immediate utility – such as a cup with a drink in it – should be kept on the side of the client’s bed, so that they can use them easily.
A quick start of systematic rehabilitation exercises can largely restore the lost functions of the body. Rehabilitation is often long-lasting and tiring, which is why exercises should be performed under the supervision of a professional caregiver.
POST-HOSPITAL HOME CARE
It is very important to prepare all family members of the affected person for a new situation at home. Symptoms of strokes include paresis, paralysis, hypoesthesia, aphasia, etc. These require a lot of work on the part of the patient, their relatives and carers. The disorder affects not just the person who suffers the stroke, but the whole family and everyone must be involved in the post-stroke rehabilitation process.
The scope and nature of care for a stroke patient is usually determined by a doctor or a qualified nurse. The carer tasked with rehabilitation helps the patient regain mobility.
An important part of care is to educate the client and their family on how to regain confidence and overcome disability. A person who is confined to the bed after a stroke requires a much bigger scope of care activities than someone who is able to move and take care of most of their own needs.
Based on the geriatric scale, the nurse will assess what daily activities the patient can do alone and which require the help of relatives or a professional caregiver.
People confined to the bed must have anti-bedsore treatment implemented. This consists of daily care of the person’s skin and oiling. The person will need frequent change of body position in bed – usually every 1-2 hours and even more often in some cases. The carer can reposition the patient frequently in a low or high position, on their side or leaning forward. If pressure ulcers are already present on the client, anti-bedsore preparations should be used that are available at most pharmacies without a prescription.
It is important to keep the patient’s body clean every day. This includes helping the person relieve in bed and taking care of oral hygiene in the morning, in the evening and after every meal. If the patient is using pads, changing them also forms part of the carer’s activities.
Post-stroke care also involves providing the person a diet rich in proteins and nutrients. If they are suffering from swallowing disorders, the carer should prepare refined, slightly dense and warm non-hot foods. The affected person may need to take meals in small amounts, 5-6 times a day. Carers must pay attention during feeding and ensure that the patient does not choke while eating. If the patient experiences difficulties with swallowing, the doctor may order feeding by the tube. The carer must also take care that the patient is properly hydrated, especially when proper communication becomes difficult. On average, a person requires approx. 2 litres of fluids every day.
If the patient chokes on water and is unable to take fluids, the carer may thicken the liquids with jelly or pudding. Fluids can also be given through a straw if the patient is able to use them. When the patient is able to eat, the carer should encourage them to chew the food on the affected side as well to prevent spasticity from setting in.
It should be remembered that the immobile person is also prone to pneumonia, so the carer would need to pat the back of the patient 2 times a day to stimulate circulation and allow expectoration of the collecting secretion.
If the person suffers from breathing problems due to the stroke, the carer should demonstrate how to breathe through simple breathing exercises. A deep breathe in, then hold the air for 2-3 seconds and then exhale slowly. The breathing motion should imitate “blowing the mattress” action. This will allow the patient to activate the alveoli and prevent respiratory diseases.
With daily care for immobile post-stroke patients, one question often arises: How to put on a shirt, so as not to hurt the patient? Carers could also be confused about what order to put the sleeves on?
When undressing the patient, carers should always take off the shirt first, starting with the sleeve of the healthy side. With the healthy side, the carer will have more room to manoeuvre. Once the sleeve is off, they can take off the other sleeve for the client.
When dressing the patient, carers should start with the arm on the affected side and then try to squeeze the arm from the unaffected side in. This will ensure that the person does not suffer unnecessarily and there are no abrupt movements on the affected side. The same order of dressing applies to trousers.
The loss of some body functions, caused by a stroke, is an unpleasant and difficult feeling to deal with. An experienced carer can help the person cope with everyday activities. This will help improve the patient’s rehabilitation and bring a smile to their face. Therapists also find it easier to restore lost functions for people who are happy and active despite the stroke.
People who have suffered a stroke require constant rehabilitation. Frequent visits to the physiotherapist means high costs while a place in a rehabilitation centre is not always available immediately. In many stroke cases, a neurologist or a qualified therapist will recommend rehabilitation for the person. Certain procedures and care activities are universal and can be performed by a caregiver at home. These include physical and mental exercises that help the client recover quicker.