Heart Disease in Women

December 13, 2009 by  
Filed under Education

Heart disease is the No. 1 cause of death of American women.  is No. 3. Cardiovascular disease (CVD) affects a woman’s heart and blood vessels.  One out of every 10 women between the ages of 45 and 64 has some form of CVD.  Once a woman reaches 65, this increases to 1 out of every 4.  Every year about 500,000 women have a and about 370,000 of them die.  And, almost 100,000 women die each year of stroke.

What are the Cardiovascular Diseases of the Heart?

The most common CVDs are:

  • Coronary heart disease is when plaque builds up and blocks or slows down the blood flow through the vessels in the heart. Some symptoms are:
  • Angina – chest pain caused when the flow of blood and oxygen to the heart is blocked for a short time
  • Heart attack – when areas of the heart die because the flow of blood and oxygen is blocked off for a longer time
  • Heart failure – when the heart can not pump enough blood out of the heart as it should and the body does not get enough blood and oxygen
  • High blood pressure – when the pressure inside the walls of blood vessels is higher than normal
  • Stroke – when a blood vessel that takes blood and oxygen to the brain gets blocked or bursts and a area of the brain (and the area of the body the body it controls) can’t work as it should

What are factors put you a risk for CVD?

Risk factors are things that increase your chances of getting a disease.  Some risk factors you cannot control.  But, some you can control and even change.  Some women’s risk are higher than others.

The main risk factors for CVD that you can’t control are age and a family history of CVD.  The factors you can control or change are:

  • Being overweight
  • Having diabetes
  • Having high blood cholesterol
  • Not being physically active
  • Smoking

What Can you do?

If you have at least 1 risk factor for CVD you should learn how to control it or prevent. By taking active role in your health care, you can make a difference.  Tell your doctor or nurse what’s going on with your health.  Ask questions or talk with about concerns you have.  Ask if there are any medical tests you should take to see if you already have CVD.

Learn which lifestyle changes can help lower your risks.  Making changes in your habits is the first step in preventing or controlling CVD.  Making these changes is very important if you are African-American or over the age of 55.

Do you have any of these risk factors and habits you can control or change?

  • Don’t smoke, or quit if you do.
  • Get up and get active.
  • If overweight, work on losing weight.
  • If you have diabetes, keep your blood glucose levels in your target range.
  • Reduce your blood cholesterol levels.
  • If you take medicine for blood pressure or pre-diabetes, take it exactly as you should.

The Good News!

Changing your habits isn’t easy – but it works.  It can lower your risks for CVD.  If you already have CVD, it can help your heart and blood vessels get healthier.  Here’s how:

  • Once you stop smoking, within a few years your risks for heart disease will be the same as that of a non-smoker.
  • Getting more exercise can help you lose weight, prevent and control , increase your good cholesterol levels and can even help prevent and control diabetes.
  • By eating less fat and cholesterol, more fruits and vegetables and watching how much salt you use, you can help reduce high blood pressure and bad cholesterol and take off extra pounds.
  • If you take off extra weight it can lower your risk for CVD, help prevent or control diabetes (if you have it) and lower your blood pressure and cholesterol.

It’s up to you. By making some effort the heart you save may be your own.

Tags: Aging-associated diseases, heart disease, Diabetes, Stroke, Cardiovascular diseases, heart failure

Help and Information Resources After a Stroke

December 8, 2009 by  
Filed under Education

Additional Resources For People Who Have Had A , Their Families, and Caregivers

ACTION
1100 Vermont Avenue, NW
Washington, DC 20525
(202) 606-4855 (call for telephone number of regional office)

  • Sponsors older American volunteer programs.

Administration on Aging
330 Independence Avenue, SW
Washington, DC 20201
Toll-free (800) 677-1116 (call for list of community services for older Americans in your area)

AHA Stroke Connection (formerly the Courage Stroke Network) American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
Toll-free (800) 553-6321 (or check telephone book for local AHA office)

  • Provides prevention, diagnosis, treatment, and rehabilitation information to stroke survivors and their families.

American Dietetic Association/National Center for Nutrition and Dietetics
216 West Jackson Boulevard
Chicago, IL 60606
Toll-free (800) 366-1655 (Consumer Nutrition Hotline)

  • Consumers may speak to a registered dietitian for answers to nutrition questions, or obtain a referral to a local registered dietitian.

American Self-Help Clearinghouse
St. Clares-Riverside Medical Center
Denville, NJ 07834
(201) 625-7101 (call for name and telephone number of State or local clearinghouse)

  • Provides information and assistance on local self-help groups.

National Aphasia Association
P.O. Box 1887
Murray Hill Station
New York, NY 10156
Toll-free (800) 922-4622

  • Provides information on the partial or total loss of the ability to speak or comprehend speech, resulting from stroke or other causes.

National Easter Seal Society
230 West Monroe Street, Suite 1800
Chicago, IL 60606
(312) 726-6200 (or check telephone book for local Easter Seal Society) Provides information and services to help people with disabilities.

National Stroke Association
96 Inverness Drive East, Suite I
Englewood, CO 80112
(303) 649-9299
Toll-free (800) STROKES (787-6537)
www.stroke.org

  • Serves as an information referral clearinghouse on stroke.
  • Offers guidance on forming stroke support groups and clubs.

Rosalynn Carter Institute
Georgia Southwestern College
600 Simmons Street
Americus, GA 31709

  • Provides information on care-giving. Reading lists, video products, and other caregiver resources are available by writing to the address listed above.

Stroke Clubs International
805 12th Street
Galveston, TX 77550
(409) 762-1022 (call for the name of a stroke club located in your area) Maintains list of over 800 stroke clubs throughout the United States.

The Well Spouse Foundation
P.O. Box 801
New York, NY 10023
(212) 724-7209
Toll-free (800) 838-0879

  • Provides support for the husbands, wives, and partners of people who are chronically ill or disabled.

Medicare Information Consumer Information Center
Department 59
Pueblo, CO 81009

By writing to this address, you can receive a free copy of The Medicare Handbook (updated and published annually). This handbook provides information about Medicare benefits, health insurance to supplement Medicare, and limits to Medicare coverage. It is also available in Spanish.

Bungalow Speech Therapy Software
Effective, Easy-to-use, and Economical. Download your FREE TRIAL-COPY at www.BungalowSoftware.com Free speech-therapy newsletter…subscribe today by sending “subscribe” to: [email protected]

Tags: : [email protected], www, Society, Greenville Avenue Dallas, Stroke

Where to Get Help After a Stroke

December 8, 2009 by  
Filed under Education

Many kinds of help are available for people who have had strokes and their families and caregivers. Some of the most important are:

  • Information about stroke: A good place to start is with the books and pamphlets available from national organizations that provide information on this subject. Many of their materials are available free of charge. A list of these organizations are under Additional Resources.
  • Local stroke clubs or other support groups: These are groups where strokesurvivors and family members can share their experiences, help each other solve problems, and expand their social lives.
  • Home health services: These are available from the Visiting Nurses Association (VNA), public health departments, hospital home care departments, and private home health agencies. Services may include nursing care, rehabilitation therapies, personal care (for example, help with bathing or dressing), respite care (staying with the stroke survivor so that the caregiver can take a vacation or short break), homemaker services, and other kinds of help.
  • Meals on Wheels: Hot meals are delivered to the homes of people who cannot easily shop and cook.
  • Adult day care: People who cannot be completely independent sometimes spend the day at an adult day care center. There they get meals, participate in social activities, and may also get some health care and rehabilitation services.
  • Friendly Visitor (or other companion services): A paid or volunteer companion makes regular visits or phone calls to a person with disabilities.
  • Transportation services: Most public transportation systems have buses that a person in a wheelchair can board. Some organizations and communities provide vans to take wheelchair users and others on errands such as shopping or doctor’s visits.

Many communities have service organizations that can help. Some free services may be available or fees may be on a “sliding scale” based on income. It takes some work to find out what services and payment arrangements are available. A good way to start is to ask the social workers in the hospital or rehabilitation program where the stroke survivor was treated. Also, talk to the local United Way or places of worship. Another good place to look is the Yellow Pages of the telephone book, under “Health Services,” “Home Health Care,” “Senior Citizen Services,” or “Social Service Organizations.” Just asking friends may turn up useful information. The more you ask, the more you will learn.

Tags: Social Issues, Sliding scale fees, Geriatrics, Stroke, Caregiver, Home care

Planning to go Home from Rehab After a Stroke

December 8, 2009 by  
Filed under Education

Discharge planning begins early during rehabilitation. It involves the patient, family, and rehabilitation staff. The purpose of discharge planning is to help maintain the benefits of rehabilitation after the patient has been discharged from the program. Patients are usually discharged from rehabilitation soon after their goals have been reached.

Some of the things discharge planning can include are to:

  • Make sure that the stroke survivor has a safe place to live after discharge.
  • Decide what care, assistance, or special equipment will be needed.
  • Arrange for more rehabilitation services or for other services in the home (such as visits by a home health aide).
  • Choose the health care provider who will monitor the person’s health and medical needs.
  • Determine the caregivers who will work as a partner with the patient to provide daily care and assistance at home, and teach them the skills they will need.
  • Help the stroke survivor explore employment opportunities, volunteer activities, and driving a car (if able and interested).
  • Discuss any sexual concerns the stroke survivor or husband/wife may have. Many people who have had strokes enjoy active sex lives.
  • Preparing a Living Place
  • Many stroke survivors can return to their own homes after rehabilitation. Others need to live in a place with professional staff such as a nursing home or assisted living facility. An assisted living facility can provide residential living with a full range of services and staff. The choice usually depends on the person’s needs for care and whether caregivers are available in the home. The stroke survivor needs a living place that supports continuing recovery.

It is important to choose a living place that is safe. If the person needs a new place to live, a social worker can help find the best place.

During discharge planning, program staff will ask about the home and may also visit it. They may suggest changes to make it safer. These might include changing rooms around so that a stroke survivor can stay on one floor, moving scatter rugs or small pieces of furniture that could cause falls, and putting grab bars and seats in tubs and showers.

It is a good idea for the stroke survivor to go home for a trial visit before discharge. This will help identify problems that need to be discussed or corrected before the patient returns.

Deciding About Special Equipment
Even after rehabilitation, some stroke survivors have trouble walking, balancing, or performing certain activities of daily living. Special equipment can sometimes help. Here are some examples:

  • Cane: Many people who have had strokes use a cane when walking. For people with balancing problems, special canes with three or four “feet” are available.
  • Walker: A walker provides more support than a cane. Several designs are available for people who can only use one hand and for different problems with walking or balance.
  • Ankle-foot orthotic devices (braces): Braces help a person to walk by keepingthe ankle and foot in the correct position and providing support for the knee.
  • Wheelchair: Some people will need a wheelchair. Wheelchairs come in many different designs. They can be customized to fit the user’s needs and abilities. Find out which features are most important for the stroke survivor.
  • Aids for bathing, dressing, and eating: Some of these are safety devices such as grab bars and nonskid tub and floor mats. Others make it easier to do things with one hand. Examples are velcro fasteners on clothes and placemats that won’t slide on the table.
  • Communication aids: These range from small computers to homemade communication boards. The stroke survivor, family, and rehabilitation program staff should decide together what special equipment is needed. Program staff can help in making the best choices. Medicare or health insurance will often help pay for the equipment.
  • dPreparing Caregivers: Caregivers who help stroke survivors at home are usually family members such as a husband or wife or an adult son or daughter. They may also be friends or even professional home health aides. Usually, one person is the main caregiver, while others help from time to time. An important part of discharge planning is to make sure that caregivers understand the safety, physical, and emotional needs of the stroke survivor, and that they will be available to provide needed care.

Since every stroke is different, people have different needs for help from caregivers. Here are some of the things caregivers may do:

  • Keep notes on discharge plans and instructions and ask about anything that is not clear.
  • Help to make sure that the stroke survivor takes all prescribed medicines and follows suggestions from program staff about diet, exercise, rest, and other health practices.
  • Encourage and help the person to practice skills learned in rehabilitation.
  • Help the person solve problems and discover new ways to do things.
  • Help the person with activities performed before the stroke. These could include using tools, buttoning a shirt, household tasks, and leisure or social activities.
  • Help with personal care, if the person cannot manage alone.
  • Help with communication, if the person has speech problems. Include the stroke survivor in conversations even when the person cannot actively participate.
  • Arrange for needed community services.
  • Stand up for the rights of the stroke survivor.

If you expect to be a caregiver, think carefully about this role ahead of time. Are you prepared to work with the patient on stroke recovery? Talk it over with other people who will share the caregiving job with you. What are the stroke survivor’s needs? Who can best help meet each of them? Who will be the main caregiver? Does caregiving need to be scheduled around the caregivers’ jobs or other activities? There is time during discharge planning to talk with program staff about caregiving and to develop a workable plan.

Tags: Stroke, Grab bar, Survivor, Bathing, Christina Crawford, Shower, Plumbing

Making the Most of Stroke Rehab

December 8, 2009 by  
Filed under Education

What the Patient Can Do
If you are a stroke survivor in rehabilitation, keep in mind that you are the most important person in your treatment. You should have a major say in decisions about your care. This is hard for many stroke patients. You may sometimes feel tempted to sit back and let the program staff take charge. If you need extra time to think or have trouble talking, you may find that others are going ahead and making decisions without waiting. Try not to let this happen.

  • Make sure others understand that you want to help make decisions about your care.
  • Bring your questions and concerns to program staff.
  • State your wishes and opinions on matters that affect you.
  • Speak up if you feel that anyone is “talking down” to you; or, if people start talking about you as if you are not there.
  • Remember that you have the right to see your medical records.

To be a partner in your care, you need to be well informed about your treatment and how well you are doing. It may help to record important information about your treatment and progress and write down any questions you have.

If you have speech problems, making your wishes known is hard. The speech-language pathologist can help you to communicate with other staff members, and family members may also help to communicate your ideas and needs.

Most patients find that rehabilitation is hard work. They need to maintain abilities at the same time they are working to regain abilities. It is normal to feel tired and discouraged at times because things that used to be easy before the stroke are now difficult. The important thing is to notice the progress you make and take pride in each achievement.

How the Family Can Help
If you are a family member of a stroke survivor, here are some things you can do:

  • Support the patient’s efforts to participate in rehabilitation decisions.
  • Visit and talk with the patient. You can relax together while playing cards, watching television, listening to the radio, or playing a board game.
  • If the patient has trouble communicating (aphasia), ask the speech-language pathologist how you can help.
  • Participate in education offered for stroke survivors and their families. Learn as much as you can and how you can help.
  • Ask to attend some of the rehabilitation sessions. This is a good way to learn how rehabilitation works and how to help.
  • Encourage and help the patient to practice skills learned in rehabilitation.
  • Make sure that the program staff suggests activities that fit the patient’s needs and interests.
  • Find out what the patient can do alone, what the patient can do with help, and what the patient can’t do. Then avoid doing things for the patient that the patient is able to do. Each time the patient does them, his or her ability and confidence will grow.
  • Take care of yourself by eating well, getting enough rest, and taking time to do things that you enjoy.

To gain more control over the rehabilitation process, keep important information where you can find it. One suggestion is to keep a notebook with the patient.

Tags: speech-language pathologist, Amyotrophic lateral sclerosis, Stroke, Rehabilitation medicine, Stroke recovery, Rehabilitation robotics

What Happens During Stroke Rehab

December 8, 2009 by  
Filed under Education

In hospital or nursing facility rehabilitation programs, the patient may spend several hours a day in activities such as physical therapy, occupational therapy, speech therapy, recreational therapy, group activities, and patient and family education.

It is important to maintain skills that help recovery. Part of the time is spent relearning skills (such as walking and speaking) that the person had before the stroke. Part of it is spent learning new ways to do things that can no longer be done the old way (for example, using one hand for tasks that usually need both hands).

Setting Rehabilitation Goals
The goals of rehabilitation depend on the effects of the stroke, what the patient was able to do before the stroke, and the patient’s wishes. Working together, goals are set by the patient, family, and rehabilitation program staff. Sometimes, a person may need to repeat steps in striving to reach goals.

If goals are too high, the patient will not be able to reach them. If they are too low, the patient may not get all the services that would help. If they do not match the patient’s interests, the patient may not want to work at them. Therefore, it is important for goals to be realistic. To help achieve realistic goals, the patient and family should tell program staff about things that the patient wants to be able to do.

  • Rehabilitation Goals
  • Being able to walk, at least with a walker or cane, is a realistic goal for most stroke survivors.
  • Being able to take care of oneself with some special equipment is a realistic goal for most.
  • Being able to drive a car is a realistic goal for some. Having a job can be a realistic goal for some people who were working before the stroke. For some, the old job may not be possible but another job or a volunteer activity may be.

Reaching treatment goals does not mean the end of recovery. It just means that the stroke survivor and family are ready to continue recovery on their own.

  • Rehabilitation Specialists
    Because every stroke is different, treatment will be different for each person. Rehabilitation is provided by several types of specially trained professionals. A person may work with any or all of these:
  • Physician
    All patients in stroke rehabilitation have a physician in charge of their care. Several kinds of doctors with rehabilitation experience may have this role. These include family physicians and internists (primary care doctors), geriatricians (specialists in working with older patients), neurologists (specialists in the brain and nervous system), and physiatrists (specialists in physical medicine and rehabilitation).
  • Rehabilitation nurse
    Rehabilitation nurses specialize in nursing care for people with disabilities. They provide direct care, educate patients and families, and help the doctor to coordinate care.
  • Physical therapist
    Physical therapists evaluate and treat problems with moving, balance, and coordination. They provide training and exercises to improve walking, getting in and out of a bed or chair, and moving around without losing balance. They teach family members how to help with exercises for the patient and how to help the patient move or walk, if needed.
  • Occupational therapist
    Occupational therapists provide exercises and practice to help patients do things they could do before the stroke such as eating, bathing, dressing, writing, or cooking. The old way of doing an activity sometimes is no longer possible, so the therapist teaches a new technique.
  • Speech-language pathologist
    Speech-language pathologists help patients get back language skills and learn other ways to communicate. Teaching families how to improve communication is very important. Speech-language pathologists also work with patients who have swallowing problems (dysphagia).
  • Social worker
    Social workers help patients and families make decisions about rehabilitation and plan the return to the home or a new living place. They help the family answer questions about insurance and other financial issues and can arrange for a variety of support services. They may also provide or arrange for patient and family counseling to help cope with any emotional problems.
  • Psychologist
    Psychologists are concerned with the mental and emotional health of patients. They use interviews and tests to identify and understand problems. They may also treat thinking or memory problems or may provide advice to other professionals about patients with these problems.
  • Therapeutic recreation specialist
    These therapists help patients return to activities that they enjoyed before the stroke such as playing cards, gardening, bowling, or community activities. Recreational therapy helps the rehabilitation process and encourages the patient to practice skills.
  • Other professionals
    Other professionals may also help with the patient’s treatment. An orthotist may make special braces to support weak ankles and feet. A urologist may help with bladder problems. Other physician specialists may help with medical or emotional problems. Dietitians make sure that the patient has a healthy diet during rehabilitation. They also educate the family about proper diet after the patient leaves the program. Vocational counselors may help patients go back to work or school.
    Rehabilitation professionals, the patient, and the family are vitally important partners in rehabilitation. They must all work together for rehabilitation to succeed.

Rehabilitation Team
In many programs, a special rehabilitation team with a team leader is organized for each patient. The patient, family, and rehabilitation professionals are all members. The team has regular meetings to discuss the progress of treatment. Using a team approach often helps everyone work together to meet goals.

Tags: physical therapy, Stroke recovery, Occupational therapy, Rehabilitation medicine, speech therapy, Stroke, Geriatric rehabilitation

Preventing a Second Stroke

December 8, 2009 by  
Filed under Education

People who have had a stroke have an increased risk of another stroke, especially during the first year after the original stroke. The risk of another stroke goes up with older age, high blood pressure (hypertension), high cholesterol, diabetes, obesity, having had a transient ischemic attack (TIA), heart disease, cigarette smoking, heavy alcohol use, and drug abuse. While some risk factors for stroke (such as age) cannot be changed, the risk factors for the others can be reduced through use of medicines or changes in lifestyle.

Patients and families should ask for guidance from their doctor or nurse about preventing another stroke. They need to work together to make healthy changes in the patient’s lifestyle. Patients and families should also learn the warning signs of a TIA (such as weakness on one side of the body and slurred speech) and see a doctor immediately if these happen.

Tags: Stroke, Aging-associated diseases, Transient ischemic attack, Nutrition, Cardiovascular diseases, Cardiology, Diabetes mellitus, Hypertension

Acute Care for Stroke Survivor

December 8, 2009 by  
Filed under Education

The main purposes of acute care are to:

  • Make sure the patient’s condition is caused by a stroke and not by some other medical problem.
  • Determine the type and location of the stroke and how serious it is.
  • Prevent or treat complications such as bowel or bladder problems or pressure ulcers (bed sores).
  • Prevent another stroke.

Encourage the patient to move and perform self-care tasks, such as eating and getting out of bed, as early as medically possible. This is the first step in rehabilitation.

survivors and family members may find the hospital experience confusing. Hospital staff are there to help, and it is important to ask questions and talk about concerns.

Before acute care ends, the patient and family with the hospital staff decide what the next step will be. For many patients, the next step will be to continue rehabilitation.

Tags: Stroke recovery, Medicine, Patient safety, Stroke, Patient safety and nursing, Healthcare

How a Stroke Can Affect You

December 8, 2009 by  
Filed under Education

Each stroke is different depending on the part of the brain injured, how bad the injury is, and the person’s general health. Some of the effects of stroke are:

  • Weakness (hemiparesis–hem-ee-par-EE-sis) or paralysis (hemiplegia–hem-ee-PLEE-ja) on one side of the body. This may affect the whole side or just the arm or the leg. The weakness or paralysis is on the side of the body opposite the side of the brain injured by the stroke. For example, if the stroke injured the left side of the brain, the weakness or paralysis will be on the right side of the body.
  • Problems with balance or coordination. These can make it hard for the person to sit, stand, or walk, even if muscles are strong enough.
  • Problems using language (aphasia and dysarthria). A person with aphasia (a-FAY-zha) may have trouble understanding speech or writing. Or, the person may understand but may not be able to think of the words to speak or write. A person with dysarthria (dis-AR-three-a) knows the right words but has trouble saying them clearly.
  • Being unaware of or ignoring things on one side of the body (bodily neglect or inattention).
    Often, the person will not turn to look toward the weaker side or even eat food from the half of the plate on that side.
  • Pain, numbness, or odd sensations. These can make it hard for the person to relax and feel comfortable.
  • Problems with memory, thinking, attention, or learning (cognitive problems). A person may have trouble with many mental activities or just a few. For example, the person may have trouble following directions, may get confused if something in a room is moved, or may not be able to keep track of the date or time.
  • Being unaware of the effects of the stroke. The person may show poor judgment by trying to do things that are unsafe as a result of the stroke.
  • Trouble swallowing (dysphagia–dis-FAY-ja). This can make it hard for the person to get enough food. Also, care must sometimes be taken to prevent the person from breathing in food (aspiration–as-per-AY-shun) while trying to swallow it.
  • Problems with bowel or bladder control. These problems can be helped with the use of portable urinals, bedpans, and other toileting devices.
  • Getting tired very quickly. Becoming tired very quickly may limit the person’s participation and performance in a rehabilitation program.
  • Sudden bursts of emotion, such as laughing, crying, or anger. These emotions may indicate that the person needs help, understanding, and support in adjusting to the effects of the stroke.
  • Depression This is common in people who have had strokes. It can begin soon after the stroke or many weeks later, and family members often notice it first.

Depression After
It is normal for a stroke survivor to feel sad over the problems caused by stroke. However, some people experience a major depressive disorder, which should be diagnosed and treated as soon as possible. A person with a major depressive disorder has a number of symptoms nearly every day, all day, for at least 2 weeks. These always include at least one of the following:

  • Feeling sad, blue, or down in the dumps
  • Loss of interest in things that the person used to enjoy

A person may also have other physical or psychological symptoms, including:

  • Feeling slowed down or restless and unable to sit still
  • Feeling worthless or guilty
  • Increase or decrease in appetite or weight
  • Problems concentrating, thinking, remembering, or making decisions
  • Trouble sleeping or sleeping too much
  • Loss of energy or feeling tired all of the time
  • Headaches
  • Other aches and pains
  • Digestive problems
  • Sexual problems
  • Feeling pessimistic or hopeless
  • Being anxious or worried
  • Thoughts of death or suicide

If a stroke survivor has symptoms of depression, especially thoughts of death or suicide, professional help is needed right away. Once the depression is properly treated, these thoughts will go away. Depression can be treated with medication, psychotherapy, or both. If it is not treated, it can cause needless suffering and also makes it harder to recover from the stroke.

Disabilities After Stroke
A “disability” is difficulty doing something that is a normal part of daily life. People who have had a stroke may have trouble with many activities that were easy before, such as walking, talking, and taking care of “activities of daily living” (ADLs). These include basic tasks such as bathing, dressing, eating, and using the toilet, as well as more complex tasks called “instrumental activities of daily living” (IADLs), such as housekeeping, using the telephone, driving, and writing checks.

Some disabilities are obvious right after the stroke. Others may not be noticed until the person is back home and is trying to do something for the first time since the stroke.

Tags: Stroke, Post stroke depression, Major depressive disorder, Abnormal psychology, Mood disorders, Stroke recovery

Rehab After a Stroke (Brain Attack)

December 8, 2009 by  
Filed under Education

This information is about stroke rehabilitation. Its goal is to help the person who has had a stroke achieve the best possible recovery. Its purpose is to help people who have had strokes and their families get the most out of rehabilitation.

Note that this information sometimes uses the terms “stroke survivor” and “person” instead of “patient” to refer to someone who has had a stroke. This is because people who have had a stroke are patients for only a short time, first in the acute care hospital and then perhaps in a rehabilitation program. For the rest of their lives, they are people who happen to have had a stroke. The brochure also uses the word “family” to include those people who are closest to the stroke survivor, whether or not they are relatives.

Rehabilitation works best when stroke survivors and their families work together as a team. For this reason, both stroke survivors and family members are encouraged to read all parts of this information.

What is a stroke?
A stroke is a type of brain injury. Symptoms depend on the part of the brain that is affected. People who survive a stroke often have weakness on one side of the body or trouble with moving, talking, or thinking.

Most strokes are ischemic (is-KEE-mic) strokes. These are caused by reduced blood flow to the brain when blood vessels are blocked by a clot or become too narrow for blood to get through. Brain cells in the area die from lack of oxygen. In another type of stroke, called hemorrhagic (hem-or-AJ-ic) stroke, the blood vessel isn’t blocked; it bursts, and blood leaks into the brain, causing damage.

Strokes are more common in older people. Almost three-fourths of all strokes occur in people 65 years of age or over. However, a person of any age can have a stroke.

A person may also have a transient ischemic attack (TIA). This has the same symptoms as a stroke, but only lasts for a few hours or a day and does not cause permanent brain damage. A TIA is not a stroke but it is an important warning signal. The person needs treatment to help prevent an actual stroke in the future.

A stroke may be frightening to both the patient and family. It helps to remember that stroke survivors usually have at least some spontaneous recovery or natural healing and often recover further with rehabilitation.

Recovering From

The process of recovering from a stroke usually includes treatment, spontaneous recovery, rehabilitation, and the return to community living. Because stroke survivors often have complex rehabilitation needs, progress and recovery are different for each person.

Treatment for stroke begins in a hospital with “acute care.” This first step includes helping the patient survive, preventing another stroke, and taking care of any other medical problems.

Spontaneous recovery happens naturally to most people. Soon after the stroke, some abilities that have been lost usually start to come back. This process is quickest during the first few weeks, but it sometimes continues for a long time.

Rehabilitation is another part of treatment. It helps the person keep abilities and gain back lost abilities to become more independent. It usually begins while the patient is still in acute care. For many patients, it continues afterward, either as a formal rehabilitation program or as individual rehabilitation services. Many decisions about rehabilitation are made by the patient, family, and hospital staff before discharge from acute care.

The last stage in stroke recovery begins with the person’s return to community living after acute care or rehabilitation. This stage can last for a lifetime as the stroke survivor and family learn to live with the effects of the stroke. This may include doing common tasks in new ways or making up for damage to or limits of one part of the body by greater activity of another. For example, a stroke survivor can wear shoes with velcro closures instead of laces or may learn to write with the opposite hand.

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Tags: Cerebrovascular disease, individual rehabilitation services, Stroke, Registry of the Canadian Stroke Network, Transient ischemic attack, Traumatic brain injury, brain injury

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