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STROKE RECOVERY

STROKE RECOVERY. STROKE FACTS. Every 45 seconds someone in North America has a stroke! 50,000 Canadians suffer a stroke yearly 1/3 of these people die within a year Most survivors are left with permanent damage. WHAT IS A STROKE?. The equivalent of a heart attack to the brain

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STROKE RECOVERY

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  1. STROKE RECOVERY

  2. STROKE FACTS • Every 45 seconds someone in North America has a stroke! • 50,000 Canadians suffer a stroke yearly • 1/3 of these people die within a year • Most survivors are left with permanent damage.

  3. WHAT IS A STROKE? • The equivalent of a heart attack to the brain • Occurs when a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot • That part of the brain cannot get the blood (and oxygen) it needs, so it starts to die. • When part of the brain dies from lack of blood flow, the part of the body it controls is affected. • Thus a stroke can affect speech, memory and movement, even causing paralysis

  4. TYPES OF STROKES 1. ISCHEMIC – 80% of all strokes • Caused by a blood clot blocking the brain’s artery • The blood clot is usually caused by fatty deposits lining the vessel walls. • Accounts for 80% of all strokes

  5. ISCHEMIC STROKE

  6. ISCHEMIC STROKE

  7. TYPES OF STROKES 2. HEMORRHAGIC - 20% of strokes • occurs when a weakened blood vessel ruptures and bleeds into the surrounding brain. • the blood accumulates and compresses the surrounding brain tissue • generally more serious than ischemic strokes

  8. HOW CAN YOU LOWER YOUR RISK? • Know your blood pressure • get it checked regularly • get proper treatment if it is elevated • Have your levels checked regularly • blood pressure • cholesterol • glucose • Know Your Numbers so you can make healthy choices

  9. HOW CAN YOU LOWER YOUR RISK? • Eat a well-balanced diet • Exercise regularly • Quit smoking • Maintain a healthy weight • Drink alcohol moderately

  10. WARNING SIGNSEven if temporary! • Sudden numbness or weakness in the face, arms or legs, especially on one side of the body • Sudden trouble speaking, understanding or confusion • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination

  11. WARNING SIGNS • Sudden, severe or unusual headache • Difficulty swallowing • If any of these symptoms occur, CALL 911!

  12. RISK FACTORS YOU CAN’T CONTROL • Age –men over 55 and women after menopause have higher risk • Family History • family members have heart disease before 55 or before menopause • family – parent or sibling– had strokes before 65 • Ethnicity—First Nations, African, South Asians

  13. TRANSIENT ISCHEMIC ATTACKS (TIA’s) • “mini strokes” -- minor or warning strokes - typical stroke warning signs develop • temporary interruption of blood to brain – but tends to resolve itself on it’s own • strong indicators of a possible major stroke • steps should be taken immediately to prevent a stroke

  14. TREATMENT Immediate Medical Care is Crucial! • This can help minimize brain damage and dramatically increase the chance of recovery. • After the onset of stroke, there is a limited "window of opportunity" of six hours, for the person to receive interventional treatment that can prevent damage.

  15. TREATMENT • Clot-busting medication can be given within three hours of the onset of stroke that will dissolve the blood clot and restore normal blood flow to the brain. • Within six to 12 hours, patient can undergo a surgical catheterization procedure to break up the blood clot. • Beyond that time period, options for treatment become more limited.

  16. EFFECTS OF A STROKE • 10 % of stroke survivors completely recover • 25% recover with minor impairments • 40% experience moderate to severe impairments that require special care • 35% are require nursing home care or die shortly after the stroke.

  17. EFFECTS OF A STROKE • the location of the obstruction • how much brain tissue is affected • health before stroke **********  Because one side of the brain controls the opposite side of the body, a stroke affecting one side will result in neurological complications on the side of the body it affects.

  18. EFFECTS OF A RIGHT HEMISPHERE STROKE Left side of the body (and the right side of the face) will be affected, which could produce any or all of the following: • Weakness or paralysis on the left side of the body    • Vision problems    • Quick, inquisitive behavioral style    • Short-term memory problems

  19. EFFECTS OF A RIGHT HEMISPHERE STROKE • Short-term memory problems • Problems distinguishing distance, up or down, front or back • “Neglect” --forgetting or ignoring objects on left side, may ignore own left arm or leg

  20. EFFECTS OF A STROKE

  21. EFFECTS OF A LEFT HEMISPHERE STROKE The right side of the body (and the left side of the face) will be affected, producing some or all of the following: • Weakness or paralysis on the right side • Trouble reading, talking, thinking, doing math    • Slow, cautious behavior     • Memory loss—needs frequent instructions or feedback

  22. EFFECTS OF A STROKE

  23. BRAIN STEM STROKES Uncommon type, at base of brain above spinal cord, may cause problems with: • Weakness/paralysis on both sides of body • Breathing and heart functions • Body temperature control • Balance & coordination • Chewing, swallowing, speaking

  24. EFFECTS OF A STROKE

  25. APHASIA • A communication disorder that affects a person’s ability to speak, understand speech, read and write • One or all these areas may be affected • Ranges from mild to severe • 20% of stroke survivors develop aphasia

  26. APHASIA • Aphasia does not generally affect the ability to think, reason and understand. • Most aphasics know what they want to say - they just have trouble putting their thoughts into words. • A similar inability to understand non-verbal forms of communication such as gestures and facial expressions may also exist.

  27. COMMUNICATING • Speak more slowly and keep to the topic • Use short sentences and common words • Ask “yes” or “no” questions • Point to things or pantomime

  28. HOW TO HELP COMMUNICATE • Break instructions into simple steps • Allow extra time for person to respond to you • Watch for gestures or expressions as clues • Avoid excluding person from conversation

  29. REHABILITATION IS VITAL… • to help the patient recover as quickly and completely as possible • important to start therapy at about 24 hours after the stroke

  30. PHYSICAL REHABILITATION • To retrain person to walk or regain use of part of body affected • To help the stroke patient relearn simple motor activities, like walking • To maintain flexibility

  31. OCCUPATIONAL THERAPY HELPS: • Build upper body strength • Improve motor and sensory skills • Relearn everyday activities: • eating, drinking and swallowing • bathing, dressing, grooming, toileting • reading and writing

  32. OCCUPATIONAL THERAPY • Helps patient set goals to become more independent • Breaks complex activities into parts and sequences and gradually increases the complexity to improve strength, dexterity, perception, cognition and self care • Progress depends on impairment and strength

  33. SPEECH THERAPY HELPS: • relearn how to use language • develop other ways of communicating: pictures, gestures, body language or word board device • develop strategies to maximize remaining language function

  34. POST STROKE DEPRESSION • Most survivors feel fear, frustration, anger, sadness • Some changes caused by physical effects of brain damage • 50% chance of major depression within 1 year of stroke

  35. POST STROKE DEPRESSION • Impairs recovery of function • Women are at greater risk of developing major post stroke depression (PSD) • Risks of depression: • 2.6 times more likely to have another stroke • mortality rate is 3.4 times greater

  36. SYMPTOMS OF POST STROKE DEPRESSION • Anhedonia—loss of pleasure • Sleep disturbances • Social withdrawal • Loss of appetite • Guilt • Lethargy • Concentration and memory problems • Suicidal thoughts

  37. WHY TREAT PSD? • If untreated, 40% of patients will never recover, but will develop chronic depression • A patient with major PSD is more likely to recover • Minor depression is more likely to become chronic

  38. HOW IS PSD TREATED? • Anti depressant medication • Psychological therapy • Physical and speech therapy • Combination of therapies

  39. CAREGIVERS NEED: • Information about stroke and its impacts, prognosis and the rehabilitation process • Education about the physical and psychological needs of stroke survivors • Support Networks • Practical Assistance in caring and coping skills

  40. PRACTICAL MEASURES Adaptive clothing makes things easier: • Avoid tight-fitting armholes and pant legs • Clothing should fasten in front • Velcro on shoes and clothing, instead of buttons/zippers TIP: Get dressed using unaffected arm to dress the affected one first

  41. RECREATION & LEISURE • No need to give up hobbies or leisure activities • A recreational therapist will help to adapt activities so they remain “doable”

  42. RESOURCES • Stroke Recovery Warm-Line 1-888-540-6666 • For non-critical, non-crisis support • Run by stroke survivors, family members and care partners • www.strokerecoverycanada.com • Ontario March of Dimes www.dimes.on.ca

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