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Coping With Physical Effects
Rehabilitation
It is important to start rehabilitation as soon as possible. Many people who are admitted to hospital have gone through rehabilitation before they return home. If the person who has had a stroke is not admitted to hospital and the GP does not mention rehabilitation services it may be worth asking about.
It will be helpful to be involved in meetings with therapists at the start so you can learn the exercises along with the person you care for. This will help you understand what is needed and give him or her extra encouragement to do exercises regularly.
Lifting And Moving
The physiotherapist, district nurse or occupational therapist can show you how to move and handle the person you care for so as not to cause injury to him or her—or to yourself. If the stroke has resulted in a weak arm, take care never to lift the person you care for by pulling on it. This may damage or even dislocate the shoulder.
- Positioning F16 [137K PDF]
Swallowing
If the stroke affects any of the muscles and nerves involved in swallowing it can cause difficulty with eating and drinking. If not tackled, swallowing difficulties can lead to other problems such as dehydration and constipation due to lack of fluids or a chest infection because food or saliva passes into the windpipe.
If the person who has had a stroke has difficulty swallowing, ask the GP to arrange a swallowing assessment. The specific cause of the problems can be identified to ensure adequate nutrition and prevent complications.
Continence Problems
A stroke can lead to a loss of bladder control—urinary incontinence, bowel control—faecal incontinence, or both—double incontinence.
Incontinence is not necessarily permanent. Bladder and bowel control can be affected for many different reasons. For some people it is a matter of time—control will improve with general recovery. For others, specific help or treatment can be given. Discuss the problem with your GP or hospital doctor.
Contact The Continence Foundation
Communication
If the stroke has affected a person’s ability to understand, speak, read or write it is important to get the problem accurately assessed by a speech and language therapist. The therapist will draw up a plan of treatment to help recover the language that has been lost and explain how to make the most of the communication skills that remain.
The daily practice of skills at home, and the involvement and encouragement of relatives and friends can make a big difference to the level of recovery. At Chest, Heart & Stroke Scotland (CHSS) we have special groups around the country for those people who have speech and language problems. This is known as the Volunteer Stroke Service. Volunteers and staff are trained to teach supported conversation. For more details telephone us on 0131 225 6963.
Falls
Someone who is learning to walk again is likely to fall more easily. Be prepared for this, but do not prevent the person you care for from being active, as this will slow down their mobilisation.
Try and make the environment as safe as possible, keeping the floor clear of obstacles and loose mats and avoid uneven surfaces. Encourage the use of sticks or zimmers if they have been provided.
If someone has visual problems their safety can be affected and they may need more support.
A physiotherapist can offer advice and guidance on safety issues. Don’t let the person tackle stairs alone unless they have been checked to be safe by a physiotherapist.
Epilepsy
In a few people, the scar that results from the stroke can irritate the brain and cause seizures, sometimes weeks or months or even years later.
If someone has a seizure
- clear a space around the person
- loosen tight clothing
- place the person in recovery position once the seizure has run its course
Don't
- lift or move the person unless they are in danger
- try to restrain or put anything in the mouth
- offer anything to drink until the person is fully recovered
Most people who experience seizures are prescribed medication to control this.
You should phone 999 if
- it is the persons first seizure
- the jerking phase lasts more than 5 minutes
- there are repeated seizures without recovery in between
- the person has been badly injured
For detailed information about the different types of seizures and treatment for epilepsy contact
Central Post Stroke Pain
A small percentage of people who have strokes develop central post-stroke pain (CPSP) some time afterwards. This is a burning, shooting and throbbing pain that is not eased by painkillers.
It can be treated, but the condition is not widely understood and can be difficult to diagnose. Speak to your GP, Stroke Nurse, Stroke Physician or phone the CHSS Advice Line 0845 077 6000 for more information.
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