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In medicinal science, stroke is a cerebrovascular disease.  When blood supply to the brain is reduced or blocked for certain causes, brain cells will suffer anoxia and become paralyzed within minutes, causing dysfunction of the part of the body that the affected cells are in charge of such as mobility, speech and understanding abilities.
 
Symptoms:
  • Slurred speech or expression difficulty
  • Sudden outburst of short periods of palsy, weakness or paralysis of one arm, foot or face
  • Sudden blurring of vision
  • Sudden severe headache
  • Difficulty in keeping body balance or maneuvering one’s hands and feet or sudden falling over unprovoked by external force
  • Dizziness or lightheadedness
  • Incontinence may occur
Transient ischemic attacks may last for only a few minutes and not disable one permanently. However, after one or several transient ischemic attacks, one should take heed of such warnings and consult a doctor immediately as a real stroke may strike.
 
For acute stroke patients, the initial stage of rehabilitation will be carried out in a hospital by a medical team comprising doctors, physiotherapists, occupational therapists and nutritionists.  They will have regard to the severity of the patients’ conditions, and train them  to adapt slowly to changes in their normal daily life.  After being discharged from the hospital and returning home, the patients will begin to face the difficulties of the caring period. 
 
Patients often have problems with daily life and self-care after suffering from strokes.  When taking care of patients, carers should pay attention to the following  to help improve  the patients’ quality of life.


Points to note when taking care of stroke patients 
 
Encourage patients to take care of themselves


Render appropriate assistance according to the ability of the patients, and let them try take care of their daily personal cleaning such as grooming and changing clothes.
 


Prevention for creating pressure sores


Prolonged confinement to bed and lack of physical exercise  exert excessive pressure on the skin and create pressure sores and skin ulceration.
 

  • Keep massaging and changing one’s lying posture once every two hours to reduce pressure on different parts of the body.
  • Strengthen skin care to keep skin clean, dry and moisturized.
  • Encourage patients to have more physical activities and pay attention to dietary nutrition.

Care of urination and excretion


Find out the main cause of urinary incontinence and apply appropriate treatment.  For patients with a urinary catheter, the urinary catheter must be fixed and replaced as needed, and the urethral orifice must be cleaned daily. Pay attention to signs of infection and treat them early.
 


Pay attention to balanced nutrition and eat carefully


Choose foods that are easy to eat and digest.  Pay attention to balanced nutrition and keep an ideal weight.  The amount of food can be based on the principle of a healthy diet pyramid  with more cereals, fruits,  vegetables, meat, fish, and eggs; milk and substitutes should be of an appropriate quantity for a balanced nutrition and enhancement of the body's anti-virus ability.  Diet should be light with a reduced intake of oil, salt, and sugar.
 
Some patients have difficulty in swallowing due to an impaired function of controlling the swallowing muscles of the mouth.  For these cases, follow the assessment and recommendations of the medical team,  prepare suitable food for the patients, and watch the patients closely while eating.

  • Food should be finely cut, and only small quantities should be taken at any one time.
  • Avoid providing foods that are prone to choking and coughing, examples are sticky food like mochi, hard food like nuts, and slimy food like beef tripes.

Physical exercise


Regular exercise and correct posture will keep the range of motion of the joints and reduce the chance of muscle atrophy and spasm.
 


Pay attention to patients' mental health


When suffering from the big changes caused by strokes, patients may have emotional problems and even induce post-stroke depression.   Carers should give due regard to the patients’ situations and pay attention to their psychological changes.  Through care, consideration and help, carers can face these changes and challenges together with the patients.  If depression is suspected of a stroke patient, seek assistance from the medical team.
 


Strengthening communication with patients


If the patients cannot speak correctly, cannot understand other people's messages, or cannot follow other person's instructions after understanding, these will increase the patients’ difficulty in communicating with others.  Therefore, patience and encouragement should be exercised when communicating with patients.  Simple words, gestures, and some auxiliary tools such as objects, pictures, or text can help communication.
 


Home Evaluation/Modification 


Stroke patients suffer from impaired physical functions, and their mobility will be impaired.  With the advancement of science and technology, new suitable products can be identified to assist with their daily life.  Occupational therapists can also perform home assessments for these patients and make recommendations for modification.
 


Support for carers 

Stroke patients who require high-level care should be taken to day care centers regularly to expand their social life where feasible.  At the same time, carers can join mutual help groups and share their experience with fellow carers to support one another and reduce stress in their work.



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