Stroke – What Happens Next?
A friend called recently and wanted my thoughts or suggestions about the care of her husband, who recently suffered a TIA (Transient Ischemic Attack) or stroke. It was not a major stroke, but has affected his speech and mobility on his left side. Normally when I speak to clients or at presentations, I will refer to the standard recommendations by the American Heart and Stroke Association. However this was different and brought back memories of when my husband had his Transient Ischemic attack (TIA) seven years ago. When this happened, our world changed.
A Transient Ischemic Attack or TIA is a “temporary blockage of blood flow to the brain” (American Heart Association, 2018). TIA’s are often called mini strokes and can indicate a coming stroke. According to the American Heart Association, “Warning strokes are often followed by more severe strokes. Approximately 15% of all strokes are heralded by a TIA. Warning strokes are often followed by more severe strokes. About a third of the people who have a TIA go on to have a more severe stroke within a year” (American Heart Association, 2018).
So, what happens after the Emergency Room visit? First, you will need an immediate follow up appointment at your primary care doctor’s office, which will probably include medication changes. Doctors may order a CT Scan or MRI to confirm a stroke and other tests which could include blood tests, ECG, blood pressure, and carotid doppler.
What do you do when your loved one now suffers from Aphasia (loss of ability to understand or express speech, caused by brain damage) or suffers from mobility changes (weakness on usually one side of the body) or vision and confusion difficulties? What do you do when you’ve watched your love one try say a sentence and only get one word out, or the confusion, or inability to move an arm, you see the fear, frustration, and anxiety. What is next?
What happens next is to gather all information, resources, and enlist family and friends. This is when you find your strength, commitment and determination. You draw on family and friends for their experiences, ideas, and suggestions. Your loved one is going to be exhausted from the overall trauma to the body, – sleep, rest, recovery is most important. This is the time to observe, assess, and prioritize the highest issue of damage.
Start to set goals. It is difficult to estimate how long for recovery and how much someone will recover. For some, recovery may be a slow process, while others recover faster. There are a number of factors on recovery to include, age, prior chronic illnesses, and how one contributes to their recovery – i.e. positive attitude, determination, faith, and allowing the support of family and friends.
It is imperative to gather an appropriate team of healthcare professionals. Talk to the primary care physician. Work as a team to request referrals for specialists and assess and diagnosis. For example, speech and swallowing difficulties – ask for speech therapist; paralysis/sensory impairment – ask for physical therapy, Neuroplasticity & Rehab Exercise; vision – ask for ophthalmologist for eye exercises and treatment; memory impairment, confusion, paying attention – ask for neurologist. Ask each specialist to give “homework assignments,” and everyday do an exercise, watch for the small changes, and set goals and timelines, just be prepared for “two steps forward and one step backward.”
Remember every stroke is unique and different, but you will find similarities when you start to talk to others. As the main care provider ask for help, go out with friends, have family and friends take your loved one out, so you can have time for yourself – this has to be a high priority and goal. This is a journey and not a fast one, but always believe in yourself and you’re loved one’s ability and you both can become stronger after a stroke.
Deon is a Certified Care Manager and the Clinical Supervisor for Elder Options, Inc. She brings a wealth of knowledge about POLST, Parkinson’s disease, VA benefits, and entitlement and waiver programs to the Elder Options team. Deon’s passion for care management grew from a commitment to advocate and support older adults, disabled, and vulnerable populations.
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