Prevention is the best option

Health tips to care for patients who have suffered a stroke

Cures per a pacients amb ictus

A stroke is a clinical syndrome characterised by rapid development of signs of neurological involvement lasting more than 24 hours. A stroke, vascular in origin, is considered a medical emergency that requires immediate diagnosis and treatment.

 

Description

Recommendations and treatment for relatives and carers

 

Communication

 

  • Talk naturally to the patient.
  • Speak slowly using easy words and short sentences and helping with gestures.
  • Ask questions with yes and no answers.
  • Give them time to respond. Do not show impatience when it comes to responding and do not try and answer for them.
  • Do not shout.
  • You can use alternative means of communication, such as boards with everyday images on them.


Movement

 

The degree of movement will depend on each patient.

  • Try to encourage them to do the exercises recommended by the physiotherapist.
  • Move joints and avoid incorrect positions.
  • When moving a patient, never touch the affected side.
  • Avoid long periods in the same position, change the patient’s position every four hours.
  • Use cushions or pillows to protect areas that rub.
  • It is important that the patient is out of bed for as long as possible. 
  • When they first start to walk, stop them from falling

 

Sleep and rest

 

  • Create a quiet atmosphere.
  • Avoid letting them sleep during the day, except during one afternoon nap.
  • Provide a source of light so that they can orientate themselves during the night.

 

Hygiene

 

  • Always taking into account the patient’s condition, try to have them help as much as possible with their own personal hygiene.
  • Dry them properly and make sure to dry skin folds.
  • Hydrate and protect the skin.
  • Do not give them alcoholic drinks because they cause dry skin.
  • Watch bony prominences to prevent pressure sores.
  • Never forget oral hygiene.

 

Getting dressed

 

  • Use comfortable clothes that are easy to put on and take off (tracksuit, elasticated, etc.) And shoes that fit properly.
  • Start dressing the patient on the affected side and undressing them on the side that is not affected.
  • Try to make sure they are sitting down when dressing and undressing them.
  • Use shoehorns.
  • Remember that the patient feels the same degree of cold or heat as the carer, do not give them too many layers.

 

Architectural obstacles

 

  • Remove obstacles (such as rugs and chairs) that may be trip hazards.
  • Adapt the home to the new situation (fitting bars, a taller toilet or shower, etc.).

 

Going to the toilet

 

Constipation is the most common problem. The following advice is recommended to avoid it:

  • Follow a diet rich in fibre
  • Establish a fixed routine for going to the toilet
  • Promote mobility. 
  • Go to the toilet when possible.
  • Laxatives or enemas may be provided on prescription.

 

To combat diarrhoea the patient should:

 

  • Eat more dry foods.
  • See a doctor if they have diarrhoea for more than two days.

 

Passing urine

 

  • Take note of the quantity and frequency of urine (incontinence, urine infection and retention).
  • If the patient is incontinent, use pads or slips.
  • Keep the skin clean and dry, use protective ointments.
  • If there is only a small amount of incontinence, encourage bladder retraining.
  • Suggest they go to the toilet more often.
  • The patient must drink one and a half litres of liquid a day and reduce liquid intake from late afternoon onwards.

 

Diet

 

  • A varied diet rich in proteins and fibre and low in salt is recommended, avoiding fats and fried foods.
  • If the patient has difficulty swallowing (dysphagia):
    • Adopt the correct position, making sure that the patient is seated upright.
    • Feed them on the healthy side.
    • Avoid distractions.
    • Use small mouthfuls, do not use straws or small bottles.
    • If they have a cough, use thickeners when indicated.
    • Food should be given in small portions bit by bit, make sure that pieces are not left in their mouth.

 

Leisure and recreational activities

 

  • Try to ensure that the patient continues to have a social life and keeps up with their interests, bearing in mind their limitations.
  • Keep the patient distracted.
  • Avoid the patient becoming isolated.

 

Sex

 

  • It is normal for patients to lose their sexual desire initially. This will gradually recover over the course of a few months.
  • It is very important to talk to their partner about any fears they may have.
  • Fear of suffering another stroke during sex is generally unfounded.
  • Ask the doctor about the specific case.
  • Paralysis may make sex trickier, but not impossible.
 
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