Prevention is the best option

Stroke. How 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. Vascular in origin, a stroke is considered a medical emergency that requires immediate diagnosis and treatment.

The person who has suffered a stroke usually needs further rehabilitation but, in general, it is important to respect their initiative and autonomy, even if it takes them longer, and to avoid overprotection.

Description

Recommendations and treatment for relatives and carers

 

Communication

  • Speak naturally, using simple words and short sentences, without shouting.
  • In the first phase after a stroke, ask short, yes/no questions.
  • Promote conversations about every-day life and familiar situations to stimulate the patient’s language.
  • If necessary, accompany conversations with gestures to facilitate understanding.
  • Items such as the radio or television should be turned off to avoid distractions.
  • Respect the response time: avoid showing impatience or cutting off the patient.
  • In serious cases, you can use alternative means of communication, such as boards with everyday images on them. There are also mobile apps that can help.

Movement

  • Do the exercises recommended by the physiotherapist.
  • Move joints and avoid incorrect positions.
  • When moving a patient, never touch the affected side.
  • It is important that the patient be out of bed for as long as possible.
  • Pillows should be used to protect zones of friction and position should be changed every four hours.
  • Before the patient drives again, a specialist should be consulted.

Sleep and rest

  • It is recommended to sleep seven or eight hours a day.
  • Provide a quiet environment and provide a point of light so the patient can orient themselves during the night.
  • Create a day atmosphere (more active, bright) and a different, night atmosphere (quieter, darker). This helps in understanding the sleep pattern.
  • Avoid letting them sleep during the day, except for a short afternoon nap.
  • After a stroke, the patient may find themself more tired for a while. It is important to become more active but without forcing it.

Hygiene

  • Encourage the patient to collaborate in their personal hygiene.
  • Whenever possible, use a shower, instead of the bathtub, with a chair inside and a handle on the wall.
  • The soap should be neutral and free of alcohol, as this can dry the skin.
  • The skin should be dried properly, taking special care with folds. It should then be hydrated and protected.
  • Maintain proper oral hygiene.
  • Watch bony prominences to prevent pressure sores.

Getting dressed

  • Wear comfortable clothes that are easy to put on and take off, such as sportswear with elastic and no buttons.
  • Start dressing the patient on the affected side and undressing them on the side that is not affected. It is preferable to be seated.
  • To put on trousers (pants), especially if the patient is in bed, it is easier to gather up the trousers, insert one leg at a time and then pull them up.
  • Shoes should be closed, with no laces and non-slip soles, which fit the foot well. Shoehorns can make it easier to put on shoes.
  • The patient feels the same degree of cold and heat as the carer, so do not give them too many layers.

 Physical obstacles

  • Remove obstacles such as carpets or chairs to avoid tripping.
  • Adapt the home to the new situation: install bars, a taller toilet or shower, etc.
  • Adapt the home to improve patient autonomy and prevent falls. For example: have a high bed (70 cm) to make it easier for the patient to get up and down comfortably.

Leisure and recreational activities

  • Maintaining social life and hobbies, while respecting the limitations of the patient, improves self-esteem and avoids isolation.
  • Incorporate leisure activities gradually, according to the degree of autonomy and in consensus with the patient.

Sex

  • Immediately after a stroke, sexual desire may decrease, but it will gradually recover. If in doubt, consult a doctor.
  • Paralysis may make sex trickier, but not impossible.
  • Fear of suffering another stroke during sex is generally unfounded.
  • It is important to talk to your partner about any fears or worries that may arise.

Return to work

  • The return to work must be planned, together with the company, so it is gradual, both in terms of demands and time.
  • After re-joining the workplace, the situation should be re-evaluated in case changes or adaptations need to be made to improve patient performance and ability.

 

 

Author:

Estela Sanjuan
Research nurse. Coordinator of research and clinical trials at the Stroke Research Group at the Vall d'Hebron Research Institute.

  
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