Health, Diseases and Conditions
Care of patients after a stroke. Rehabilitation after a stroke
One of the most difficult conditions in neurology is a stroke. What is it, what are its consequences and how to help the patients who have suffered it?
What is a stroke?
Stroke is now understood as an acute disorder of the cerebral circulation, which develops as a result of thrombosis or narrowing of the cerebral vessels.
There are two main forms of stroke - hemorrhagic and ischemic.
Hemorrhagic stroke is characterized by a hemorrhage into the brain tissue. It develops sharply. Most often, the cause of its development is hypertension. It is characterized by a sharp onset, rapid loss of consciousness. The amount of damage to the brain tissue depends on the severity of the hemorrhage (the faster the bleeding stops, the better the prognosis).
Ischemic stroke, in turn, develops gradually, against the background of atherosclerosis of cerebral vessels and ischemic heart disease. It flows more favorably than the hemorrhagic form.
The rehabilitation period after a stroke is quite severe for the patient. If you do not provide him with appropriate care, the risk of irreversible damage to all the functions of the patient's body is high.
Rehabilitation after a stroke
As you know, no matter how severe a stroke, with properly organized care for the patient there is the possibility of a full recovery of the patient's life with the return of it to the sphere of society.
The most important in this period is the observance of certain rules, principles and norms in communicating with the patient.
First of all, it should be borne in mind which stroke developed in humans and which part of the brain is damaged, because the clinic of lesions of the different hemispheres differs from each other.
It should be remembered that all activities and exercises need to be carried out consistently, according to the plan drawn up. Only then will care for the sick after the stroke be the most complete and allow the victim to get back on their feet as soon as possible.
It should always be remembered that stroke treatment is not a one-day and not a week process; Only persistent and correct treatment will be effective and lead to proper recovery.
Drug therapy
Drug treatment after a stroke is appointed already in intensive care. The accuracy and correctness of the administration of doses makes it possible to withdraw the patient from the coma and limit the area of the lesion in case of hemorrhagic stroke (with ischemic stroke - restore cerebral circulation).
After the transfer of the patient to the department, he is assigned maintenance therapy, which allows to consolidate the achieved results. Care should be taken to ensure that the patient regularly takes all the medications prescribed to him. If he can not take them on his own, you need to help him in this (sometimes support his head, help swallow, crush the tablet to a powdery state).
Treatment after a stroke at home begins after discharge. Assistance to the victim should be the same as in the hospital (support the patient, tilt it, apply water). In no case should you not allow the patient to miss the medication.
Food
This factor is one of the most important in the period when there is an active rehabilitation after a stroke.
It should be remembered that because of the developed disease, most patients lose the ability to self-feed. It should be actively help them in eating (in the early stages of maintaining a plate and spoon, prevent the choking of patients). Later, when he can already try to service himself, it is necessary to monitor how the patient eats and, if necessary, helps him.
Patients after a stroke need a healthy diet. The man's diet should be filled with vegetables and fruits, meat. Only then is the most effective restoration of affected areas of the brain ensured.
From everyday use, all products that increase blood pressure, as well as acute, smoked, should be excluded. Do not feed patients with bulk products, since the risk of their getting into the respiratory tract is high.
Prevention of infectious diseases
As is known, recumbent patients are classified as severe and are at risk of developing infectious diseases. In such patients, bedsores often appear - local areas of inflammation and necrosis. Especially in the case when the patient for a long time lies in one position. Because of this, stagnation of blood and lymph takes place in places of the bony protuberances, which leads to maceration, infection and necrosis.
Care for patients after a stroke in this situation should include daily hygienic wiping (if possible - using a bath or shower). The patient's bed is recommended to be changed as often as possible, do not allow the formation of wrinkles on it. After each meal, it is desirable to shake it to remove the fallen crumbs.
Another fairly common complication in recumbent patients is pneumonia. To prevent its development, it is recommended to avoid hypothermia of patients (and also overheating). Periodic ventilation of the room is shown, thorough cleaning. For the purpose of prevention, you can ask the doctor for a prescription for injectable or oral antibiotics.
Restoration of motor functions
This group of measures is appointed in the event that there are certain motor disorders.
At the initial stages of the patient, they are taught to keep objects. Over time, it is possible to work with fine motor skills (sorting out coins or keys, opening locks).
It is not always possible to restore the movement completely. Despite this, all efforts should be aimed at returning the patient to society.
If the lower extremities were affected, recovery after a stroke begins with training steps. It is best to spend her lying in bed.
Begin the exercises with simulated steps. Over time, when a patient is able to "walk in bed", if he can not sit, then help him to rise, and further training he spends sitting.
Speech Reconstruction
Quite often, patients who have had a stroke have speech disorders. They can be either insignificant (mild lisp or swallowing of letters), and completely deprive the patient of speech (up to the publication of individual sounds).
On the other hand, the patient may not be aware of what is being said to him, which is written on a piece of paper. In this case, there is sensory aphasia, to cope with which is much more difficult than with speech impairment.
Recovery after a stroke accompanied by loss of speech should start with talking with the patient. If the patient understands what he is told, he can try to answer for himself or simply reproduce the same words. However, when sensory aphasia developed, the patient needs to be taught everything afresh - to explain the letters of the alphabet, to show how they are written.
Over time, speech after the stroke will gradually recover. The main thing is not to give up attempts and persevere until the end.
Psychoemotional disorders
Unfortunately, many people who have suffered a stroke are at risk for developing these complications. After all, any disease for a person - stress, but here there is almost complete shutdown of a person from society. Against this background, many patients who are aware of their condition are locked in themselves, shielded from the relatives seeking to help them.
All this adversely affects the ongoing treatment and leads to a delay in complete cure.
In this case, recovery after a stroke should be combined with active communication with the patient. It is necessary to periodically tell him something cheerful, help to unwind. Only then the person ceases to be locked in himself, seeing that someone else needs him. Improves his mood, there is interest in life.
Do not try to raise the mood of the patient medications - there is a risk of severe post-medication depression. It is much easier to show a patient that he is being taken care of, he is loved, and then a person will soon recover after a stroke.
Neurological disorders
Many strokes are accompanied by a violation of the sensitivity of the affected limbs. Sometimes there is only a reduction in the pain threshold; Anesthesia (complete impairment of sensitivity) and paresthesia (sensation of chills or chills) may be noted less frequently.
In this case, rehabilitation after a stroke can be useless, and with the manifested violations it is necessary to live for the rest of your life. In order to increase sensitivity, physiotherapy is recommended - the "Bioptron" lamp, impulse currents. In some cases there was a restoration of sensitivity (if the lesion in the brain was not extensive).
Occasionally, pathological reflexes may appear (for example, a grasping reflex that is present in newborns before 4-5 months, should not appear in an adult). If you notice that the patient's hand after the stroke began to shrink when you touch it, you should either wait a while (the reflex may disappear after treatment) or consult a neurologist. Sometimes this reflex can last a lifetime.
Physiotherapy
To restore muscle activity immediately after the acute period has passed and the patient has already started to get up and sit down independently, special exercises should be performed after a stroke.
Physiotherapy includes gymnastics (flexing and extending the arms and legs, warming up the fingers, trying to weave or folding small mosaics) and massage.
It is best to do exercises with the patient in the pool. Water helps to reduce the load that affects the affected limbs, resulting in motor rehabilitation after a stroke occurs much faster.
After performing the exercises, we recommend relaxing baths and hypnotherapy.
Treatment in rehabilitation centers
Whatever the good treatment in hospitals, and at home - care, patients are best recovered after a stroke in specialized centers.
Many neurologists recommend immediately after discharge from the hospital to send the patient to the rehabilitation center. After a stroke, the first month is extremely important, since it is in this period that it is possible to restore the patient's activity with properly selected therapy.
It is there that the best specialists in the field of rehabilitation are gathered, who will help to formulate a program of treatment competently with achieving the best effect in treatment.
The right combination of medical support, exercises and physiotherapy allows you to put the patient on its feet in the shortest possible time.
Care for patients after a stroke in these centers is carried out around the clock. Each patient is assigned a nurse who cares for him and monitors his health.
Professional and social adaptation
Unfortunately, quite often after a stroke, a person's professional skills are lost. This condition can be suppressed by trying to re-train the patient's work activity. If it can not be restored, a person is assigned a disability group (usually the third one). This applies to specialized skills (for example, it is not recommended to return to work for doctors - especially neurosurgeons, turners, jewelers). At the same time, the ability to work together and self-service can be maintained.
If general labor skills are lost, the patient can apply for group 2.
If you lose the ability to self-service to a person, you need to attach the nurse. In this case, rehabilitation after a stroke continues throughout life. In addition, 1 group of disability is established (that is, it is considered that a person is not adapted to existence in society and he needs an assistant).
Where to treat a patient after a stroke?
For many people, caring for a patient who has undergone a stroke is extremely difficult work. Not everyone is ready to take care of a seriously ill person, because this way all your free time is lost. Many people who remain confined to bed change their character (quite often - for the worse). Because of this, no one wants to deal with the patient (even if it is the next of kin). In this case, the best way is to send the patient to the rehabilitation center after a stroke. However, not everyone can afford the services of such institutions. In this case, the only solution is to restore the patient at home.
Some particularly irresponsible people send the patient to the orphanage, refusing him. Nevertheless, it should be remembered that in these establishments the patient receives less necessary care, because of what in most cases he becomes disabled.
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