Caring Stroke Patients
Stroke can cause various degrees of brain damage that may lead to different levels of physical, cognitive and speech impairment. Such disability affects the daily living and self-care of stroke patients. Applying the appropriate care is of utmost importance in helping the stroke patient to cope with these disabilities and to improve their quality of life.
Caring goals:
- To help the patient to adapt to the disability and gain independence.
- To maintain the body in optimum status to prevent complications.
- To improve the patient's quality of life.
Points to Note when Caring for Stroke Patients:
1. Encouragement of self-care
Encourage patients to take responsibility of their personal hygiene such as combing and changing clothes according to their functional ability. Provide them with a well-ventilated, warm and clean living environment.
2. Psychology of stroke patients
A warm, caring approach is important in helping stroke patients to cope with the tremendous changes and challenges ahead. Professional help should be sought if patients develop symptoms or signs of depression.
3. Nutritional care
A balanced diet using the principles of the Healthy Eating Food Pyramid should be offered to the patient in order to ensure adequate nutrition and to maintain ideal body weight. Easily digestible food is preferred.
4. Bowel and bladder care
Identify the causes of incontinence so as to provide specific management. For those using urinary catheters, the catheter should be properly fixed and changed whenever necessary. Check for any sign and symptom of urinary tract infection and seek medical advice when necessary.
5. Limb exercises
Performing mobilization exercises and maintaining a good posture help to maintain the range of joint movements and prevent contractures.
6. Communication
A patient with speech or comprehension difficulties may experience significant communication problems. Patience and appropriate encouragement helps the patient to communicate more effectively. The use of simple words, body language, real objects, and word cards may help the patient in overcoming his communication problems.
Prevention of complications
1. Pressure sore
Being bed-ridden together with reduced activity increase the risk of localized skin damage due to prolonged pressure.
Prevention:
- Relieve localized pressure over the skin by turning every 2 hours and massaging.
- Protect the skin by keeping it dry, clean and soft.
- Perform regular exercises and improve nutritional status.
2. Chest infection
Being bed-ridden and lacking in physical activities, stroke patients often have weakened body resistance and reduced ability in clearing secretions from their lungs. Hence, they are usually more prone to chest infections.
Prevention:
- Increase body resistance by performing exercise and eating a balanced diet.
- Change body positions frequently, sit upright when eating, increase fluid intake and perform deep breathing exercises.
3. Choking
Patients may have difficulties in swallowing after a stroke. Prepare food according to health professional's advice and closely observe the patients when they eat.
Prevention:
- Encourage patients to take in small amounts at a time and prepare food in small pieces for easy swallowing.
- The following types of food should be avoided or to be taken with care
| Types of food | Examples |
|---|---|
| Sticky | Peanut butter, mashed potatoes, melted cheese |
| Too hard | Nuts |
| Chewy or hard to control | Marsh mallow, caramel, chewing gum, peas |