Coping with Adults with Stroke During COVID-19

Coping with Adults with Stroke During COVID-19

Stroke – Symptoms and causes, In the current situation of the pandemic, we are all trying to adapt to the new normal with its unexpected changes and the challenges. Wearing a mask, maintaining social distancing, avoiding meeting relatives to be precautious, online classes, using sanitizer these have become our new normal. Along with new normal routines, everyone is always anxious about contracting COVID-19.  All we have to do is stay updated and be aware of the facts though reliable sources and take up precautionary measures as guided by the Government and Medical professionals. 

Hospitals and medical professionals have multiple challenges to take up extra care to treat, many other health problems, one among which is stroke. Special caution will be required and is taken care in the hospitals and by medical professionals to differentially diagnose the stroke patient with and without COVID-19 and treat them accordingly and provide emergency services.  

What is stroke?

Stroke occurs when there is disruption in the blood flow to the brain due to blockage [Ischemia] or rupture [Hemorrhage] of blood vessels that carry oxygen and nutrients to the brain. The stroke occurs suddenly and needs medical attention immediately. Knowledge about early signs and symptoms during the attack of stroke in an individual can be life saving/ can be helpful in restricting the damage to the brain for a smaller region. 

Ischemia

 

Hemorrhage

How do we detect the early warning signs of stroke?

Stroke occurs suddenly, it is important to detect it early and provide immediate medical care. Ischemic stroke is the most common type of stroke which occurs. The “golden hour” [First hour] is important because with the immediate medical care provided [clot-busting drug called TPA (Tissue Plasminogen Activator) for ischemia], there can be greater chance of survival and avoids more damage to the brain. BEFAST- these are the symptoms mentioned below which need to be detected and medically addressed at the earliest.

What happens after a stroke?

The blood flow disrupted to the brain can lead to damage of blood cells. Based on the part/s of brain which is affected the following listed Cognitive –communication and swallowing difficulties can be noted

  1. Dysarthria: Slurred and imprecise speech due to muscle weakness
  2. Aphasia: Loss of ability to speak/write/read [degree of loss can vary for each skill based on the part of brain affected] and communicate because of left hemisphere damage
  3. Apraxia of Speech: A neurogenic speech disorder showing poor planning and programming necessary for speech production
  4. Cognitive deficits: Memory deficits, problem solving difficulties, poor judgment 
  5. Right Hemisphere Damage: difficulty to understand prosody, pragmatics, humor, some cognitive difficulties
  6. Dysphagia: Difficulty in swallowing 

For better Quality of Life and to be independent for activities of daily living, the rehabilitation services should be provided from the point of hospitalization, to discharge from hospital and after coming back to home. Many professionals are involved in the rehabilitation team for stroke patients.

Speech Therapy exercises for stroke management.

Recovery and rehabilitation 

Recovery happens with time, due to internal healing naturally and also new parts of the brain getting activated as it is stimulated to perform different functions [trying to relearn the lost skill through therapeutic exercises and activities]. The following multidisciplinary team will be required to work efficiently to help in rehabilitation

Team of specialist:

  1. Neurologist: Help in identifying the deficits in nervous system and providing appropriate medical care
  2. Radiologist: Help in neuro-imaging using CT scan MRI, etc. and studies the reports to determine presence and extent of lesion.
  3. Nurse: Help in initial care and co-ordination between patient, family and doctors
  4. Physiotherapist : Help individuals with gross motor difficulties which affect movement, strength and balance  post stroke.
  5. Occupational Therapist: Help individuals to exercise and practice performing skills required for daily living and work [such as eating, dressing, writing, or cooking, etc.] which are affected post stroke. 
  6. Social worker: Help the individual to integrate to the community at the functional, social and economical level.
  7. Dietician: Help in planning balanced diet for specific individual, based on associated medical history [such as Diabetes, Cholesterol, etc]
  8. Psychologist: Help in dealing with behavior problems
  9. Speech language pathologist: Help in enhancing the communication  skills and swallowing abilities
  10. Family Members and friends: They play an active role in overall rehabilitation, providing a friendly environment, supporting in adaptation to the changes at home and work after stroke.

Communication and Swallowing:

Communication and swallowing are essential skills to fulfill our basic life requirements. For example an individual after stroke wants to say he has pain in his stomach, or the food is spicy etc, he/she cannot say it as there is loss of speech or weakness. Weakness in the muscles following stroke can lead to difficulty in chewing/ controlling food inside the mouth/ food wrongly entering into the windpipe, such deficits in swallowing can lead to choking which can be very critical. Guidance from Speech-Language Therapist for stroke patients is very crucial to provide recommendations and provide therapy services to enhance and cope up communication and swallowing abilities. 

Further you can obtain details on Speech- Language therapy and Swallow therapy in the following links: Speech Therapy Exercises for Stroke Management, Tips To Improve Speech After A Stroke, Swallowing: The WH’s of Dysphagia

With the above details about stroke, changes that occur after stroke, early detection of warning signs, rehabilitation team, the importance of Speech-Language and Swallow therapy, we shall just have a brief insight on tips to cope up with Communication and Swallowing difficulties after a stroke.

Quick tips:

 

  1. If the person is not able to express his/her pain you can use visual cards to indicate which body part is paining and the severity. This is helpful for patients who very less expressive and need more care after discharge
  2. Use more visual pictures to help communicate basic requirements such as food, toilet, clothing
  3. Prevention of stroke: Prevention is better than cure: During this COVID 19 Stroke care is more challenging in hospitals. We need to be aware of the possible causes and prevent the occurrence of stroke. Individuals who already have one stroke attack might have increased risk of another stroke, which can lead to further damage of the brain. The following lifestyle modifications can reduce the risk factors causing stroke.
  4. Speak slowly and use simple sentences- this will help them to understand you better
  5. Use simple utensils, recommended diet and type of food suggested by the Dietician and consistency of food suggested by Speech language therapist
  6. Maintain oral hygiene to avoid cause of pneumonia when there is swallowing difficulties
  7. For memory difficulties: Give repeated reminders, use reminders [visual] for routine and any task
  8. Individual may face problem in processing and understanding when there is noise or man disturbances- Use simple sentences, keep the environment quiet so that the can attend to it completely
  9. Help the individual to connect to family and friends socially. Social distancing does not mean no socializing, Connect to Family and friends regularly via teleconference and encourage the individual to indulge and interact
  10. Engage the individual in many activities which require mental abilities [in games such as cross words, suduku, puzzles, etc] it will enhance brain activity
  11. Create a routine, have family time and encourage the individual to try something new. Speak about earlier events and incidents, speak about the current affairs, enjoy activities together such as singing, etc.
  12. There are multiple apps which can be used to help person with communication difficulties which can be used as guided by Speech-Language Therapist
  13. Proper rehabilitation services to be availed at the earliest, however in this pandemic period, there is high risk to take up direct therapy. You can avail online rehabilitation services. Tele services are growing since the pandemic period.  These tele services will be helpful in obtaining and working for tailor made goals to enhance various skills of the individual.

Say yes to social distancing and no to distancing the rehabilitation services that need to be provided for stroke management. 

 

 

If you wish to know more about Speech Therapy, kindly contact us at info@1specialplace.com

https://therakonnect.com/appointments/book/1specialplace

For more ideas check out our other blogs https://1specialplace.com/news/

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(1 Comment)

  • Vasanth

    Very detailed study and report-appreciated

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