A stroke occurs when there is an interruption of blood flow to the brain. This can be caused by a broken or blocked blood vessel. The lack of oxygen causes the effected brain cells to die, setting off a chain reaction that spreads the damage to surrounding brain tissue. Abilities controlled by the effected area of the brain are compromised.
The location and severity of the stroke determine what abilities will be lost or damaged. For example, a stroke in the brain's right hemisphere affects the left side of the body, which interferes with spatial and perceptual abilities, results in impulsive behavior, and/or short-term memory loss.
A stroke in the brain's left hemisphere affects the right side of the body, which interferes with speech and swallowing, results in cautious behavior, and causes problems conceptualizing, generalizing and retaining information.
A brain stem stroke can be devastating as this area controls involuntary functions like breathing and heartbeat. A stroke in the cerebellum interferes with balance and causes abnormal reflexes.
Treatment Team
Each patient is evaluated by a stroke team operating under the leadership of a physiatrist. Together with the family, professionals in the fields of rehabilitation nursing; speech-language pathology; clinical nutrition; psychology; pastoral care; vocational counseling; case management; respiratory care; and physical, occupational and recreational therapies work with the patient to achieve the best outcome possible.
One of the most important parts of the treatment team is the family. The family is provided with training, professional support, education and counseling and works with the patient's treatment team to provide information about the patient's personality, lifestyle, and hopes.
Goals
The goals of the program are specific to each patient and injury, but overall are aimed at restoring, enhancing, and supporting the patient's maximum level of independence. Through inpatient, outpatient, day hospital, sub acute, and vocational rehabilitation programs, Siskin Hospital offers comprehensive rehabilitation at every level of treatment, from initial therapy to returning the patient to the community, school or work.
Components of Care
Because stroke can affect normal functioning of muscles, therapists provide intervention to prevent further muscle damage. Therapists move the patient's body in ways that provide therapeutic benefits working to restore posture, muscle function, coordination, and balance.
Every clinician integrates a number of techniques into therapy to improve the patient's thinking, reasoning, memory, communication, understanding and problem solving, but speech-language pathologists, occupational therapists and psychologists are the clinicians most involved in this process.
An occupational therapist assesses the patient's visual skills and will teach ways to improve this function. This can be accomplished with additional lighting, magnification, and practice.
Depending on the patient's progress, therapists help the patient relearn daily living skills to live as independently as possible. The individualized treatment plan is adjusted according to the patient's lifestyle and personal goals. Daily living goals may include nutrition, dressing and personal care, mobility, communication, problem solving, vision, perception, leisure activities, driving, and returning to work or school. Patients may use our transitional living apartment complete with a full kitchen, bathroom, living and sleeping area to practice independent living skills in a supervised environment.
A dietician develops a nutritional plan based on personal preference and medical, texture, and religious restrictions. A speech-language pathologist provides evaluation and treatment of chewing, swallowing and speech disorders. Therapeutic recreation specialists use leisure activities to enhance the patient's physical endurance and stamina while returning them to a familiar lifestyle. The treatment team also identifies adaptive devices that are needed.
To return to community living, patients participate in planned outings, using their newly acquired adaptive equipment, to confront obstacles in the community and learn strategies to overcome these barriers.
Addressing the patient's depression and anxiety about the ability to communicate and function after a stroke is primarily the responsibility of psychologists and pastoral care counselors, but every member of the treatment team helps the patient manage anxiety and look to the future with hope.
Nurses work with patients to establish a medication schedule so patients can take their medications independently upon discharge. If the patient is unable to manage their medicines, nurses work with the family to educate them on medication management.
For some, successful return to work or school will only require minimal adjustment, but others may require assistance with finding a new career direction. The entire team, including the family, conducts evaluation and planning for the patient's vocational and educational needs.
Resources
Siskin Hospital offers a monthly stroke support group. The group discusses the challenges of overcoming stroke, resources, social, and care issues. For more information, click here.
The National Stroke Association began celebrating their 25th Anniversary in November 2009. The NSA has been an active participant in fighting Stroke in American since 1984. Please visit their website (listed above) for more information.
