Effects on Brain Damage |
||
|
|
||
|
When a stroke patient first returns to his home after hospitalization, he may appear to be extremely happy and unconcerned about his condition. It is difficult for both the patient and his family to recognize immediately the numerous deficiencies that have resulted from damage to the nervous system. Once the patient begins to recognize his own physical, emotional, and communication deficiencies, he may begin to show despair. At this point, the family must be careful not to be discouraged. Professional guidance to hasten their understanding of the patient's over-all condition will help. Unrealistically high goals, continually forced upon such a patient, most often result in his refusal to try, accompanied by a complete rejection of the household. The growth of his anxieties drastically interferes with retraining. It is necessary for the family to carefully regulate conversations with the patient. Abstract ideas may be extremely difficult to talk about because of the patient's reduced ability to express and understand spoken language. A simple vocabulary must be used, along with frequent references to the topic being discussed. A short memory complicates the patient's language abilities. The patient's persistence in frequently repeating the same conversation is involuntary and should not be interpreted as purposeful nagging. He may, for example, be concerned with the fact that fuel for heating the home is extremely low and repeatedly instruct the household members to order more fuel. Even though he may have heard repeated explanations that fuel had been ordered the day before, it is possible that within a matter of two or three hours he may again make the same request. Many times such patients eventually come to understand their own memory inadequacies when the family has had the patience to accept such behavior. It is important to keep in mind that the patient may be disgusted with himself as he begins to recognize his memory failures. Certainly, he condemns himself enough without having his frustrations increased through unkind comments from those about him. When he is repeatedly blamed for his unavoidable forgetfulness, he has no choice but to develop deep and morbid depressions. The family may need professional counseling to assist them to accept unusual behavior in an unruffled manner, thus providing an opportunity for the patient to improve his insight into his own behavior. Disrupting factors in our daily lives bring on feelings of helplessness, hopelessness, and exhaustion even in normal persons. The stroke patient, as may be readily understood, frequently develops such feelings. This is apt to occur as he acquires longer memory spans for they may tend to increase his consciousness of his failures in physical and social activities. Many of our basic attitudes toward our husbands or wives depend upon our ability to express maximum affection toward them. The reestablishment of a stable relationship between a stroke victim and his or her husband or wife many depend upon their achieving an adequate sexual relationship. A short memory span handicap the patient in doing this. A vast number of patients, both male and female, have described difficulties in concentrating upon even this basic drive. Such failures can create marked emotional problems for both partners. Unless the normal sex partner has a good understanding of the recovery that is likely to come, it is possible that he or she will develop a frigid attitude toward such relationships. This reaction can have a severe effect upon the patient's total recovery. Many stroke patients object to visits by friends and relatives. They often withdraw immediately from the living room upon the arrival of visitors. This reaction may be due to their inability to control emotional outbursts, toilet problems, or conversation. If at all possible, friends and relatives should have careful guidance concerning their conversation. They should especially be warned to avoid negative comments about the patient's condition and welfare. Often they will begin a conversation with the patient and then find that his responses are unrelated to the topic being discussed. When this occurs, visitors should then direct their conversation toward other family members. If at all possible, the family should prepare their friends and relatives for contact with the patient. They must advise them to allow the patient time to respond, to avoid topics that may upset him, and to do their utmost to allow the patient to take part in the conversation. The better the visitors understand the situation, the less will they fear the patient. As a result, they will assist in improving the patient's social relationships and in building his self-confidence. Everyone should treat the patient with as much courtesy and consideration as they would have before his illness. The well members of the immediate family must be aware of the patient's reactions to what he may hear and see regarding himself. The family must keep in mind that the .patient needs frequent periods of emotional "ventilation." Such outbursts are often his chief means of gaining emotional relief. If the patient has no one to listen to him, his only alternative may be to withdraw completely from all activities. Doing so will, in the long run, greatly reduce the degree of his recovery. |
||