Stroke – Recovery

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of stroke.

Alternative Names

Transient ischemic attack; TIA

Recovery:

After a stroke, patients should take all necessary measures, including medications and lifestyle changes, to prevent another stroke. For those whose stroke was ischemic, aspirin, warfarin, or both will usually be prescribed.

Having a neurologist as the primary doctor after a stroke, rather than some other specialist or primary care doctor, significantly increases the chance for survival. Patients or their families should be persistent in requesting the best care possible during this important early period.

Receiving initial treatment at a stroke unit, instead of a general ward, plays a strong role for better long-term quality of life. Rehabilitation services aimed at patients living at home are also very effective in improving independence. Patients or their families should seek patient advocates or support associations to ensure they receive the right care.

Reducing the Risk for Non-Neurologic Complications after a Stroke

In addition to problems brought on by neurologic damage, stroke patients are also at risk for other serious problems that reduce their chances for survival. They include:

• Blood clots in the legs (deep vein thrombosis)
• Pulmonary embolism (a blood clot that travels to the lungs)
• Pneumonia
• Widespread infection
• Heart problems
• Urinary tract infections (a catheter is sometimes used in the first 48 hours after stroke to help with urinary retention, but if it is left in longer it can cause urinary tract infections)

Measures should be taken to monitor and treat patients for these important problems.

Candidates for Rehabilitation

In all, 90% of stroke survivors experience varying degrees of improvement after rehabilitation. The current cost-cutting climate generates pressure to send elderly patients who have had a stroke directly to a nursing home rather than a rehabilitation first. Not all patients, however, need or benefit from formal rehabilitation:

• If the stroke is severe, intensive training would not be helpful.
• If the stroke is mild, patients often improve without rehabilitation.

Positive factors that help predict good candidates for rehabilitation:

• A patient should be able to sit up for at least an hour.
• The patient should be able to learn and be aware.
• Spasticity may be a good sign, because it indicates live nerve action.
• Patients who are able to move their shoulders or fingers within the first 3 weeks after having a stroke are more likely to recover the use of their hands than patients who cannot perform these movements. The ability to feel light pressure on the affected hand, however, makes no difference for future hand movement.
• Family members or close friends are available to be active participants in the rehabilitation process.

Factors that predict a poor response to rehabilitation:

• Dysphagia (the inability to swallow) is associated with a higher mortality rate, possibly because of increased risk for infection and malnutrition. Dysphagic patients are given nutrition using a stomach tube or a feeding tube inserted down through the nose.
• Incontinence.
• The inability to recognize nonspeech sounds that occur right after a stroke.
• A poor hand grip that is still present after 3 weeks is an indicator of severe problems.
• Having had very severe seizures after the stroke.

Factors that do not rule out rehabilitation:

• About 30% of patients experience aphasia (an impaired ability to speak). However, this disability does not necessarily affect the ability to think. Aphasia can also be temporary.
• Although confusion is common among people who have had strokes, partial or even complete recovery is very possible.

Some Approaches to Rehabilitation

Physical therapy should be started as soon as the patient is stable, as early as 2 days after the stroke. Some patients will experience the fastest recovery in the first few days, but many will continue to improve for about 6 months or longer. Because stroke affects different parts of the brain, specific approaches to managing rehabilitation vary widely among individual patients:

• Exercise program. Recent guidelines from the Veteran’s Administration recommend that patients get back on their feet as soon as possible to prevent deep vein thrombosis. Patients should try to walk at least 50 feet a day. Assisted devices or bracing are sometimes used to help support the legs. Treadmill exercises can be very helpful for patients with mild-to-moderate dysfunction. Exercise should be tailored to the stroke survivor’s physical condition and can include aerobic, strength, flexibility, and neuromuscular (coordination and balance) activities.
• Retraining muscles. Stretching and range-of-motion exercises are used to help treat spastic muscles. They can also help patients regain function in a paralyzed arm. Multiple techniques have been developed and studied. These include the Bilateral Arm Training with Rhythmic Auditory Cueing (BATRAC) technique, (which involves moving a bar with both arms in a sustained rhythmic pattern), and constraint-induced movement therapy (CIMT), which involves doing a series of repetitive exercises while the less functional arm is restrained.
• Speech therapy and sign language. People who have had a stroke often have aphasia, a brain condition that makes it difficult to speak and understand language. Aphasia can come in many different forms. A person may be unable to speak at all, or just have difficulty saying the right word. Intense speech therapy after a stroke is important for recovery. Some experts recommend 9 hours a week of therapy for 3 months.
• Swallowing training. Training patients and their caregivers regarding swallowing techniques, as well as safe and not safe foods and liquids, is essential for preventing aspiration (accidental sucking in of food or fluids into the airway).
• Attention training. Problems with attention are very common after strokes. Direct retraining teaches patients to perform specific tasks using repetitive drills in response to certain stimuli. (For example, they are told to press a buzzer each time they hear a specific number.) A variant of this approach trains patients to relearn real-life skills, such as driving, carrying on a conversation, or other daily tasks.
• Occupational training. Occupational therapy is important and improves daily living activities and social participation.

 Managing the Emotional Consequences

The Emotional State of the Patients. Strong motivation with the goal of independence after rehabilitation is important for recovery. Unfortunately, depression is very common after a stroke, both as a direct and indirect result of the stroke:

• Strokes that affect the right hemisphere in the brain increase the risk for depression.
• Patients can become depressed by the changes in their ability to function.
• A peculiar stroke-induced condition, known as post-stroke crying or neurologic emotionalism, is a neurologic not a psychologic disorder.

If depression is prolonged, it can interfere with recovery. One study showed that people who suffered strokes and became depressed were three times more likely to die within 10 years than stroke victims who were not depressed. There is a significantly increased risk of suicide in patients with stroke, especially in women and those under age 60.

Antidepressants, particularly fluoxetine (Prozac) and similar so-called SSRI drugs, have been beneficial in relieving post-stroke crying as well as improving recovery in general and mood in particular. Antidepressants may also help restore mental abilities.

Some doctors also recommend tricyclic antidepressants, which include amitriptyline (Elavil) and nortriptyline (Pamelor). In one study nortriptyline (Pamelor) not only improved mood but also had positive effects on mental functioning, suggesting perhaps that some dementia associated with stroke may actually be due to depression. Tricyclics may also be useful for neurologic emotionalism.

Anxiety disorder is also common and debilitating. Some research indicates that many patients suffer from feelings identical to post-traumatic stress syndrome. The two disorders often overlap, but drug treatments for each differ and may offset the other.

Many drugs for psychologic disorders affect the central nervous system and can delay rehabilitation. Skilled professional help is needed to determine the most effective and safest treatments.

The Emotional State of the Caregiver. The caregiver’s emotions and responses to the patient are critical. Patients do worse when caregivers are depressed, overprotective, or not knowledgeable about the stroke. Unfortunately, in one study, over half of the caregivers themselves were depressed, particularly if the stroke victims were left with dementia or abnormal behavior.

How to Better Understand Our Aging Parents

5 Star Home Care quality homecare for Seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

 The elderly are living longer thanks to developments in the health care field. This longer life expectancy not only affects them but their children who will most likely take care of their parents. How can we, the children, better understand the emotional needs and ever changing behavior of aging parent?

 Instructions

Difficulty: Moderately Easy

Step1

First, we must free ourselves of guilt. Yes, our parents are aging. It’s a fact of life, but we are not to blame because they have lost a mate or their bodies are deteriorating. Once we accept that we cannot stop the aging process, than we are ready to care for the elderly and help them cope with the changes.

Step2 

 Learning to communicate is the most important task we face as our parents try to hide their true feelings. Before we can understand them, we need to understand the times that they grew up in. Most elderly people were taught to keep their feelings suppressed and never discuss issues with their children. Remember, “Children are to be seen, not heard.” So when they refuse to tell us what ails them, it’s because we are the children; they are the parent. Be patient and observe. Mom may not let you know about her personal problems, and Dad may not want to go to the social because he’s afraid.

Step3

Be attentive. Sometimes it’s tough, but let Mom vent. If she lives alone, she needs to talk. Show that you are listening by nodding and repeating some of what she says. Don’t judge. Our parents have a right to their opinions, no matter how we feel about the issues.

Step4

 Finally, spend time with your parents. Take them out for coffee. Have physical contact with a touch of the hand or a hug. Ask their opinion on different subjects. Play games, watch their favorite tv show, and have dinner with them. Show them they are still important.

If you are in need of respite care for a short time or need  for more information on assisting your parents with their daily activites please call

5 Star Home Care  at 404-719-4118.

Elder Care – First Steps

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

 

 Beginning Your Journey through Elder Care Caring for an aging parent, elderly spouse, domestic partner or close friend presents difficult challenges – especially when a crisis hits and you are suddenly faced with the responsibilities of elder care. Perhaps your aging mother fell, is hospitalized with a broken hip and needs to go to a rehab facility or nursing home to recover.

Caregiving can also begin as a result of unsettling mishaps and warning signs that indicate a need for long term elder care. Perhaps your elderly spouse has wandered off and gotten lost several times. Or a long-time friend has lost a lot of weight and rarely leaves home. You may be the only person to step in and become the caregiver. Or, you may be the linchpin of a network of family members and friends willing to help care for your elderly senior. Whatever the situation, you are not sure of the next step, or even the first step.

Whether you are in the middle of a crisis and decisions have to be made quickly, or planning ahead for an elderly loved one because of unsettling warning signs, 5 Star Home Care can help you find the answers you need. What kind of help does your loved one need … long term elder care? Or, help for only a short time to recover after a hospital stay? Are problems undiagnosed but correctable? For example, prescription drugs interactions and side effects, Vitamin B12 deficiency, dehydration and other treatable causes are often mistaken, even by doctors, for Alzheimers and other forms of dementia. If their problems are not correctable, what elder care living arrangements are available for your loved one? What nursing care plans are most appropriate? If they are able to remain in their own home, what kind of elder care services do you arrange?

Is assisted living preferred over a nursing home? What challenges does your loved one’s condition pose? What is the best way to access community elder care resources? How will you manage it all – and still maintain a life of your own? Your loved one’s medical history, financial resources, personality, relationships with potential caregivers, proximity to services and other factors all determine the best approach to take.  For more information please call a representative at 5 Star Home Care at 404-719-4118.

32 Safety Tips for Seniors at Home

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

 

 

 

Saftey Tips for Seniors

• Keep outdoor steps and walkways in good condition and clear of debris.

• Illuminate all stairways and hallways and provide light switches at both ends.

• Use nightlights or bedside remote controlled switches.

• Provide handrails in hallways and stairways.

• Keep a sturdy nightstand next to the bed so glasses and other personal items are within reach.

• Put felt or soft material over sharp edges and corners of furniture such as nightstands, tables and shelves.

• Tack down the edges of carpets and rugs; remove throw rugs that slide.

• Keep pathways clear of furniture and other objects.

• Provide handrails in the bathroom (especially near the toilet) and use non-skid strips in bathtubs.

• Use a shower seat and shower hose for those unable to stand in the shower.

• Avoid using bath oils or lotions in the bathtub.

•  Use kitchen appliances with thermostats and timers. The elderly find appliances with signal lights and buzzers easier to use.

•  Use fireproof curtains on windows near the stove.

•  Clearly mark the “off” position on stoves and ranges so a person with diminished eyesight can immediately tell if the element is off.

•  Set water heater thermostats or faucets so water does not scald the skin.

•  When cooking, don’t wear loose fitting or flammable clothes. Long sleeves can catch fire easily.

•  Install smoke detectors in the kitchen and throughout the rest of the house.

•  Keep a fire extinguisher handy and know how to use it.

•  Arrange frequently used kitchen items in an easy to reach storage cabinet.

•  Have regular eye examinations and keep glasses clean and in good condition.

•  Use a walker or cane if you need one.

•  Wear light-colored clothing with reflector tape on your shoes and carry a flashlight when going out at night.

• When catching the bus, have your fare or bus pass ready to avoid losing your balance while looking for it.

• Always have an umbrella on hand, even during sunny days.

• Choose shoes, which are flexible and easily molded to the feet.

• When choosing house slippers, make sure the soles don’t have too much grip (which may grab carpeting and cause a fall).

• Shoes with Velcro straps are easier to put on and take off.

• Apply reflective tape on the sides and back of your shoes to make you more visible at night.

• Many older people trap themselves behind multiple door locks that are hard to open, especially in an emergency. Install one good lock that can be opened easily from the inside.

• Avoid isolated areas and bring a friend along when leaving your neighborhood.

• Always keep your identification and important medical information on you at all times in case of an emergency.

• For more information about safety, talk with your physician or call your local fire or police station.

Respite Care: Much Needed Relief For The Family Caregiver

5 Star Home Care quality homecare for Seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

“I love my Mom but I am wondering how much more I can take, I am doing everything all on my own. Caring for her is so demanding, my own health is starting to deteriorate. I need help!”

Statements like this are common among family members and caregivers caring for loved ones such as the elderly with disabilities, chronic illnesses and other conditions that require around-the-clock care. Even though most families take great joy in providing care to their loved ones so that they can remain at home, the physical, emotional and financial consequences can be overwhelming without some support, such as respite. Respite provides the much needed temporary break from the often exhausting challenges imposed by constant caregiving.

Respite care provides, short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home. Research has shown that providing this type of help can have a positive effect on the health of the caregiver. Call 5 Star Home Care  at 404-719-4118 , we can provide you with a Caregiver so that you can get some short term relief.

Alzheimer’s Care: Tips for Maintaining Emotional and Physical Fitness

5 Star Home Care quality homecare for seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

Caring for someone with Alzheimer’s disease impacts every aspect of daily life.  As Alzheimer’s patients lose one ability after another, caregivers face tests of stamina, problem-solving, and resiliency.  During this long and difficult journey, communication diminishes, rewards decrease, and without strong support, caretakers face challenges to their own well-being.

Maintaining emotional and physical fitness is crucial. Preparing and protecting yourself, working to understand your loved one’s experience, and embracing help from others can minimize the hazards and enhance the joys of your caregiving experience.

 The Alzheimer’s care journey

The challenges and rewards of Alzheimer’s care

Caring for a person with Alzheimer’s disease is often a series of grief experiences as you watch memories disappear and skills erode.  Initially, this process can go unnoticed until difficulties impact more areas of daily life and the disease can no longer be denied. For both caretakers and their loved ones, this often produces an emotional wallop of confusion, anger and sadness.  If left unchecked, these feelings can last throughout a caregiver’s long journey.

Exploring common Alzheimer’s experiences can shift your perspective and show you that you are not alone. For many, Alzheimer’s care includes not only challenges but many rich rewards:

Caring for Someone with Alzheimer’s Disease
Challenges:	Rewards:
Overwhelming emotions as capabilities lessen Fatigue and exhaustion as caregiving demands increase Isolation and loneliness as independence disappears Financial and work complications as costs rise and resources are challenged	Bonds deepen through care, companionship, and service Problem solving and relationship skills grow through experience New relationships form through education and support Unexpected rewards develop through compassion and acceptance

Tips To Help Seniors Drive Safely in Atlanta GA

5 Star Home Care quality homecare for seniors – call 404-719-4118.  Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

You can take an active role in helping a senior to drive more safely. Following are some tips for a senior to stay on the road. Help the senior to implement these safe driving adjustments.
Tips on your car:

• Drive a car that meets your needs.  Choose a vehicle with automatic transmission, power steering, and power brakes. See an occupational therapist for special driving aids that compensate for physical problems. For tips on making sure your car fits you and on how to adjust car mirrors for maximum visibility.
• Keep your car in peak operating condition. Visit your mechanic for scheduled maintenance, and keep your car windows and headlights clean.

Tips on the road:

• Drive during daylight hours if you have trouble seeing well in reduced light.
• Consider staying off the freeway or highway if fast-moving traffic bothers you.
• Avoid driving in bad weather (rain, thunderstorms, snow, hail, ice).
• Plan your route before you leave the house so that you feel more confident and don’t get lost.
• Focus on the road. Carry a cell phone for emergencies, but don’t use it while driving. Some cars have controls for the radio on the steering wheel that require no reaching and no looking. Eating and conversation may be distracting while driving.
• Don’t follow too closely. Use the three-second rule: choose a stationary object on the road ahead of you, start counting when the car in front of you passes that object, then allow three seconds until you pass that object. You can figure three seconds by saying to yourself, “a thousand one, a thousand two, a thousand three.” If you pass that object sooner than in three seconds, maintain a longer following distance.
• Yield the right of way at an intersection if you are in doubt. The majority of senior-citizen accidents happen because the senior has not yielded the proper right of way.
• Be careful of left-turns. Seniors have a large number of accidents at intersections when they are making left turns. If you wish, you can even avoid left turns by turning right instead, and making successive right turns to go around the block or blocks to get to your destination.
• Be considerate of others if you drive slowly. On the highway, if other drivers are passing you in the lanes on both sides of you, be sure to move over to travel in the slow lane. On two-lane roads, be aware of cars lining up behind you. Pull over to a safe spot on the right side of the road to let other cars get around you.

Tips for overall safety:

• Enroll in a driver safety course for people over 50. A refresher course will remind you of safe driving practices and teach you about new traffic control and roadway design features.
• See your health care provider regularly. Have your vision, hearing, and general health checked regularly. Be sure to discuss any medications you are taking (even over-the-counter ones), and ask about their possible effects on your driving.
• Maintain physical and mental fitness! With your doctor’s approval, some stretching exercises, a walking program, or a yoga class may help you stay fit. Fitness affects your driving abilities: you need to be flexible, have quick response time, and be able to move your hands and feet quickly to control the car.

Transportation alternatives available for seniors

If an elderly person is going to stop driving, alternative modes of transportation will facilitate errands, going to doctors’ appointments, and continuing to attend social and cultural events. If transportation is not available, a senior will be much less willing to give up driving. Getting out of the house is essential not just for practical reasons, but also for participation in life!
An increasing number of innovative ways for seniors to get around without a car are available. These include:

• ride-sharing with friends and relatives
• public transit: buses, subways, and light rail
• community shuttles
• taxis, limousines, and chauffeur services
• private drivers
• specialized transit for seniors
• bicycles or tricycles (you can find large tricycles made for adults)
• walking
• motorized wheelchairs for nonambulatory seniors

You may think that paid transportation is not affordable, but money saved on car insurance, maintenance, registration, and gasoline can be used for rides. To encourage a senior to use alternative transportation, you might ride along the first few. If you offer rides to the senior, set up a regular time when the person can count on you to be there, without their asking. See if other friends or relatives can do the same. Many seniors find it difficult to ask for a ride, so if you schedule it regularly, the awkwardness is diminished.

Tips for Preventing Falls for Seniors

5 Star Home Care quality homecare for seniors – call 404-719-4118. Serving all areas in Metro Atlanta including Fulton County, Dekalb County, Cobb County, and  Gwinett County.

 

Falls and fractures are not an inevitable part of growing older. Many can be prevented. Many falls result from personal or lifestyle factors that can be changed. Your doctor or other health care provider can assess your risk of falling and suggest ways to prevent falls.

At your next check-up, talk with your health care provider about your risk of falling and changes you might make. You might be referred to another health care provider who can help. Also, let your doctor know if you’ve fallen or almost fallen. Here are some changes you might make:

Be Physically Active

Regular physical activity is a first line of defense against falls and fractures. Physical activity strengthens muscles and increases flexibility and endurance. In turn, your balance and the way you walk may change, decreasing the chances of a fall.It’s important to keep muscles strong. Strengthening muscles in the lower body can improve balance. Work with your doctor or a physical therapist to plan a physical activity program that is right for you.

Have Your Medicines Reviewed

Find out about the possible side effects of medicines you take. Some medications might affect your coordination or balance, or cause dizziness, confusion, or sleepiness. Some medications don’t work well together, adding to your risk of falls. Bring your prescribed and over-the-counter medicines with you when you visit the doctor. Also bring any vitamins, minerals, and herbal products you are taking.

Have Blood Pressure Checked When Lying and Standing

Some older people have normal or increased blood pressure while seated, but their blood pressure drops too much on standing. There is no way to know unless you check. Most often, though, your blood pressure is checked when you are sitting.
Your health care provider should check your blood pressure and pulse after you have been lying down for at least 5 minutes and again after you get up. If it drops too much when you get up, ask if any of your medications may be decreased or if you should make other changes. Drinking more water, getting up more slowly, pumping your feet or hands before getting up, or wearing special stockings can help, too.

Get a Vision Check-up

Have your vision tested regularly or if you think it has changed. Even small changes in sight can make you less stable. Wear your eyeglasses so you can see your surroundings clearly. Keep them clean and check to see that the frames are straight. When you get new glasses, be extra cautious while you are getting used to them. If you use reading glasses or multi-focal lenses, take them off when you’re walking.

Choose Safe Footwear

The soles of our feet have nerves that help us judge the position of our bodies. To work correctly, our feet need to be in touch with the ground and our shoes need to stay securely with the foot as we take each step. Otherwise, falls may occur. Wear sensible, low-heeled shoes that fit well and support your feet. There should be no marks on your feet when you take off your shoes and socks.

Your shoes should completely surround your feet. Wearing only socks or wearing floppy, backless slippers or shoes without backs can be unsafe. Also, choose shoes with non-slip soles. Smooth soles can cause you to slip on waxed or polished floors.