The following was originally posted in the StrokeNet Newsletter
December 1, 2017.By David Wasielewski
Memory and Function Deficits
Many stroke survivors experience deficiencies in memory and executive function after their stroke. These issues can be similar to those experienced with Alzheimer’s. The survivor becomes unable to process any multistep processes or process a logical train of thought. This can be frustrating for caregivers as it appears that the survivor is purposely ignoring instructions. Somehow these folks just refuse to listen or understand, no matter how much effort is put into explaining the process and their part in it.
Speaking loudly and slowly makes no impression. In fact it makes things worse. The survivor becomes aware of the frustration and anger but cannot determine why it is their ‘fault.’ The only thing left is bad feelings: frustration, anger and sadness. Caregivers need to understand that this logic process is no longer a part of the survivor’s capabilities.
The notion of action and its consequences may no longer exist. A therapist explained the process to me. The logic and executive function are no longer possible in the injured brain. What does remain, however, is the emotional component of the process. The brain can still process emotions. Anger and frustration exist but the survivor cannot understand why.
So, how does the caregiver cope? Processes need to be broken into simple single steps. For example, the caregiver cannot rely on the survivor to get breakfast on their own. The caregiver needs to break the process into its components. Go to the cabinet, get a bowl, get the cereal, get a spoon, go to the refrigerator, get the milk, pour milk in the bowl…. etc., etc. Arguing about why something needs to be done is pointless here.
This can be especially frustrating when dealing with issues of personal hygiene. The embarrassment component remains while the inability to process multistep instructions can have very messy consequences.
The caregiver needs to realize that no amount of explaining is going to make the problem go away. The reality is that the caregiver needs to let go of the need to explain, accept the situation and incorporate the new reality into their daily routine. Making life as simple as possible for the survivor is a reasonable way to deal with the potential frustration. Explaining ‘why’ becomes pointless.
Remove logic from the situation and simply be with the survivor as they move very slowly through their day. This is especially difficult for caregivers but can help reduce stress for both the survivor and caregiver.
David had a stroke in 2005 ending his career as a logistics consultant. Since the stroke he returned to college for a Sociology degree. He is a peer counselor, facilitates a local stroke support group, volunteers at the local United Way and writes for The Stroke Network.
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