Stroke - The role of the health care worker
The term 'stroke', denotes a neurological disturbance after bleeding in the brain, which results in loss of
movement, control, strength and reaction times. Other after-effects include spasticity of the limbs, loss of feeling, vision and speech difficulties and loss of body awareness. Strokes can be minor (a transient ischaemic attack), or major (haemorragic or ischaemic
A haemorragic stroke refers to a blood vessel in the brain that is either leaking or has burst, while an ischaemic stroke means a blockage in an artery leading to the brain. Implications of a stroke
The social and emotional implications of a stroke for the patient and family are the concern of the health care social worker, who may be involved at all stages of rehabilitation.
Subtle or significant changes mean awareness and acceptance of the new situation, as well as some adjustments in family lifestyle. Each family member will need to accept and respond in a supportive way to: personality changes, loss of pride and dignity, frustration, mobility issues which necessitate acquiring a barrier-free home, role reversal with accompanying new responsibilities and financial stress. A stroke patient sheds tears easily and this is a result of brain trauma, and not necessarily an emotional
upset. I often suggest to the family that they continue the conversation, and acknowledge the tears without making a fuss. However, if depression is suspected, the family should consult a mental health professional. Anger, anxiety, fear and guilt are present in virtually every stroke situation. Thus, my preferred helping modality is family therapy because:
A high anxiety level makes it difficult to take in new information.
A stroke can arouse strong emotions about past events and relationships and having the family group present assists in keeping issues current and focused. I advise that the concerns of the stroke patient should not be allowed to block out the needs of other
family members. As an example, young children may develop symptoms and attitudes that they cannot easily explain and this calls for discussion, explanation and encouragement. In order to facilitate an understanding of stroke-related personality changes, I use the term "hibernation." Hibernation is intended to convey that the individual is drawing on inner resources to assist with the healing process, and to help the stroke patient through a crisis, rather than isolating themselves from loved ones. It is used to ease any feelings of being rejected by the family members, and it is my opinion that depression does not fully describe the intensity and purpose of the withdrawal.