Stroke Awareness Month

May is Stroke Awareness Month 🎗️

What is a Stroke?

A stroke occurs when the blood supply to part of the brain is cut off, causing the death of brain cells. Damage to the brain can affect how we think and feel as well as how the body works. Every stroke is different, affecting people in different ways depending on where it takes place in the brain and how much damage is done. Strokes can happen to anyone of any age and can strike without warning.

Signs and Symptoms

The FAST acronym (Face, Arms, Speech, Time) is a test commonly used to determine if someone is having a stroke.

• Face – can the person smile? Is there any drooping to their mouth or eye.
• Arms – can the person raise both of their arms?
• Speech – can the person speak clearly and understand what is being said to them?
• Time – if you see any of these signs, call 999

A stroke is a medical emergency, it is important to call 999 immediately if you or someone you are with is experiencing any of the above symptoms. Getting the person medical attention as quickly as possible gives them the best chance of survival and recovery.

Although the FAST test helps to spot the most common symptoms of a stroke, there are other, less common symptoms to be aware of:

• Sudden weakness/numbness affecting one side of the body
• Difficulty speaking or finding words
• Loss of or blurred vision in one or both eyes
• Sudden confusion or memory loss
• A sudden, severe headache

All of the above symptoms could be a sign of a stroke, don’t wait, always dial 999 straight away if you or someone you are with is experiencing any of these symptoms.

Managing Risk

The risk of having a stroke increases with age or if you have had a stroke or a TIA in the past, but you can still take steps to reduce your overall risk.

Making the following lifestyle changes can reduce your stroke risk:

• Stop smoking
• Exercise more
• Drink alcohol within safe limits
• Eat healthily
• Maintain a healthy weight

It is also important to attend regular check-ups to find and treat stroke risk factors before they become a problem.

Risk factors include:

• High blood pressure
• High cholesterol
• Atrial fibrillation
• Diabetes

Effects of Stroke

Everyone experiences the effects of a stroke differently. Some people will experience very mild effects and will recover fully over time, others may be left with serious long-term disability. There are various ways in which having a stroke can affect people, some of the most common long-term effects are listed below.

Muscle Weakness

Muscle weakness associated with a stroke can cause difficulties with walking, sitting, standing and holding things. This can have a knock-on effect on a person’s ability to complete day-to-day tasks, and they may need support in maintaining their independence.

It can also make a person more likely to experience slips, trips and falls, as they may find their joints buckle when weight is put on them.

Fatigue

Fatigue is common after a stroke. A person may feel exhaustion that does not improve after rest and find that they become tired much more quickly than they did before they had a stroke. This tiredness can affect even simple tasks, like struggling to hold cutlery towards the end of a meal or unexpectedly dropping things. This fatigue can also lead to an increased risk of tripping as the person’s body runs out of energy, and walking becomes more difficult.

Pain and Spasticity

A stroke can damage the way the nerves control muscles, causing them to contract for long periods or going into spasm. Muscle spasticity causes muscles to have increased tone, often causing them to become very difficult to move. Spasticity affects around a quarter of stroke survivors and can develop within a week of a stroke. Spasticity can be treated to help avoid permanent shortening of the muscles.

People can also experience pain due to muscle weakness, joints become less well supported which can lead to partial dislocation. As well as the possibility of contracture, muscle spasms and tightness can also cause chronic pain, so it is very important for a person to seek treatment if spasms or spasticity occurs.

Changes in Sensation

A stroke can affect sensation in various ways.

After a stroke, some people find that they are more sensitive to stimuli, this is known as hyperaesthesia. This sensitivity can affect a range of senses such as touch, taste and hearing, making certain situations, like crowds, loud music or confined spaces feel overwhelming.

Feeling less sensitive to touch or temperature, known as hypoesthesia. This can cause a person to feel numbness, leading to them not being able to tell if their clothes or shoes are too tight, this can cause skin damage and infections. An insensitivity to temperature can cause a person to become too cold or burn themselves without being able to feel the injury occurring.

People should take extra precautions to protect themselves from injury if they are experiencing hypoesthesia, asking for support from others where necessary.

People may also feel they are unaware of the position of their limbs or having unusual sensations like pins and needles or tingling. These can be unpleasant sensations, such as burning or the feeling that something is crawling on the skin.

Rehabilitation

As every stroke is different, a stroke team will tailor a person’s treatment and rehabilitation to their needs, trying to ensure the best recovery possible. Many people find that their recovery progresses fastest in the few months immediately after their stroke, but improvements can still be made even years after a person has a stroke.

Rehabilitation options include:

Physiotherapy

A physiotherapist will define recovery goals, recommending activities, exercises and movements to help a person reach them. Physiotherapy can improve strength, stamina and flexibility, making activities such as walking, sitting, standing and reaching for objects easier for people.

Occupational Therapy

Occupational therapists help people to find new ways to do day-to-day tasks and live as independently as possible. They will assess how a stroke has affected a person’s life and work to find solutions to try to allow a person as normal a life as possible. They will often suggest specialist equipment or alternative ways in which to complete tasks.

Aphasia and Communication

There are more than 350,000 stroke survivors affected by communication problems.

These problems include difficulty understanding speech, speaking, reading, writing or using numbers. To be able to communicate effectively, a person’s brain must complete a series of tasks; after a stroke, parts of this series may be damaged, making communication difficult.

Aphasia affects a person’s ability to speak and understand what others say, it can also affect the ability to read and write. It is a common problem after a stroke, with around a third of stroke survivors being affected. People experience aphasia to varying degrees and no two people have exactly the same difficulties.

Dysarthria is when a person cannot control the muscles in their face, mouth or throat properly, leading to slow, quiet or slurred speech.

Apraxia of Speech is when a person cannot move the muscles required when speaking, this can make it difficult for others to understand what they are trying to say.

These is often the assumption that these problems with communication signify that a person’s intelligence has been affected, this is not the case, the problems solely affect the process of speaking and understanding language.

Although it can be daunting trying to start a conversation about communication difficulties, there are strategies that can be used to allow people to communicate and enjoy conversations again after a stroke.

Speech and Language Therapists can help people improve their speech, understanding, reading and writing as much as possible. They can also suggest alternative ways to communicate, these strategies may include gestures, electronic devices or anything else that will help a person get across what they want to say. Communication will improve with practice, so it is important that people put work in outside any therapy sessions to find out what works best for them.

Emotional Effects

A stroke is sudden and shocking, often striking with no warning and affecting every part of a person’s life. Most people who have a stroke will be impacted emotionally as a result.

For many people, having a stroke feels like they have been robbed of the life they had before, leading to shock, denial, grief and guilt. These emotions are normal when a person has a stroke and it can be difficult to deal with them or ask for help as some people do not want to admit how they are feeling.

It is important for people to acknowledge the way they feel before their emotions become overwhelming. Communication problems may make it difficult for people to explain how they are feeling, but using techniques and alternative communication methods can help a person to ask for help.

The damage a stroke does to the brain can make a person feel differently; so, emotional changes can sometimes be caused by the damage that the stroke did to a person’s brain.

Treatments are available for the emotional effects of a stroke. Treatment can come in the form of therapies, medication or a combination of the two. It is important for a person to recognise that they are not alone and these feelings are normal after a life changing illness. Most people who experience emotional problems after a stroke find that they improve over time, and that seeking advice and treatment is the best course of action.

Cognitive Effects

A stroke can cause various cognitive problems. As every stroke is different, people will be affected cognitively in different ways, if at all.

Memory and Thinking

A stroke can affect the way a person’s brain understands, organises and stores information. These problems with cognition are very common after a stroke, and as with all strokes, each person will have a different experience.

The brain is constantly receiving and processing large amounts of information through a person’s senses. Different parts of the brain work together to process the information and allow people to understand, organise and store this information. If one of the parts of the brain involved in cognition is damaged by a stroke, this can make thinking clearly and creating or retrieving memories more difficult.

People who have a stroke will be assessed by healthcare professionals to understand whether they are experiencing cognitive problems related to their stroke. If cognitive problems are found, there are various treatments available and problems are likely to improve over the first few months after a stroke.

Treatments focus on learning ways to cope with the problems, rather than reversing them. Coping strategies may be suggested by an occupational therapist and may include using labels to recognise certain objects or writing in a diary to remind people of tasks or events.

Vascular Dementia

Strokes can cause vascular dementia, but not everyone who has a stroke develops it and not everyone who has vascular dementia has had a stroke.

Vascular dementia occurs when the blood supply to parts of the brain is reduced, it accounts for around 20% of dementia diagnoses in the UK. The effects of vascular dementia differ between people as symptoms depend on what areas of the brain have been damaged.

When a person has a stroke, the blood supply to part of the brain is cut off, leading to the death of brain cells. This damage can cause cognitive problems that will usually improve over time. If these problems with memory and thinking do not improve or get worse, a person may be diagnosed with vascular dementia.

Vascular dementia can also be caused by ‘silent’ strokes, this term describes when many small strokes occur, causing lots of small areas of damage in the brain. These strokes can be so small that people do not even know they are having them as the symptoms are very minor. When vascular dementia is caused by multiple small strokes, it may appear gradually over a period of time, worsening as the person has more strokes.

Symptoms

There are various signs and symptoms of vascular dementia, not everyone has all of the symptoms and everyone will experience these symptoms differently, depending on the damage to the brain.

Some of the most common signs of vascular dementia are:

• Not being able to understand or respond to things quickly
• Being forgetful
• Having difficulties concentrating
• Struggling to find the right words when speaking
• Being unable to plan ahead for everyday tasks
• Having difficulties learning new things
• Experiencing low mood or depression

As the condition develops, the following symptoms may develop:

• Becoming confused
• Behaving inappropriately or becoming aggressive without explanation
• Lacking motivation
• Finding it difficult to control emotions
• Problems with walking and balance
• Urinary incontinence

At present, there are no treatments to reverse the damage that causes vascular dementia, but it is possible to treat some symptoms. There are also treatments that may help to stop or slow the progression of vascular dementia.

Support

Apart from the support and treatment available to people through their healthcare professionals, there are various additional ways people can be supported and helped as they come to terms with life after a stroke.

There are support groups, where stroke survivors and their loved ones can talk to others who experiencing similar feelings. Many people find these support groups bring them hope and reassurance that they are not facing the new challenges of life after a stroke alone.

Memory Café

In 2021 Caremark NI the first Health and Social Care provider in the UK to launch our Memory Café. Participants have the opportunity to do a wide range of activities from arts and crafts to musical sing-a-longs.  We have held tea parties and themed days.  We have also enjoyed fun filled day trips out to local places like Eden Pottery and took part in community art projects with local schools.

The Memory Café is a free service, and is for anyone who has a medical diagnosis of Alzheimer’s, Dementia, or other diagnosed cognitive impairments such as Parkinson’s, MS, Stroke or brain injury.  We would ask that when attending if clients/service users/customers could please be accompanied by a family member or carer.

If the Memory Café is something you or a loved one would like to attend, please contact our Wellbeing Manager, Christopher at our Head Office on 02891467004 or alternatively email christopher.downes@caremark.co.uk