When the right side of the brain is damaged, the left side of the body is paralyzed and the patient has difficulty with judging distance, size, position, and rate of movement. Sometimes we tend to overlook our other abilities because we put such emphasis on speaking. If stroke victims can talk and understand speech, we assume they are unimpaired, but it might still be difficult for them to care for themselves.
Remember a time when you were preoccupied while walking up the stairs, and you thought there was another stair but there wasn’t? You were jarred when there wasn’t a place to put your foot. Or, have you ever been reading and tried to put your coffee cup on the end table and missed the edge? These are some of the common mishaps of a right-brain-damaged victim, because their perception is impaired. They may not be able to get their wheelchair through a large doorway without bumping the frame, or read a newspaper or add a column of figures, because they lose their place on the page. It’s important to know their limitations so you don’t misjudge your patient or think that they are being uncooperative, unmotivated, or confused.
Right brain damage may also cause the stroke patient to overestimate their ability to perform easy tasks. Sometimes they are unaware of their limitations and dive right in. However, if they act too fast they can fall or hurt themselves.
If you suspect this overconfidence, ask them to demonstrate their task before you let them go forth. If they can handle the task, fine, but sometimes they can’t and you have to prove it to then.
If you are having trouble teaching them a task, slow down and talk them through it. Words are more effective than hand motions. Take it slow and easy.
Stroke patients can also have visual field defects. Perhaps their vision is only half there and they may have difficulty seeing to one side or another. Make sure their room isn’t cluttered, since they could fall over something in their way.
My husband had a unique problem with his vision. One of his eyes reversed itself. Before his stroke it was nearsighted and now it is farsighted. He also had a cataract develop on the right eye, but even after it was removed he couldn’t see peripherally, so it made it difficult for him to read. He would lose his place because of his tunnel vision.
There will be more problems with behavior, depression, brooding, forgetfulness and many other things to numerous to mention. Each stroke victim is different. A mild-mannered man may begin cursing and an extrovert may become introverted. It is up to us to evaluate the problems and deal with them as best we can. Use your ingenuity. Be sure to discuss anything you don’t understand with your physician. He can suggest ways to deal with each unique situation as it comes up.
Stroke leaves an enormous impact: memory is lost, routine is forgotten, emotions surface, crying is not unusual, there is sensory loss, and depression often results.
Healing comes from within, not just healing of the body, but healing of the mind with determination and hard work. The doctors take care of the body, but the mind is a different story. It may snap back or it may take years to bring back even normal responses. Be patient...it’s worth all the work you do.
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