In this assignment I discuss Paul who is a 65 year old male and has suffered a stroke. My aim is to explain what a stroke is, the causes and effects, and give you my understanding of how I as a Health Care Worker can help identify, meet and care for the client’s needs following a stroke. For this assignment I will bring together the knowledge I have gained as a health care assistant student to date along with some research also.
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I have carried out my research using the internet, Irish heart foundation, stroke centre organisation, stroke.ie. My focus as a health care assistant is to explain what care my client should receive after his stroke, identify the assistance needed and give recommendations to meet his rehabilitation, to help him keep abilities and gain back lost abilities and also take care of his needs such as physical, emotional, social and intellectual needs.
“A stroke is caused by an interruption of the blood supply to part of the brain, the term stroke comes from the fact that it usually happens without any warning, ‘striking the person from out of the blue” (ihf.com) A stroke can happen to anyone, some people are at higher risk for different reasons such as age and family history. Other risk factors include high blood pressure, smoking, being overweight, diabetes, and high cholesterol. “2 people per 1000 in the world have a stroke, people affected are mostly over the age of 60, and stroke is the 3rd leading cause of death over the age of 65yrs”. (ihf.com) Paul is 65 years old and lives alone he was very active and in good health up until he suffered a stroke. Paul suffered an ischaemic stroke (a cerebral thrombosis) a cerebral thrombosis is the most common type of stroke. When Paul arrived at the hospital he was met by the stroke physician. He spent 2 days in intensive care and 4 days on the high dependency ward and is now is on a recovery ward. I the health care assistant along with the rehabilitation team in the hospital doctor, nurse, consultant, and physiotherapist etc will help assist in my client’s recovery.
“A stroke causes damage to the brain, the effects depend on the part of the brain that is affected, but every stroke is different”. (stroke.ie) For some people the effects are mild and don’t last long, other strokes can have severe or continued disability. “The right side of the brain controls the left side of the body and vice versa”. (stroke.ie) Any weakness or paralysis in the right arm can result from a stroke from the left side of the brain. The left side of the brain in the majority of people controls language, reading, talking, writing and understanding. On the right side perceptual skills (understanding what you see, hear, touch) and spatail skills (speed, position, and distance) are controlled.
Paralysis happens because of damage to the area of the brain that sends messages to the limbs and balance can be affected also. Swallowing problems affect half of the people who have had a stroke, so food and liquids are harder to swallow. Communicating can affect the person’s ability to use and understand language this is known as aphasia, two main communication problems are difficulty understanding the spoken word and trouble to express words. Vision can be lost on one side, if the person has weakness on the left side of the body it can be difficult to see on that side. “Emotional changes ups and downs can be caused either by distress that comes from having a stroke, or changes that have happened in the brain”. (stroke.ie) Changes in the brain cause mood swings, depression, anger, sadness and loss of confidence, so the patient may find it hard to control emotions and can laugh or cry for no reason.
Physical ~ some people find it difficult to keep up with leisure activities due to low mood, no motivation, a disability or low self-esteem following a stroke. While still in my care, i will help my client by keeping his abilities he has, and gain back the abilities he has lost with stroke, I will help my patient with any exercise he needs and help him become more independent. I will along with the physiotherapist will help my client get into good sitting and lying positions as this helps to prevent skin breakdown, support the weak side affected to help reduce changes in muscle tone due to inactivity, and at all times encourage my client to reach his personal goals.
Hygiene ~ the care of a client’s personal hygiene is very important for their health and wellbeing. I will ensure that the client’s hygiene needs are met and will help my client with his daily hygiene by washing him at his bedside until he is able to get into the shower, also helping him with dressing, shaving and brushing his teeth.
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Nutrition ~ is very important in maintaining the client’s health, and good nutrition is vital as it helps maintain body weight and keeps the cells working properly. My client Paul is left handed and is very weak on the right side so I will assist with his meals until he gains enough strength to feed himself. He has dysphagia (difficulty in swallowing), so I have pureed his food to make it easier for him to swallow. There are specialised utensils that will help my client when he gains the ability to feed himself.
Emotional ~ following a stroke the person is left with a sense of loss and may feel anger, fear, worry, uncertainty and rejection. I will provide Paul with psychological comfort re assuring him that he is in safe and secure surroundings, and will show him patience, understanding, empathy and encouragement supporting him always in his recovery.
Aftercare & Care at Home
“Stroke rehabilitation is the process by which a stroke survivor works with a team of health care providers with the aim of regaining as much of the function lost after a stroke as possible”. (sc.org) My client will join in a comprehensive rehabilitation programme in hospital and when he leaves, this will increase his chances of recovery and help him regain a large part of his functions lost as a result of stroke. Some of the professional team involved in this will be: Physical medicine & rehabilitation physicians, “physiatrists take both the physical impairments and medical conditions of their patients into account and work with other health practitioners to devise treatment plans”. (stroke.org) Physical therapy will help my client restore function, improve mobility, relive pain and help limit permanent disabilities and also help with maintaining overall fitness and health. Occupational therapy will help Paul with any mental, physical or emotional problems by developing his ability to perform tasks in his daily living surroundings, and help him recover or keep daily living and work skills. Speech therapy is a very important part of life after a stroke as aphasia disturbs the process of language and understanding due to brain damage from a stroke my client can receive this to help him gain back this ability. My client has family are able to help, and will play a vital part in the care and wellbeing that Paul will need when he goes home. They can help him by supporting and encouraging him through the different stages of his recovery. The public health nurse is part of a community care team and will provide helpful advice on managing difficulties that can happen while caring for a person in their home. She will also assess my client’s needs, so that she can supply him with appropriate support services, speech therapy, physiotherapist, social worker, and home help etc. Paul can also get advice on practical aids such as walking frames, suitable beds and any other mobility aids my client may need.
A stroke can be a devastating and distressing experience to happen to the individual and their families, stealing the person effected of their independence, confidence, abilities and health. Stroke recovery is usually a slow process and can often take months while the brain is healing. Recovery all depends on the person and long term effects can range from mild to severe. There is a wide range of specialists that care for a stroke patient from the medical, nursing, and therapy professionals. The multi-disciplinary team give care to the person in a range of settings, ICU, general ward, and home after care. Some people are affected mildly and may not take long to recover, but in others it can leave the person with severe disabilities, paralysis, communication problems, and loss of vision, physical and emotional changes. All of the people involved aim to help the person regain the highest level of function, although after a stroke the person may depend totally on others as they can be very ill. The care and needs will change as their conditions may get worse or better,
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