19 Apr Stroke Complications In Elderly: Recognize Signs Of Decline After Stroke
A stroke is a serious medical condition that happens when the brain suddenly doesn’t get enough blood. This can lead to major health issues.
Quick treatment is important to limit damage and improve recovery. However, the neurological complications of stroke can greatly affect a person’s life.
These problems can vary, such as difficulty moving one side of the body or trouble speaking. For older people, their health may gradually decline after a stroke.
According to Dr. Vivek Pratap Singh neuropsychiatrist in Patna Bihar, to truly help stroke survivors, we need to recognize worst possible complication of stroke and continue to support them after the initial emergency.
Doctors and caregivers play an important role in this by creating tailored plans to help each survivor based on their needs.
By focusing on rehabilitation and preventing future strokes, we can improve life for those recovering from a stroke.
Now that we know how urgent it is to respond to a stroke, let’s look at the challenges survivors face afterward.
In this blog, we’ll discuss ‘what are the complications of a stroke that can affect a person’s long-term recovery and overall quality of life’.
Definition of Stroke
Stroke is a medical condition that happens when blood stops flowing to the brain suddenly, which can harm brain cells.
This interruption can be caused by either: Ischemic Stroke and Hemorrhagic Stroke.
Strokes can affect a person’s movement, thinking, and feelings, making it hard to recover.
Because of this, strokes are one of the main causes of disability and death around the world, showing the need for early detection, treatment, and support for recovery.
Types Of Stroke: Ischaemic and Hemorrhagic
Strokes are primarily classified into two main types: ischemic and hemorrhagic. Each type has distinct causes, mechanisms, and implications for treatment.
Here’s a brief overview of both:
Ischaemic Stroke
Ischaemic strokes happen when a blood clot or plaque blocks an artery, stopping blood flow to the brain.
They make up about 87% of all strokes, making them the most common type.
This blockage can kill brain cells that are already damaged and not getting enough oxygen and nutrients, and it can also hurt other brain tissues.
Some reasons for an ischaemic stroke include narrowed arteries, heart problems, or issues with blood clotting.
The two main classifications of ischemic strokes are:
- Thrombotic: when a thrombus or clot is formed in one of the arteries supplying blood to the brain.
- Embolic: a piece of clot or debris that comes from another part of the body and gets stuck in a brain artery.
Hemorrhagic Stroke
A hemorrhagic stroke happens when blood builds up in or around the brain because a weak blood vessel bursts.
These strokes are rare but very serious and often lead to death.
They can be caused by high blood pressure, weak blood vessel walls, head injuries, or too much use of blood thinners.
There are two main types:
- Intracerebral hemorrhage: This is when bleeding happens directly inside the brain, which can damage nearby brain cells.
- Subarachnoid hemorrhage: This is when bleeding occurs in the space between the brain and the thin layers covering it, usually caused by a burst aneurysm.
Note: Both ischemic and hemorrhagic strokes are medical emergencies that require immediate attention.
Statistics on Stroke Prevalence and Recovery
Global statistics place strokes as the second leading cause of mortality in the world, with millions of new victims every year.
Statistics thus exert the toll a stroke takes on both the person and society:
- Stroke remains the second-leading cause of death worldwide.
- An estimated 15 million people experience a stroke annually.
- Approximately 5 million people die from stroke each year.
- Another 5 million are left permanently disabled.
Recovery Rates
Recovery rates vary widely, with a 30-day case fatality rate ranging from 18% to 46.3% in rural areas.
Rehabilitation strategies are crucial for improving outcomes post-stroke, with ongoing research into effective treatment modalities.
On the other hand, in India, stroke incidence rates have risen from 76 per 100,000 in 1990 to 88 in 2021, with prevalence varying between 44.54 to 150 per 100,000.
Recovery rates indicate a 30-day case fatality rate ranging from 18% to 46.3% in rural areas, highlighting significant challenges in stroke management and recovery.
Studies are exploring various treatment options, including multi-modal therapies and the use of stem cells for recovery.
Ongoing research aims to identify risk factors and improve preventive measures against stroke.
Recognize Signs Of Decline After Stroke
It is important to notice signs of decline after a stroke so that help can be given quickly.
Caregivers and family members should watch for some main signs.
Physical decline might show up as more weakness or paralysis on one side of the body, making it hard to move and do everyday tasks. Losing coordination or balance can lead to more falls.
Cognitive decline can look like forgetting things, confusion, or not knowing what time it is or where you are. Stroke survivors may have trouble solving problems or planning tasks they used to do easily.
Changes in speech and language can mean worse speech problems or feeling frustrated when trying to communicate, which can show a setback in recovery.
Emotional and behavioral changes are also important; more feelings of sadness or worry, along with pulling away from others, can indicate emotional issues.
Caregivers should also look for changes in daily activities, like trouble with self-care or not keeping up with hygiene.
Lastly, new or worsening pain, signs of infection, or changes in appetite may mean there are other health problems.
Risk Factors And Triggers
Many things can increase a person’s chance of having a stroke.
These risk factors can be divided into two groups: those that cannot be changed and those that can.
The factors that cannot be changed are important for helping people be aware and take steps for early prevention.
Uncontrollable Risk Factors
Such risk factors will not be changed nevertheless; the importance thereof will be scissors in creating an awareness level for possible early prevention.
- Age: The older the individual, the more risk factor operates, particularly after 55 years of age.
- Hereditary: Family history of cerebrovascular or cardiovascular diseases has considerable bearing on increasing the level of risk.
- History of Past Stroke or TIA: Prior blows or mini-strokes increase the risk of subsequent high-magnitude strokes.
- Sex: Males are generally more at risk, and inexplicably more females are risked to die of strokes.
Controllable Risk Factors
These factors would basically fall under lifestyle choices and medical conditions that could greatly increase or decrease a person’s chances of suffering a stroke:
- High blood pressure (hypertension): The primary stroke caused due to their destroying effects on the blood vessels, together with creating platforms for any clots or bleeding.
- Diabetes: Persisting high glucose levels can damage blood vessels and increase the chances of a person suffering a stroke.
- Tobacco: This narrows blood vessels, enables clotting, and increases the risk for stroke.
- Obesity and Poor Diet: Unhealthy diets increase the likelihood of stroke.
- Physical inactivity: A sedentary lifestyle promotes hypertension coupled with obesity and a stroke.
- Excessive alcohol intake: Consuming a lot of alcohol triggers high blood pressure and, consequently, high stroke risks.
Most Common Complication Of Stroke
A variety of complications may arise after a stroke, each of which may affect different aspects of life.
Stroke complications in elderly people can be very serious because of their age and other health problems.
The complications of stroke survivors will broadly get classified into the physical, cognitive or mental, emotional changes, or secondary medical challenges.
1. Physical Complications
Paralysis (Hemiplegia and Hemiparesis)
Many stroke survivors experience weakness or paralysis on one side of the body (hemiparesis or hemiplegia).
- Hemiplegia: Complete paralysis of one side.
- Hemiparesis: Weakness or partial loss of function.
Activities of daily living affected by this include walking, dressing, and eating.
Difficulty with coordination and balance
Any injury to the areas of the brain that control motor coordination may cause poor balance and the feeling of dizziness even while walking.
Speech and Language Problems (Aphasia)
Aphasia Disorder like problems in speaking, understanding (language), reading, or writing are things that stroke survivors could have.
- Expressive aphasia: lack of ability to write anything intelligible into words or sentences.
- Receptive aphasia: People having trouble understanding the spoken and written words.
Swallowing difficulties (dysphagia)
Some survivors cannot swallow at all, and this causes choking hazards.
Dysphagia can lead to aspiration pneumonia if food or liquid enters the lungs.
Requires diet changes and help in feeding or therapy.
2. Cognitive and Emotional Complications
Dementia and Cognitive Decline
Stroke can accelerate cognitive decline, leading to difficulties with memory, attention, and problem-solving.
This can increase the risk of developing vascular dementia.
Depression and Anxiety
There is emotional instability which includes the feelings of sadness, frustration, and fear.
Anxiety concerning having future strokes or being unable to gain independence can deter mental health improvement.
Changes in the Personality
A patient may have mood swings, become irritable, aggressive, or want to be alone.
Family members might notice these unusual changes in their feelings, like getting angry quickly or not caring.
3. Secondary Medical Complications
Infections (e.g., pneumonia, urinary tract infections)
Stroke patients unable to swallow have an increased risk of aspiration pneumonia.
The female and male urinary tract infections developed due to catheterization, and partly because of an impaired bladder function.
Blood Clots (DVT)
Risk of diabetes formed in the long leg increases significantly with very little movement, which can cause fatal death if it reaches the lungs.
Pressure Sores (Bed sores)
A bedridden person develops bedsores at times causing ulcers because of continued pressure.
Prevention against sores is possible through appropriate positioning, movement, and skin care.
Overall, complications after having a stroke can greatly lower the quality of life for older people, making it important for them to get good rehabilitation and support from healthcare workers, family, and caregivers to help them recover and feel better.
Early treatment, managing risk factors well, and teamwork in care can help reduce these issues and improve recovery.
Long-Term Complications Of Stroke
A stroke leaves lasting effects on the individual in the physical, cognitive, and emotional aspects of his or her health.
Rehabilitation will help individuals regain what was lost, but there are some long-term complications, which will stay with them.
1. Permanent Mobility Problems and Long-Term Pain
Many people who survive a stroke have some weakness or paralysis, which can be mild or severe.
This often makes it hard for them to move and be independent.
Many also experience spasticity, which means their muscles become stiff and hard to control, causing pain in the stiff areas.
Pain, stiffness, and movement issues can be managed with regular medicine and physical therapy.
2. Loss of Independence and a Need for Continuous Care
Some survivors may struggle with basic tasks like bathing, getting dressed, and eating.
How serious their situation is will decide if they need help from a caregiver, special tools, or changes in their home, like ramps and handrails.
They will need ongoing support from family, therapists, and health workers while considering these changes.
3. Increased Risk of Future Strokes
Having one stroke makes it more likely to have another one later.
High blood pressure, diabetes, high cholesterol, and smoking can make this risk higher.
To prevent having another stroke, stroke survivors need to follow their doctor’s advice about changing their lifestyle and taking their medicine.
In short, early complications of stroke can have serious and varied effects over time, affecting physical abilities, thinking, feelings, and social life.
To help stroke survivors adjust and improve their lives, it is important to have complete rehabilitation, continued medical care, and support from doctors, family, and community resources.
How Long Does It Take to Recover from a Stroke?
Recovery from a stroke is different for everyone and depends on many things, like the type and seriousness of the stroke, which part of the brain was affected, the person’s overall health, and how quickly they get treatment.
Here’s a general overview:
- The severity of the stroke (mild, moderate, or severe).
- The area of the brain affected and the severity of brain damage.
- Age and condition of the person before having a stroke.
The organization or approach taken with respect to rehabilitation and availability of medical treatment.
General Timelines for Recovery
Days to Weeks
The most critical time to begin recovery is when medical personnel attempt to stabilize the patient and assess the damage.
Some spontaneous recovery happens as the swelling in the brain subsides.
Initial therapy or treatment in the form of physiotherapy, occupational therapy, and speech therapy may begin within days after the incident, before the patient is discharged to a rehabilitation facility.
Months 1–6
The period for the greatest changes.
Stroke survivors, during this time, relearn the coordination of walking, talking, and using their hands. Rehabilitation programs are conducted continuously and intensively.
6-Months Onwards
Recovery would slow down and continue for some time, with maintenance of therapy.
Some might regain almost all functions, while others may still need assistance on a very long basis.
The role of rehabilitation therapy remains vital in improving strength, cognitive function, and activities of daily living.
It’s important to have realistic goals, as recovery can take time.
Some people may get back most of their abilities, while others might have long-lasting effects.
Ongoing support, helpful strategies, and a positive attitude can greatly improve the recovery process, allowing stroke survivors to have fulfilling lives despite the challenges.
Rehabilitation and Management Of Complications
Stroke rehabilitation focuses on treating patients in a complete way by using different methods to address problems that may be physical, mental, or emotional.
Multidisciplinary Approach
Life-saving measures and neurological recovery treatments are thereby instigated by the multidisciplinary team composed of:
- A neurologist (to monitor the brain and to administer treatment).
- Physical therapist (to help initiate movement and muscle strength).
- Occupational therapist (to aid recovery of activities of daily living).
- Speech and language pathologists (working to remediate communication and swallowing problems).
- Psychology and counseling empower emotional and mental wellbeing.
Physical therapy and occupational therapy
Restoration of movement, strength, and balance is the primary focus of physical therapy; while
Occupational therapy helps stroke survivors regain independence related to carrying out daily routines such as eating, dressing, taking care of themselves, etc.
Therapies may include anything from muscle strengthening exercises to coordination training along with recommendations for assistive devices (walkers, braces, etc.).
Speech and Language Therapy
In cases of aphasia, speech and language therapy is likely indicated, given that the stroke has been a great impediment to communication.
Possible techniques involve:
- Speech rehabilitation activities to assist in regaining the ability to speak intelligibly.
- Alternative aids for communication include gestures, writing, and technology-assisted speech.
- Treatments for overcoming choking and aiding in eating dysphagia therapies.
Psychological support and counseling
Emotional challenges, frustation, depression and anxiety are common among stroke survivors due to the present situation.
These challenges and coping strategies are being facilitated by therapists/counselors.
Support groups will provide encouragement through motivation, sharing experiences with survivors of strokes.
Medication management for physical and emotional symptoms
The doctor can prescribe a variety of medications to prevent another stroke and counteract effects of the stroke:
Anticoagulation (either by aspirin or warfarin) in order to inhibit clotting;
- Drugs to control blood pressure and reduce cholesterol level in order to avert risks for stroke;
- Antidepressants and anti-anxiety drugs in order to safeguard emotional well-being.
Tips For Caregivers And Families
Caring for a stroke survivor can be challenging, but with the right strategies and support, caregivers and families can make a significant difference in the recovery process.
Here are some tips for caregivers and families:
1. Be patient and emotionally supportive
Stroke survivors often experience frustration, helplessness, or discouragement regarding their state.
Positive encouragement, along with motivation through reassurance and support, will help keep them on track with their recovery.
2. Educate Yourself
Learn about stroke, its effects, and the recovery process.
Understanding the condition can help you provide better support and anticipate the needs of the survivor.
3. Promote independence but assist when needed
Encouragement in doing as much as possible will boost the confidence of stroke survivors, but at the same time, assist them with as many daily tasks as possible.
Adaptive aids and a supportive environment (such as grab bars, non-slip mats, specialized utensils) should be put in place to foster independence.
4. Make the home as safe as possible
Preventing falls and injuries to stroke survivors with compromised mobility.
Modifications around the house include:
- Handrails in bathrooms and staircases
- Non-skid flooring
- Adequate lighting clear of clutter
5. Encourage compliance with medications and follow-up
Good medication management could avert further strokes and complications.
Consistent follow-up ensures the treatment plan remains relevant to their needs.
6. Join support groups to gain knowledge and buddies
Caregivers conduct searches for community support in stroke recovery groups.
Such groups are of great value in granting outside assistance, emotional encouragement, and professional views and opinions.
7. Seek Professional Help
Don’t hesitate to reach out for professional support, whether it’s from healthcare providers, therapists, or support groups for caregivers.
Taking care of someone who has had a stroke needs kindness, patience, and strength.
By following these tips, caregivers and families can make a helpful space that supports healing and improves the survivor’s life.
Conclusion
After a stroke, survivors deal with many challenges that affect their body, mind, and feelings for a long time.
It’s important for caregivers and healthcare workers to know what are complications from a stroke and help stroke survivors in all ways.
By helping with physical, mental, and emotional needs, we can make life better for stroke survivors and their families.
Besides meeting the immediate needs of stroke survivors, ongoing help and therapy are very important for their long-term recovery.
Rehabilitation, like physical therapy, speech therapy, and mental exercises, should continue long after the stroke to help survivors do more on their own.
Also, creating a strong support system with healthcare workers, caregivers, and community resources can give ongoing help to stroke survivors and their families.
By focusing on complete care and continuous support, we can help stroke survivors live happy lives despite their challenges.
Additionally, seeking support from a psychiatrist in Patna or consulting the best psychiatrist in Patna Bihar, can be beneficial for addressing any emotional challenges that may arise after a stroke.
Emotional well-being is an integral part of stroke recovery, and professional assistance can aid in addressing any mental health concerns effectively.
With personalized help and proactive management, we can help stroke survivors feel better and more hopeful as they navigate their recovery journey.
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