Brain stroke changes lives forever not only for the patient but also for the family and caregivers. Even though there are a number of effective interventions available today, still a large number of patients end up with permanent disability of one kind or the other.
The neurological disabilities created by stroke are many, the most common and known ones being, paralysis and sensory disturbances including numbness, burning, pain in limbs, visual defects, hearing, speech and swallowing problems, memory, language and behavioural issues, difficulties in the functions of passing urine and motion, gait and balance difficulties causing falls and fractures, intractable tremors of hands and legs and so on, to state a few. These neurological deficits can be mild, moderate or severe. Some patients can be bedridden for life. Being bedridden creates a number of other physical and mental problems related to the immobilised state, including chest infections, bed sores, urinary infections, constipation, pain, joint stiffness, contractures, fractures, venous thrombosis, depression, frustration, agitation, irritability, sleep disturbances etc.
With this knowledge one can understand that post stroke coping mechanisms will depend on the amount of disability an individual has. Coping with the loss of function of a limb or speech is very challenging for the patient as well as the relatives.
Most people with milder strokes, who retain ability to walk are helped a great deal with physiotherapy, occupational therapy and neuro rehabilitation. The idea is always to achieve functional independence for activities of daily living, like bathing, toilet, eating, dressing, swallowing etc. So all efforts should be made to provide good physiotherapy to these individuals, who continue to benefit even beyond 3 months of the stroke, due to neuroplasticity. Speech and swallowing therapy also is a must for individuals who have trouble swallowing and speaking.
Continued motivation to exercise and to keep going on with the disability is a challenge for most patients and positive reinforcement, positive attitude and moral support of family members goes a long way in helping the patients regain physical and mental stability. Joining groups of stroke survivors, even online, may be beneficial, as each one can benefit from each other's experiences and helps give emotional support. The caregivers also benefit from the same.
Struck with this calamity the human spirit is evolving a number of ways to not only emerge a victor but turn the difficulty into an opportunity for progress by exploring certain new ways of being. Some of these coping strategies can be:
1. Neurorehabilitation -Using neuroplasticity and exploring alternate possibilities in the healthy limbs, to help use the functional senses to the maximum.
2. Caregivers to give back the love they have received from the person when they were healthy.
3. Love, patience, faith, perseverance are the emotional powers needed.
4. Meditation and prayer.
5. Since life slows down one has to learn to live slowly and consciously.
(The author is a Neurology Consultant at Manipal Hospital, Goa.)
