Stroke Helpline 0303 3033 300 stroke.org.uk Care Home Training A workshop on Stroke

Stroke Helpline 0303 3033 300stroke.org.uk

Care Home TrainingA workshop on Stroke

To be clear about what a stroke & TIA are, what causes them and the range of effects

Learning Objectives •To be clear what a stroke and TIA are•To know about the physical effects of stroke•To know how stroke affects swallowing and the importance of oral care •To have an understanding of the effects on communication and vision following a stroke•To have an awareness of the cognitive and psychological impact

A guide to stroke

What is a stroke?

• Damage to part of the brain

• Caused by a problem with its blood supply

• Blood is supplied through arteries

• There is a ‘blockage’ or ‘burst’

• Usually happens quickly and strikes suddenly- brain attack

How does this happen?

Ischaemic (69% - 80%)• Death of tissue

(infarction) because of blockage by:

• Thrombosis – a solid clot of blood in artery supplying brain or

• Embolism – a clot or other substance (fat, cholesterol, blood platelets) carried from elsewhere in circulation

How does this happen?

Haemorrhage (15% - 20%)• Bleeding in the brain• Burst blood vessel e.g.

artery• High blood pressure can

weaken artery• Bursts and damages tissue• Brain damage is the result

Transient Ischaemic Attack

• Occurs when the brain’s blood supply is briefly interrupted

• Classification: effects last no longer than 24hours from onset or the symptoms start to resolve within 1–20 minutes

• Very rarely, symptoms of a TIA are due to bleeding (haemorrhage) in the brain

• The FAST test helps people to quickly recognise the key symptoms of a TIA or stroke

.Facial weaknessC

Arm weaknessCan the person raise

Speech problemsCan the person speak say

Time to call 999Stroke is a medical emergency. If you see any one of these signs, seek immediate medical attention

.Facial weaknessC

Arm weaknessCan the person raise

Speech problemsCan the person speak say

Time to call 999Stroke is a medical emergency. If you see any one of these signs, seek immediate medical attention

Act FAST

Other symptoms include:•Sudden weakness or numbness on one side of the body•Sudden confusion•Sudden dizziness or unsteadiness •Sudden visual problem•Severe headache

Obesity

Family History or Ethnicity

Diabetes

Previous Stroke & TIA Age

Binge Drinking & Substance Misuse

Inactivity

Heart Disease

HypertensionHormonal Contraception & HRT

Smoking

Stroke Facts

• Every year, approximately 152,000 people have a stroke in the United Kingdom

• That is more than one every five minutes

• In 2008, stroke was the fourth largest cause of death in the UK after heart disease, cancer and respiratory disease

• Stroke is the largest cause of complex disability in adults

Body talk

Temporal Lobe•Memory functions•Word based memory (dominant)•Visual Memory (non-domination)

Frontal Lobe•Planning actions •Learning New tasks•Motivation•Behaviour regulation

Brain Stem•Breathing•Blood Pressure•Digestion•Heart Rate•Other Autonomic Functions

Cerebellum•Coordination•Balance•Equilibrium •Muscle tone

Occipital Lobe•Visual Perception •Colour recognition

Parietal Lobe •Taste, temperature, pain•Understanding language

• Auditory & visual memory• Calculations• Reading & writing• Spatial awareness

The brain

LEFT BRAIN controls:

•Right side of body •Movement•Vision •Hearing•Memory•Reading•Writing•Speaking•Understanding•Mathematics

RIGHT BRAIN controls:

•Left side of body •Movement•Vision•Hearing•Memory•Art•Music•Spatial awareness

What happens in the brain?

Exercise:

Neuroplasticity

Neuroplasticity: The brain's ability to reorganise itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment

Normal muscle tone?

The amount of contraction in a group of muscles which enables smooth voluntary movement to take place

How stroke affects tone

• Low tone – muscles tend to be loose and weak, hanging limply.

• Flaccidity

• High tone – tightening of muscles, tendons and ligaments that prevents normal movement.

• Spasticity

What can help

• Good positioning• Support and stabilise limbs• Symmetrical

• Medication • Baclofen• Botox

• Encourage use• Move in normal patterns

Down the wrong way

The swallow process

There are four stages to a swallow:• Preparation/anticipation• Mouth• Throat• Throat to stomach

Stroke can affect any stage - Dysphagia

Aspiration

• Epiglottis fails to close off windpipe

• Fluid/food goes into the lungs

• Chest infection/pneumonia

• Life and death matter

Warning signs of Dysphagia

• Recurrent chest infections

• Weight loss

• Inability to maintain posture

• Poor dentition

• Aphonic / weak voice

• Weak, ineffective cough reflex

• Coughing / choking pre/post swallow

• Wet, gargly voice quality

• Change in respiratory status

• Change in colour

Speech and Language Therapists

may advise:• Thickening drinks and soups

• Food supplements

• Soft diet

• Pureed diet

• Enteral feeding (NG / PEG)

Tips for safe swallowing

Ensure carers and family members understand the stroke survivors swallowing problems

Daily Mouth Care

Making sense of the world

What did you have for breakfast?

How do we communicate?

When we talk...

• 55% is communicated via body language

• 38% is communicated via tone of voice

• 7% is communicated by actual words

Types of aphasia

Receptive aphasia

• Unable to understand words

Expressive aphasia

• Unable to find words or sentences

Stroke and communication

DYSARTHRIA

• Weak muscular activity• Difficulty articulating speech• Slurred, unclear speech

DYSPRAXIA

• Difficulties sequencing speech • Co-ordinating movements• “jumbled-up” unintelligible

speech, can be repetitive

She shells sea shells on the she shore

I was a rangahoo

Visual problems after stroke

• High proportion of people who have had a stroke have some form of visual dysfunction as a result - 62% - 71%

• Visual Field loss

• Visual Inattention & Neglect

• Eye movement problems

• Perception problems

• Focussing and reading problems

http://www.undergrad.ahs.uwaterloo.ca/~aktse/drawing.gif

Cognitive effects

• Memory

• Language

• Attention

• Concentration

• Vision and perception

• Reasoning and problem solving

How are you feeling?

Psychological effects

• Anxiety/fear

• Frustration

• Anger

• Apathy

• Depression

• Emotional lability

Stroke Helpline 0303 3033 300 stroke.org.uk Care Home Training A workshop on Stroke

Documents

stroke.org.uk Accessible Information Guidelines · Accessible Information Guidelines 3 Stroke Association is a Company Limited by Guarantee, registered in England and Wales (No 61274)

When you have a stroke · Call the Stroke Helpline on 0303 3033 100 stroke.org.uk 19 When you have a stroke Many stroke survivors say they feel isolated at first, and it can be hard

stroke.org.uk Take action on Stroke...the UK, just £22 is spent on medical research each year, compared to £295 for every cancer patient. We are the only UK-wide charity supporting

F09 Stroke in younger adults - stroke.org.uk · Web viewStroke Association is a Company Limited by Guarantee, registered in England and Wales (No 61274). Registered office: Stroke

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Transient ischaemic attack (TIA) - Stroke Association · 2020. 7. 10. · 2 Call the Stroke Helpline on 0303 3033 100 Transient ischaemic attack (TIA) A TIA is the same as a stroke,

stroke.org.uk State of the Nation · 4 State of the Nation Stroke statistics - January 2016 • Stroke kills twice as many women as breast cancer and more men than prostate and testicular

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stroke.org.uk Life After Stroke Awards 2017 · Join our current partner Irwin Mitchell Solictors as a co-headline sponsor for our Life After Stroke Awards 2017. Become a category

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Stroke helplineWebsite 0845 3033 100 Raising the Profile of Stroke Neurological alliance AGM 24 th November 2009

What’s new in stroke? · Stroke Helpline 0303 3033 100 stroke.org.uk What’s new in stroke? Professor Pippa Tyrrell Greater Manchester ODN Launch 2016

My Stroke Guide - GP WEB SOLUTIONS · stroke.org.uk Designed by stroke survivors for stroke survivors A unique online platform to support stroke survivors to make the best possible

‘Focus on Stroke’ Ross Evans. Stroke Helpline 0303 3033 100 stroke.org.uk because Stroke is one of the top clinical conditions demanding attention. It

stroke.org.uk State of the nation · • Stroke survivors are at greatest risk of having another stroke in the first 30 days following a stroke.10 • Around 1 in 4 stroke survivors

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Stroke helplineWebsite 0845 3033 100 The Stroke Association, servant leadership, and Transformation Cass Business School

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