* Stroke survivors trying to figure out why they're different from before
* Families/friends trying to understand the stroke survivors' change
* Caregivers who act as a bridge, aka lynchpin, between survivors and families/friends
First, some background. Scientific American's Jon Stone, a consultant neurologist, writes, "Friends and relatives may report a personality change that is hard to pin down. Some of these changes, such as low mood and anxiety, are more likely to be related to a person's feelings about having a stroke than to any harm to the brain."
But he contradicts by saying (I am the critic, too), "A genuine shift may occur, however, when the frontal lobes sustain damage. The frontal lobes play an essential role in regulating emotion, decision making, and judgment."
He also says less common are cases of “positive” personality changes, in which people reportedly become happier and even nicer. (I became more compassionate and less judgmental).
The Stroke Foundation of Australia lists changes in personality including inability to do anything, being irritable or aggressive, saying or doing things that seem inappropriate to others, and acting without thinking, and doing things that are not safe or are not appropriate.
(In my book, The Tales of a Stroke Patient, I escaped from the sub-acute facility, and lived to tell about it, in search of soft-serve ice cream, ignoring safety concerns like traffic and mixed-up directions. Poor decision, right?)
Stroke survivors under 50 years of age were studied, and found that family conflict and loss of home, employment, and spousal dissension were common practical problems.
The austere Cleveland Clinic says the loss of a person’s former identity can result in depression, anger, and frustration which calls the grieving process, denial, anger, bargaining, depression, and acceptance, into play.
Some stroke survivors have difficulty with their communication skills following a stroke. They can be categorized in two general areas.
"Some stroke survivors may have slurred or garbled speech as a result of muscle weakness or incoordination (called dysarthria) or motor programming of speech muscles (called apraxia)."
A Speech-Language Pathologist (SLP) will be on the scene to evaluate the patient’s communication skills and show ways in which the family can help. The SLP will also recommend any follow-up after the survivor is released from the hospital.
In a randomized trial, the patients and caregivers were asked to complete 2 measures of emotional distress. A "regression analysis" was used to name the factors that were associated with poor caregiver outcomes.
Fifty-five percent of responding caregivers indicated that emotional distress is common. Caregivers were more likely to be depressed if the patients were severely dependent.
The study's main goal was to help to identify those caregivers at greatest risk of poor outcomes.
Otherwise, as I've said to the caregiver, more times than I'd like to count, "Get the hell out!"