Neuro

Card Set Information

Author:
jessiekate22
ID:
181071
Filename:
Neuro
Updated:
2012-11-01 00:51:54
Tags:
psycho social impact stroke
Folders:

Description:
Exam
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user jessiekate22 on FreezingBlue Flashcards. What would you like to do?


  1. Stroke vairies between people through?
    • - age
    • - pre morbid personality
    • - relationships
    • - social situations prior to the stroke
  2. What can a stroke impact on?
    • - QoL
    • - socail impacts of stroke
    • - psychological effects
    • - sexuality
    • - supporting clients and carers
  3. What % of stroke survivours live at home and have a disability?
    • 88%
    • Meaning 12 are instituionalised
  4. How many people die in the first month and first yr post stroke?
    • 1/5 die within a month of having their first stroke
    • 1/3 die within the first yr
    • For every stroke survivor there are at least 4 family members or carers whose lives are changed forever
  5. What is HRQoL?
    • Health related quality of life
    • - instruments look at mental health, social and physical functioning
  6. What is NEMESIS?
    • - North East Melbourne Stroke Incidence Study
    • - is the largest incidence study of stroke conducted in australia
    • - major aims were to determine the incidence, costs and outcome of stroke in Aust
    • - at 2yr post stroke 25% of stroke survivors had very poor HRQoL
    • - 8% had HRQoL assessed as equivalent to or worse than death
    • At 5 yrs 20% have HRQoL very poor
  7. Stroke grief and loss
    • for many families stroke is overwhelming
    • - shock- numbness, confusion, sense of unreality
    • - denial- pt thinks they will be right in a month
    • - reaction- depression, guilt, anger, fusteration
    • - mobilisation- when pt is ready to live
    • - coping- learning to live with a disability
  8. How many people post stroke will experience depression?
    33%
  9. What are the types of depression?
    • acute
    • medium
    • long
    • may undergo unrecognised and diagonsed
    • may be organic in origin- from the brain
    • 1/5 people will experience depression in their lives people after stroke seems to be 2/3
  10. Reactive depression
    • - a normal response after a loss is experienced
    •  
  11. Who are those with a high risk factor for stroke?
    • - female
    • - past history of stroke
    • - dysphasia
    • - social isolation
    • - functional impairment
    • - cognitive imapirment
  12. What are the signs of depression?
    • - feeling miserable or sad most of the time
    • - lost interest in activities you would have once enjoyed
    • - lost/ gained lot of weight or changes in appetite
    • - sleep disturbances
    • - feeling tired or had no energy
    • - feeling worthless or excessively guilty
    • - poor concentration or difficulty thinking or very indecisive
    • - recurrent thoughts of death
  13. What is the impact of rehab on pts?
    • - may compromise achievement or maintenance of functional gains
    • - slow recovery> longer hospital stays
    • - remission in post stroke depression leads to greater improvement in ADL function
    • in english depression can make it hard for people to manage the treatment for their stroke effectively
    • people with untreated depression find ithard to concentrate, stay motivated, keep appointments and stick to treatment plans, including meds
  14. How can we manage depression?
    • - meds
    • - psychological therapy- cognitive behaviour therapy, counselling
    • - lifestyle- PA, diet, reduced alcohol use
  15. What emotional changes might wee see post stroke?
    • - anxiety
    • - emotional liability- 25% in first yr
    • - apathy- lack of motivation
    • - frustration
    • - irritability
    • in first 6  months post stroke emotional problems affect 1/4 of stroke survivors
    • - gentle guidance, prompting, support and encouragementwill assist
  16. What behavioural changes will u see post stroke?
    • - difficulty recognising emotional cues
    • - imapired social awareness
    • - impaire capacity for self control
    • - difficulty with judgement
    • - lack of insight> act impulively
    • - inability to learn from experience
  17. What sid of the brain strokes will people experience behavioural issues?
    • - right sided (non dom)
    • - can tell emotional cues from voice, expression, behaviour if happy or sad
    • - unaware of deficits- may attempt to drive
    • - neuro- pyschologicsts may be able to help provide some strategies to help you manage these pts
  18. What other issues do stroke victims suffer from?
    • - fatigue
    • - communication difficulties
    • - pain, sensory changes, numbness
    • - incontinence
  19. What personal challenges do stroke victims suffer?
    • - loss of previous self
    • - loss of independence
    • - changes to life plan eg retirement
    • - fear of another stroke
    • - stage of life resopsibilites caring for grandkids
  20. What changes in relationships can be seen before a stroke?
    • - changes in estabilished dynamics
    • -increased burden for partner/ family
    • - mourning the lost partner
    • - reestablishing relship with new partner they r
  21. What happens to sexuality and intimacy post stroke?
    • - fear of another stroke
    • - changed physical function
    • - changed body image/ self esteem
    • - changes in libido (desire)
    • - communication difficulties
    • - behavioural. cognitive issues
  22. Children and teenagers
    • - loss of care of one parent
    • - loss of consistent roles
    • - loss of emotional stability
    • - unwillingness to bring friends home
    • - want parent to be like other parents
    • - more expected of them
    • - can feel emotionally neglected
    • - feel responsible for parents mood
  23. WHat is emplyment like post stroke?
    • - may be unable to work as previously
    • - impact on self esteem
    • - change of role
    • - reduced contact with workmates
    • - effect finacically
    • - may affect accomodation options
    • each yr 12,000 ausies of working age survive a stroke
    • pt may not be able to return to work as they cannot maintain the physical expectations
  24. What are the social changes that occur post stroke?
    • - cahnges to leisure
    • - fill in the day
    • - decreased community participation
    • - social isolation- loss of networks
    • - community attitudes
    • - driving and transport
    • these r both carer and stroke person
  25. impact of caregiving
    • emoitonal il healht
    • no social life
    • no leisure
    • effefts family
    • isolation
    • exhausting
  26. some suggestions
    • ¥Be aware most people need to take
    • time to        mourn losses and to adjust
    • to change

    ¥

    • ¥ 
    • Be mindful of the psychosocial impact of stroke

    •      and refer clients to other disciplines
    • like

         psychology and social work as appropriate



    • ¥ 
    • Help clients set realistic and achievable goals



    • ¥ 
    • Involve carer/ family



    • ¥ 
    • Plan comprehensively for discharge 16
    • Understand behaviours may not be
    • controllable

    • As physiotherapist you have an
    • important role to play in the multidisciplinary team and decisions to be made
    • in regards to safe discharge options for the patients from the hospital
    • environment.

    • Client centred and goal directed
    • physiotherapy can be valuable to both the multidisciplinary team and the
    • patient to  assist in planning a
    • comprehensive discharge for the patient. 


    • ¥    Evaluate longer term needs of
    • clients & carers
  27. provide info
    • ¥Studies show families and
    • patients                          

         want more information

    ¥

    • ¥ 
    • Information is most effective if given in

         various forms and provided repeatedly



    • ¥ 
    • Keep your own knowledge current



    • ¥ 
    • Encourage clients & carers to utilise 

    •      available services and resources
    • >referrals
    • Sometimes mismatch between goals of
    • therapists and family.

    • Ongoing therapy is important for
    • patients to continue to work on rehab goals and to help improve their mobility,
    • coordination, strength which in turn can improve their quality of life. 

What would you like to do?

Home > Flashcards > Print Preview