May is American Stroke Month, and the American Stroke Association wants you to know that every 40 seconds, someone in the United States has a stroke. Stroke is the 3rd leading cause of death and the leading cause of disability in the U.S., with 795,000 people suffering a stroke every year. While strokes can happen at any age, 75% of strokes occur in people over 65, and the danger of having a stroke doubles every decade over age 55, so caregivers and homecare companions of seniors with risk factors for stroke need to be aware of the symptoms, and be ready to get help. But there is good news, thanks to increased awareness of stroke symptoms and faster door-to-hospital-treatment times: the stroke death rate fell by about 30% from 1995 to 2005, and continues to drop. Learning what stroke symptoms are, and how to react fast, enables caregivers and home care companions help seniors survive strokes.
There are three types of stroke: ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Ischemic stroke is by far the most common, representing about 80% of all strokes suffered, and is the type more than twice as likely to affect smokers as non-smokers. An ischemic stroke occurs when a clot or blockage in an artery leading to the brain blocks blood flow, impeding the function of whatever areas of the body are controlled by the region of the brain denied oxygen. The type of stroke is called an intracerebral hemorrhage occurs when a blood vessel or artery ruptures within the brain, releasing blood into the surrounding brain tissues, thus compressing the brain folds. A subarachnoid hemorrhage also involves the sudden rupture of a blood vessel or artery, but this type of stroke is specific in location because the blood is released into the space between the brain and the skull, causing internal pressure. A subset of ischemic strokes, called transient ischemic attacks (TIA) are caused by temporary clots that cause ‘mini-strokes.’
Stroke is a particularly unkind affliction, because the brain is such a complex organ, controlling not just bodily functions that we take for granted but the intangible mind, personality and spirit as well. When a stroke occurs, some part of the brain is either deprived of blood, or under pressure from blood that has leaked into the cortex, or folds, or between the brain and the skull.
Depending on what part of the brain is damaged or stressed during a stroke, some level of disability will occur. Each lobe of the brain commands different functions, and physiology on the opposite side of the body, so an obstruction on the right side of the brain will cause damage on the left side of the body.
For example, a stroke that occurs on the right side of the body will affect the left side of the face and body, potentially producing paralysis, vision problems, memory loss, and a lively, inquiring behavioral affect. A stroke on the left side of the brain will affect the right side of the body, potentially producing paralysis, difficulties with speech and language, memory loss, and a measured, careful behavioral affect. A stroke that occurs in the brain stem is particularly destructive because it can affect both sides of the body, leaving the patient in what’s called a ‘locked-in’ state, where they are both unable to speak and unable to move below the neck.
Additionally, stroke survivors can develop anxiety, depression, anger issues, confusion, reflex crying, and a phenomenon called one-side neglect, all of which can further reduce a survivor’s ability to live independently. Fortunately, the physical and emotional complications of a stroke can improve over time with physical therapy and follow-up care.
As the American Stroke Association says, “Remember: the sooner stroke is treated, the better the odds of survival and a full recovery.” The most common sign of a stroke is sudden weakness in the face, arm or leg, usually on one side of the body. But the ASA gives other warning signs:
- Sudden numbness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding speech
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
The symptoms a stroke victim experiences will depend on the part of the brain that is affected, the side of the brain affected, and the severity of the blockage or pressure. While everyone should know the signs of stroke – Face Drooping, Arm Weakness, Speech Difficulty, Time To Call 911 – caregivers of at-risk seniors should be particularly aware. High risk factors for stroke include high blood pressure, atrial fibrillation, and smoking. Caregivers who notice any of the warning signs in their loved ones should call 911 and get medical help immediately, because recognizing and treating stroke ASAP are the best way to mitigate the long-term effects of stroke. Whether the symptoms pass quickly or they don’t, they represent an important warning sign that family caregivers, home care companions and seniors should not ignore.