American Medical Association Family Medical Guide - American Medical Association [417]
• Nurses Nurses who specialize in rehabilitation teach stroke survivors and their caregivers about eating, exercising, taking medication, preventing pressure sores, and other aspects of home health care.
• Physical therapists Physical therapists evaluate a person’s physical abilities and develop and carry out a treatment program designed to help him or her regain muscle strength, mobility, flexibility, and coordination. The program may include exercise, massage, and other therapies. Physical therapists can teach people how to use equipment such as walkers, canes, and wheelchairs.
• Occupational therapists Occupational therapists help the person regain muscle control and coordination and adjust to and compensate for physical limitations. They help the person relearn the basic activities of daily living (such as eating, bathing, and dressing). Occupational therapists teach people how to use equipment such as canes, walkers, and wheelchairs. They also show people how to change their home environment to make it safer and more user-friendly.
• Speech therapists Speech therapists help people regain the ability to speak, or teach them (and their families) other methods of effective communication. Speech therapists also help people learn to deal with swallowing problems.
• Social workers Social workers can provide counseling, guidance, support, and direct assistance. They can evaluate the person’s needs for assistance and make arrangements or referrals for needed services such as transportation, financial assistance, legal assistance, home health care, and housing.
• Mental health professionals A psychiatrist, psychologist, or other mental health professional can help the person deal with depression (see page 709) or other psychological problems that frequently occur after a stroke (see box below).
• Vocational therapists Vocational therapists can help people return to work by helping them develop résumés, assisting in job searches and retraining programs, and providing referrals to vocational rehabilitation agencies.
Stroke and Mental Health
After a stroke, many people experience depression. They may feel isolated or frustrated, especially if their recovery is progressing slowly or if they are having problems communicating. Symptoms of depression include sleeplessness, indifference, and withdrawal. For most people, the depression is temporary, and they may benefit from joining a support group or talking to a psychiatrist or other mental health professional. If the depression persists, a doctor may prescribe antidepressant medications (see page 712) such as tricyclics, selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), or bupropion.
Some people who have had a stroke may have difficulty controlling their emotions. For example, they may experience mood swings or they may laugh or cry more easily than usual. These emotional changes result from injury to the brain, so it is important for family and friends to understand that this is not deliberate behavior.
Preventing Strokes
If you have had a stroke, you are at risk of having another one. You can reduce your chances of having a stroke by doing the following:
• Exercise regularly. Regular, moderate exercise—such as brisk walking or swimming—lowers your blood pressure, helps you maintain a healthy weight, reduces stress, improves your cholesterol profile, and reduces your risk of diabetes.
• Eat a healthy diet. Eating a wide variety of nutritious foods—especially fruits, vegetables, and whole grains—that are low in salt, fat, and cholesterol improves your cholesterol profile, lowers your blood pressure, and helps you control your weight.
• Control your cholesterol. You can improve your cholesterol profile by eating a nutritious, low-fat, high-fiber diet; exercising regularly; losing weight if you are